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AHA releases first health care plan accountability update for 2025
The AHA today released its Health Care Plan Accountability Update, covering the latest developments in Medicar
Health Plan Accountability
Commercial health plan abuses must be addressed to ensure fair coverage for patients and providers. The AHA has worked to hold health plans accountable through letters, statements, white papers, member updates and earned media.
AHA brief urges court to oppose motion by MultiPlan to end antitrust case
The AHA March 10 filed a friend-of-the-court brief in the U.S. District Court for the Northern District of Illinois, urging the court to oppose a motion by data analytics firm MultiPlan to dismiss claims that the company conspired with insurers to reduce out-of-network reimbursements for hospitals and health systems.
AHA Amicus Brief Challenges MultiPlan, Inc. Motion to Dismiss Antitrust Litigation
Commercial insurance reimbursements comprise the majority of many hospitals’ revenue. Moreover, because government programs like Medicare do not cover the costs of providing care, commercial reimbursements can be the difference between losing money, breaking even, or earning a sustainable margin.
The Effects of Medicare Advantage on Rural Hospitals With St. Bernards Healthcare
Half of all Medicare beneficiaries get their benefits through Medicare Advantage (MA) plans, which are offered by private companies and in theory should provide the same level of coverage of traditional Medicare.
Clinical Validation Audits and the Impact on Hospitals and Health Systems
. In this conversation, Richelle Marting, director of managed care contracting at North Kansas City Hospital, and Chris Thompson, executive director of reimbursement and compliance for managed care at AdventHealth, discuss the rapid growth in these audits, the financial strain they can put on hospitals and health systems, and what can be done to protect providers and ultimately, patients.
Health Care Plan Accountability Update - December 2024
The Centers for Medicare & Medicaid Services Nov. 26 proposed changes to the Medicare Advantage and prescription drug programs for contract year 2026.
AHA discusses impact of vertical integration on health care providers
The AHA today participated in a panel discussion during a conference hosted by The Capitol Forum on the impact of insurer vertical integration.
OIG warns of marketing schemes in certain MA programs
The Department of Health and Human Services Office of Inspector General yesterday issued an