“Operation Spinal Cap” Uncovers $600M in Healthcare Billing Fraud

“Operation Spinal Cap” Uncovers $600M in Healthcare Billing Fraud

The former CFO of a Long Beach hospital in California, two orthopedic surgeons and two others have been charged in relation to a $600 million fraudulent billings scheme involving illegal referrals of thousands of patients for spinal surgeries.

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USDA Funds Telehealth Capabilities in Rural Areas with Additional $23.4M

USDA Funds Telehealth Capabilities in Rural Areas with Additional $23.4M

The USDA's Rural Development's Distance Learning and Telemedicine Program will add $23.4 million in additional funding for 75 new projects in 31 states. These grants are used to purchase telemedicine educational tools, equipment and services in rural areas because those areas often lack access to specialized medical care or advanced educational opportunities. 

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Greenway Health is Connecting Care Seamlessly via CommonWell

Greenway Health is Connecting Care Seamlessly via CommonWell

Greenway Health is one of the seven founding members of CommonWell, a non-profit trade association dedicated to establishing a standard process for exchanging patient information across healthcare organizations both efficiently and securely. 

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Why Humana is Giving $77M to Various Physician Groups

Why Humana is Giving $77M to Various Physician Groups

Humana will distribute $77.2 million in bonus payments to roughly 3,700 physician groups nationwide who were engaged in its Provider Quality Rewards Program in 2014. The goal is to increase the 59% of Humana individual Medicare Advantage members who have primary care physicians participating in value-based relationships, to 75% by the end of 2017.

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Jury's Still Out on Whether Local Mergers Will Increase Healthcare Costs

Jury's Still Out on Whether Local Mergers Will Increase Healthcare Costs

A new report paid for by America’s Health Insurance Plans (AHIP) suggests a merger between Mountain States Health Alliance (MSHA) and Wellmont Health System would “likely lead to significantly higher post-merger prices.” AHIP aims to “advocate for public policies that expand access to affordable health care coverage to all Americans through a competitive marketplace that fosters choice, quality and innovation.” Competition Economics, LLC completed the report last month and concluded a merger would give the new organization a 77% market share, which would likely cause prices to shoot up. 

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