Medicaid ICD-10 workarounds in California, three other states worry providers

Medicaid ICD-10 workarounds in California, three other states worry providers

On Oct. 1, Medicaid programs in California and three other states will not fully convert from the ICD-9 to the ICD-10 coding system. Instead, they have received CMS approval to convert claims coded in the new ICD-10 system into ICD-9 codes, and use the older system to calculate payments to healthcare providers.

What Medicare's value-based insurance test could mean for commercial plans

By Bob Herman  |  September 03, 2015

Supporters hope a new Medicare Advantage experiment offering lower out-of-pocket costs for high-value services and providers will become a template for health plans with sizable cost-sharing, which have become the standard offering from employers and insurers.

Some states iffy on extending 'duals' demo

By Virgil Dickson  |  September 04, 2015

The Obama administration says it needs more time than expected to evaluate a large-scale test that aims to better manage benefits and care for low-income and disabled Americans. The 12 states participating in the initiative seem willing to stick with it, although the two biggest ones have...


Biotechnology companies, 2015

Biotechnology companies, 2015

A list of the 20 largest biotechnology companies ranked by 12-month revenue as of June 30, 2015. Source: BioPharm Insight. Published Aug. 31, 2015, p. 35.


Georgia system to pay up to $35M in settlement with feds

Georgia's Columbus Regional Healthcare System will pay the government up to $35 million to settle lawsuits accusing it of violating a federal law governing physician self-referrals and billing the government for higher levels of services than those actually provided.

Safety & Quality

Premier launches nationwide battle against superbugs

Premier, the Charlotte, N.C.-based group purchasing and performance-improvement company, has launched a nationwide initiative to combat antibiotic-resistant "superbugs." Later this week, the National Quality Forum will consider an antibiotic stewardship measure proposed by the CDC.

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