In an interview with The American Journal of Managed Care, Michael A. Bernstein, MD, stressed the need for effective ...

We spoke recently with Craig Burton, MBA, executive director of the Biosimilars Council, a trade and lobbying group for the ...

“We can point to situations where prior authorization has literally saved lives. There are good docs and there are bad docs ...

Under a managed care arrangement, Medicaid MCOs determine the rates they pay providers for inpatient hospital services.

Indiana House lawmakers on Tuesday passed several pieces of legislation that would curb some of the Medicaid savings measures ...

OLEAN — Total Senior Care recently celebrated four dedicated employees for their years of service and commitment to enhancing the lives of seniors in our community.

The AHA calls on Congress to reject changes to states’ use of provider taxes, which help fund their Medicaid programs.

STATEWIDE— NEW YORK STATE DEPARTMENT OF HEALTH'S eMedNY COMPUTER system improperly paid $16.2 million in Medicaid claims during a six-month period that started in October 2023, reports an audit that ...

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As managed care expands in the United States, few prescribed therapeutics today are purchased completely out-of-pocket. Rather, most are covered, at least in part, by a third-party payer ...

As a result, avoidable costs from inappropriate variability in practice patterns coupled with patient noncompliance are a significant focus of managed care. Managed care plans play a key role in ...