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Recent Humana Report Suggests Value-based Care Improves Costs, Outcomes 
Recent Humana Report Suggests Value-based Care Improves Costs, Outcomes 

Sarasota, FL (WorkersCompensation.com) – In a “pay-for-performance” program or agreement, providers receive either a bonus or a penalty based on cost and outcome benchmarks that are set by a payer. Value-based payment models use quality […]

  • Nov 23, 2023
  • F.J. Thomas
CMS Announces $31.2 Billion in Improper 2023 Payments
CMS Announces $31.2 Billion in Improper 2023 Payments

Sarasota, FL (WorkersCompensation.com) – Earlier this month, the Centers for Medicare & Medicaid Services (CMS) released their findings of Fee-for-Service claims audits conducted this year.  Last year, CMS estimated that the rate of improper payments […]

  • Nov 21, 2023
  • F.J. Thomas
Combination COVID-19 and Flu Vaccines On Track For Phase 3 Trials 
Combination COVID-19 and Flu Vaccines On Track For Phase 3 Trials 

Sarasota, FL (WorkersCompensation.com) – COVID-19 has certainly been persistent in leaving its mark on the world. Some studies have suggested that when it comes to Long COVID, the numbers have been grossly underestimated. Three years […]

  • Nov 20, 2023
  • F.J. Thomas
Increase in Provider Administrative Burdens Could Impact Access to Care 
Increase in Provider Administrative Burdens Could Impact Access to Care 

Sarasota, FL (WorkersCompensation.com) – Healthcare has seen an 84 percent increase in provider bankruptcies according to evidence presented before the House Committee on Ways and Means in September. While reductions and delays in payment, as […]

  • Nov 15, 2023
  • F.J. Thomas
CMS Final Rule Reduces Physician Reimbursement Again 
CMS Final Rule Reduces Physician Reimbursement Again 

Sarasota, FL (WorkersCompensation.com) – Despite strong complaints from the American Medical Association (AMA) about a 26 percent decrease in physician reimbursement from 2001 to 2023, it appears those complaints have fallen on deaf ears.  On […]

  • Nov 06, 2023
  • F.J. Thomas
Drug Manufacturer Agrees to Settlement After 400% Price Hike 
Drug Manufacturer Agrees to Settlement After 400% Price Hike 

Sarasota, FL (WorkersCompensation.com) – Recently, drug pricing and rebates have been under scrutiny by not only the American Medical Association, but the federal government as well.  The U.S. Department of Justice recently announced a settlement […]

  • Nov 02, 2023
  • F.J. Thomas
CMS Proposes Stricter Requirements for Payers Under No Surprises Act 
CMS Proposes Stricter Requirements for Payers Under No Surprises Act 

Sarasota, FL (WorkersCompensation.com) - Earlier this year, testimony presented to the House Committee on Ways and Means, showed that the number of healthcare provider bankruptcies increased 84 percent from 2021 to 2022. Although workforce shortages […]

  • Nov 01, 2023
  • F.J. Thomas
Former Health Plan Risk Adjustment Director Indicted for Fraud Charges
Former Health Plan Risk Adjustment Director Indicted for Fraud Charges

Sarasota, FL (WorkersCompensation.com) – Starting in 1996 Anthem, Inc was one of the largest healthcare companies in the U.S., offering medical coverage through its association and acquisition of Blue Cross Blue Shield plans. In 2022, […]

  • Oct 29, 2023
  • F.J. Thomas
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