A wave of hospital bankruptcies has brought in its wake high-stakes lawsuits aiming to boost creditor payouts by targeting ...

A Pennsylvania health system filed suit this week against Aetna, challenging a policy around "downcoding" that has drawn ire from providers. Philadelphia-based Jefferson Health said in a complaint ...

The Centers for Medicare & Medicaid Services has proposed a 2.4% Medicare pay hike for fiscal 2027 and is developing ways to eliminate payment “creep” under the Patient Driven Payment Model. The 2027 ...

MedPAC answers the dollars-and-cents question—how much more Medicare pays MA plans due to favorable selection and upcoding than it would spend if MA beneficiaries were in traditional ...

Anyone working in skilled nursing today understands how much is being asked of providers. Staffing challenges, reimbursement changes, survey pressure and quality expectations all collide at once.

As audits and downcoding become more common, audit defense isn’t a back-office function. It’s a financial imperative.” — Moghis Uddin, CEO of AlethianAI ...

Illinois residents have been walloped by surging health insurance costs this year. According to one estimate, premiums for an Illinois family of four earning $64,000 annually were set to rise nearly ...

Philadelphia-based health system Jefferson Health is suing Aetna, claiming the payer is unfairly reducing payments for some hospital stays under Medicare Advantage. Aetna said that it has done nothing ...

Forbes contributors publish independent expert analyses and insights. Joshua Cohen is a Boston-based writer who covers health policy. This voice experience is generated by AI. Learn more. This voice ...

Tennessee hospitals report that health insurance red tape is delaying patient care and straining resources. Lawmakers are considering two bills to increase transparency and accountability for health ...

One of the most somber days of the Christian calendar has arrived: Good Friday. The holy day, which takes place a couple of days before Easter, commemorates Jesus Christ's sacrifice, more specifically ...