Commercial Insurer Accountability
The Centers for Medicare & Medicaid Services Nov. 26 proposed changes to the Medicare Advantage and prescription drug programs for contract year 2026.
The AHA today participated in a panel discussion during a conference hosted by The Capitol Forum on the impact of insurer vertical integration. Molly Smith, AHA group vice president for public policy, highlighted the experiences of hospitals and health systems in helping patients navigate care in…
The Department of Health and Human Services Office of Inspector General yesterday issued an alert warning of marketing schemes by certain Medicare Advantage plans.
A $2.8 billion settlement from Blue Cross Blue Shield to health care providers resolving a 12-year antitrust lawsuit received preliminary approval yesterday from the U.S. District Court for the Northern District of Alabama. The settlement will also "significantly improve how Providers will interact…
Before the lame-duck session ends and the 118th Congress adjourns, it is essential that federal lawmakers understand the challenges hospitals and health systems face and what is at stake for the patients and communities they represent.
AHA letter urging Congress to act on key priorities in Lame-duck session.
The AHA Oct. 17 released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and regulation of private health insurers, as well as other resources from the last quarter.
Health Plan Accountability Update -for October 2024.
While lawmakers are in their district, it is important for the field to engage with members of Congress to remind them of the importance of preserving access to care by continuing to fund vital programs like telehealth and hospital-at-home waivers, and avoiding harmful policies such as site-neutral…
Clinical validation audits are a new tactic that certain commercial insurers are adopting to reduce or deny payment to health care providers and can take months or even years to be adjudicated and resolved.