She Wrote the Compliance Book. Then She Ran a $136M Fraud Scheme.
There is a sentence in the DOJ’s press release about Jean Wilson that deserves to be read twice. After her…
Author: wchinsights
$5.7 Trillion and Climbing: What America’s Health Spending Surge Actually Signals
The number itself is almost too large to process. U.S. healthcare spending reached $5.7 trillion in 2025 — a 7.3%…
Nurses Gain ‘Professional’ Status for Federal Loans: What It Means for Healthcare Providers
By Elizaveta Bannova, Billing Department, WCH A federal court stepped in one week before new lending rules would have dramatically…
The OIG Is Back — And Their Math Doesn’t Add Up
By Elizaveta Bannova, Billing Department, WCH If you were hoping the OIG’s audit activity would stay quiet through the summer,…
When Your Provider Is Abroad: The Hidden Compliance Trap in Cross-Border Telehealth
By Elena Pak, Credentialing Department, WCH Telehealth has made geography feel irrelevant. A physician in Portugal, a therapist in Thailand,…
Ghosts in the Network
How Inaccurate Medicaid Managed Care Provider Directories Undermine Real Access to Maternal Care in the United States By Elena Pak,…
Criminalizing Coverage Denials?
What Pennsylvania’s New Bill Reveals About the Growing Backlash Against Health Insurers By Elena Pak, Credentialing Department, WCH When Pennsylvania…
When a Half-Star Is Worth Hundreds of Millions
The Clover Health Ruling May Be Less About One Insurer—and More About a Growing Crisis of Confidence in Medicare Advantage…
Deny First, Approve Later?
New Federal Findings Raise Questions About Whether Medicare Advantage Prior Authorization Is Functioning as a Clinical Safeguard—or a Cost-Control Tool…
One in Five Patients Denied Care: Why This Matters to Every Medical Practice
By Elena Pak, Credentialing Department, WCH A new survey from the Commonwealth Fund found that one in five privately insured…