Category: FierceHealthPayer

A doctor who falsely posed as the owner of a medical clinic was sentenced Wednesday to 18 months in prison for his participation in a $30 million scheme to defraud Medicare and Medicaid.

Viable alternatives or junk plans? Whether the final short-term plan rule is a good thing depends on who you ask.

The insurer, which acquired two providers and launched a Walgreens-based clinic last month alone, hinted that moves like these can advance value-based care.

While the plans will advance consumer choice, most Exchange enrollees will not leave the individual market, HHS Secretary Alex Azar told reporters.

The second quarter of 2018 was another robust one for healthcare deal-making, according to a new report from PwC. The group’s Thad Kresho tells FierceHealthcare that private equity’s interest in the industry will be a trend to watch.

The Trump administration has finalized a rule to allow insurers to sell short-term limited duration health plans for up to 12 months, a controversial move that has been criticized by the industry.

In this exclusive interview, Independence Blue Cross’s CMO explains why the opioid crisis in the Philadelphia area got so bad and what his organization is doing to prevent and treat opioid use disorder now.

On Tuesday, Virginia Gov. Ralph Northam announced the launch of the state’s Emergency Department Care Coordination program, designed to share ED data between 129 hospitals across the state to control utilization. A second phase scheduled for next year …

As policymakers continue their search for solutions to lower healthcare costs, experts say it’s crucial that they target a major source of bloat: wasteful administrative spending. 

Six weeks after a devastating court ruling pulled the rug out from under a case involving $12 billion in the ACA’s risk-corridor program, Moda Health and Land of Lincoln are asking the Federal Court of Appeals to rehear it.