In this guide, we define how a proactive approach to provider network eligibility helps payers create greater efficiency and profitability within government programs, reduce the risk of ineligible claims, and improve interoperability.
In this conversation with data and policy analyst Allan Baumgarten, we discuss the key differentiating areas of procurement, contracting, and oversight, and where these may be headed.
What are the top trends driving provider network innovation and how are provider networks changing? We explore how payers are adapting.
October HHS OIG Work Plan updates include oversight of state MFCUs, a review of national drug control program funds, an audit of COVID-19 Uninsured Program and more.
September HHS OIG Work Plan updates include COVID-19 data and guidance, MAO provider identifier suggestions, FDA reviews, and more.
In this guide, we’ll review healthcare exclusion authorities as they relate to rules and requirements for participation in federal healthcare programs.
As the meaningful data surrounding the mid and long term effects of the COVID-19 crisis begin to come into focus, one aspect of the dramatically impacted healthcare industry is becoming clear: growing Medicaid MCO enrollment.
August HHS OIG Work Plan updates include MAO risk assessments, reports on nursing home safety and emergency preparedness, COVID-19 CARES Act funding audits, and more.
Discover the latest figures for criminal and civil recoveries from MFCU cases and referrals to HHS OIG, and exclusion data for individuals and entities.
We had a blast at the 2020 HCCA Managed Care Conference. Take a look at some of the highlights from the event.