What the End of Four CMMI Payment Models Means for Healthcare Providers
The Center for Medicare and Medicaid Innovation (CMMI) has announced the early termination of four payment models by the end…
Category: Medical Policy Updates
The Rising Tide of Claim Denials
How Providers and Policymakers Are Fighting Back The growing crisis of healthcare claim denials has reached a tipping point. With…
UnitedHealth Wins Landmark Ruling in DOJ Medicare Advantage Fraud Case
In a significant legal development, UnitedHealth Group, the nation’s largest Medicare Advantage insurer, has secured a favorable ruling in a…
The Rising Cost of Health Insurance
Health insurance premiums have been climbing at a pace that outstrips inflation, creating financial burdens for employers, employees, and independent…
SEP Changes and Their Impact on Your Patients
In our previous article, we discussed the significant changes that the Centers for Medicare & Medicaid Services (CMS) is introducing…
Why Automated Insurance Verification is the Future of Financial Stability in Healthcare
One of the biggest obstacles for healthcare providers is insurance eligibility and benefit verification. While it has long been a…
CVS Health’s Bonus Cuts
CVS Health Corp., one of the largest healthcare conglomerates in the United States, has been facing significant financial challenges, leading…
Understanding the 2025 SEP Changes for Dual-Eligible & LIS
The Centers for Medicare & Medicaid Services (CMS) is introducing significant changes to the Special Enrollment Period (SEP) for dual-eligible…
The Healthcare Breach: the Path Forward
The 2024 cyberattack on Change Healthcare was more than just a breach—it was a turning point for the entire healthcare…