Check out Knicole Emanuel’s recent blog post about CMS monetary recoupment before full adjudication. The Centers for Medicare and Medicaid Services (CMS) has the authority to recoup alleged overpayments from healthcare providers before the full adjudication of an...
Check out another insightful blog by healthcare attorney Knicole Emanuel, “Trump’s Deregulations…But Not in Health Care Fraud Detection!”. Her assessment is that, while the Trump Administration may be reducing the regulatory burden in many areas of...
After the outpouring of public anger at the health insurance industry following the shooting of the United Healthcare CEO, the Cigna Group has announced a new multi-year effort to improve accountability, transparency and customer support. Public outrage over insurer...
The Kaiser Family Foundation (KFF) has released a report on claims denials and appeals in the ACA (Affordable Care Act) marketplace plans in 2023. ACA insurers denied 1 in 5 medical claims in 2023, the highest rate since 2015. UnitedHealth Group had the highest...
On January 1, 2025, a 2.83% Medicare reimbursement cut went into effect for physicians due to a rule finalized by the Centers for Medicare & Medicaid Services (CMS) in November of 2024. CMS also estimates a projected 3.6% increase in practice cost expenses for...
