Policymakers are exploring reforms to address shortcomings of risk adjustment that inflate Medicare Advantage payments and ...

Denials, audits and delayed payments are accelerating across ASC, and leaders say payer behavior has become more aggressive, ...

Explore 2025 managed care enforcement trends under the Trump administration. Learn about Department of Justice (DOJ) and ...

Administration comprises 25% of all healthcare costs, making it a key target for automation. Organizations are using AI to ...

Stark law enforcement is intensifying as the Justice Department recovered a record $6.8 billion under the False Claims Act and regulators continue refining key exceptions that shape how physicians ...