Nightmares just beginning for healthcare.gov

When legislators work through an especially contentious negotiation process to arrive at a final policy, many refer to it as “sausage making.” The reason is obvious: There’s an end product, but you do not want to know how it was made. » Full article

Medicare fee schedule has foothold in contracting

Even under innovative payment models, RBRVS is here to stay.
» Full article

6 ways a health plan loses grandfathered status

If any one of the following changes were made to a policy at any time since the Affordable Care Act became law, the plan will lose its grandfathered status. » Full article

BLOG: Look beyond pharmacy claims to detect fraud

Advanced analytic solutions are being used to detect improper payments in pharmacy claims. » Full article

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• Single payer issue will rise again

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