A Crack in CMS’s Star Ratings System Is Turning Into a Courtroom Pile-On
Four Medicare Advantage insurers have now sued the federal government over the same grievance, and the number is unlikely to…
Category: Policy Updates
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,…
Ghosts in the Network
How Inaccurate Medicaid Managed Care Provider Directories Undermine Real Access to Maternal Care in the United States By Elena Pak,…
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…
ACA Under Fire Again: Why Cities Are Suing Over New Marketplace Rules — and Why Providers Should Pay Attention
By Elena Pak, Credentialing Department, WCH A new legal challenge against federal Affordable Care Act (ACA) marketplace regulations may appear…
The MultiPlan Litigation: Why Every Provider Should Be Paying Attention
For years, many physicians, hospitals, ambulatory surgery centers, and specialty practices have shared a common frustration: out-of-network reimbursements that seemed…
Surgical Coding: The Global Period Is Not Bureaucracy. It’s a Trap.
By Edita Petrosyan, Billing Department, WCH Why Physicians Lose Money Without Breaking a Single Rule Picture this: you performed a…