Provider Network Monitoring Solution Guide
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.
Evolution in Medicaid Managed Care
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.
Top Trends Driving Provider Network Innovation
What are the top trends driving provider network innovation and how are provider networks changing? We explore how payers are adapting.
October 2020 OIG Work Plan Updates
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 2020 HHS OIG Work Plan Updates
September HHS OIG Work Plan updates include COVID-19 data and guidance, MAO provider identifier suggestions, FDA reviews, and more.
A Guide to Healthcare Exclusion Authorities
In this guide, we’ll review healthcare exclusion authorities as they relate to rules and requirements for participation in federal healthcare programs.
Growing Medicaid MCO Enrollment Provides Opportunities for Payers
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 2020 HHS OIG Work Plan Updates
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.
HHS OIG Releases the FY 2019 MFCU Report
Discover the latest figures for criminal and civil recoveries from MFCU cases and referrals to HHS OIG, and exclusion data for individuals and entities.
2020 HCCA Managed Care Conference Takeaways
We had a blast at the 2020 HCCA Managed Care Conference. Take a look at some of the highlights from the event.
