Billing Management

Nagaland Health Body Addresses CMHIS Billing Dispute
Infrastructure & Management Nagaland Health Body Addresses CMHIS Billing Dispute

A recent conflict in Dimapur underscores the legal weight of the Memorandum of Understanding signed by private hospitals during the empanelment process. This specific case centers on a newborn’s sixty-four-day stay in the neonatal intensive care unit at Eden Medical Centre, where the intersection

CMS 2027 Proposal Sets New Economic Path for Medical AI
Imaging & Diagnostics CMS 2027 Proposal Sets New Economic Path for Medical AI

The 2027 proposal distinguishes the act of acquiring clinical data from the subsequent computational transformation into diagnostic insights. For a decade, the medical community has focused on whether artificial intelligence can accurately diagnose disease, a question that has largely been answered

The Hidden Costs and Financial Risks of Medicare in Retirement
Infrastructure & Management The Hidden Costs and Financial Risks of Medicare in Retirement

Many Americans view the milestone of their sixty-fifth birthday as a financial finish line, a moment when the lifelong burden of healthcare premiums and unpredictable medical bills finally gives way to the security of a government-backed safety net. Standard Medicare coverage is structurally

States Use Medicare Benchmarks to Limit Hospital Prices
Infrastructure & Management States Use Medicare Benchmarks to Limit Hospital Prices

Legislators in Vermont are focusing on transparency by mandating that any savings generated from hospital price regulation must be reflected in the monthly premiums paid by citizens. This initiative represents a broader movement across the United States where state governments are abandoning the

Can Florida Stop PBM Giants From Fixing Pharmacy Prices?
Infrastructure & Management Can Florida Stop PBM Giants From Fixing Pharmacy Prices?

Florida's lawsuit asserts that the 2019 deal between Express Scripts and Prime Therapeutics effectively removed the competitive incentive for PBMs to offer fair rates to retail pharmacies. This legal challenge highlights a growing concern that the pharmaceutical supply chain has become increasingly

Rep. Harshbarger Demands Transparency in AMA Medical Coding
Infrastructure & Management Rep. Harshbarger Demands Transparency in AMA Medical Coding

Lawmakers are scrutinizing the American Medical Association’s internal processes to ensure that private interests do not dictate the reimbursement rates for life-altering medical procedures. Representative Diana Harshbarger, a Tennessee Republican and a career pharmacist, has formally challenged

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