Colonoscopy billing can be very complex, hinging on distinctions between screening and diagnostic intent. A single ICD-10 code, CPT selection or missing modifier can shift a procedure from fully ...

Not long ago, I was sitting across from a nursing home leadership team as they stared at a quality measure report that didn’t make sense to them. “We’re ...

Moby Strategic Transformation and Performance Drivers. Performance in 2025 was impacted by elevated medical cost trends, ...

Patients with oHCM experience significant variation in cardiovascular events, health care resource use, and costs across age, sex, race, and US region.

With private insurers set to receive $1.2 trillion in excess payments by 2036, retirees may soon face a reckoning over costs ...

Oakland, Calif.-based Kaiser Permanente is suing nine liability insurers for breach of contract, alleging they have refused to cover any portion of its $556 million settlement with the federal ...

Terry Gerton We’re going to talk about False Claims Act. The Department of Justice announced that 2025 was a record-breaking year for them, $6.8 billion in recoveries and almost 1,300 cases. What is ...

An analysis of nearly 28 million Medicare beneficiaries indicates that long-term exposure to air pollution is a risk factor ...

The legal battle exposes the irrationality of a healthcare system subordinated to financial manipulation, fraud settlements and insurance profiteering.

A new voluntary Medicare model starts in July, and it could save you $11,000 per year. But there are steps you need to take right now.

Rising housing costs may be more than a financial strain—they could be a health risk for low-income adults with heart failure. A new study found that a higher area-level housing cost burden was ...

Hello, and welcome to Clover Health's Fourth Quarter 2025 Earnings Call. [Operator Instructions] Also, as a reminder, this conference is being recorded today. If you have any objections, please ...