Retrospective risk adjustment running out of road as CMS excludes unlinked diagnoses and DOJ prosecutes invalid HCC submissions, raising compliance risks.

Over the last several months, there has been no shortage of commentary about the Department of Justice’s (DOJ) Fraud Oversight through Careful Use ...

AHIP is the national association whose members provide health care coverage, services, and solutions to hundreds of millions ...

Ambient AI scribes are sold on a generous promise: give clinicians their time back. The early evidence backs it. In a six-system study, clinician burnout fell from 51.9% to 38.8% within a month of ...

Two New York ophthalmology practices’ $2.3 million settlement over outside transcranial doppler testing arrangements is the latest example of a Stark law problem hiding in plain sight: a referral ...

The San Francisco 49ers arrived a week in advance of their Melbourne NFL game, while the Rams will arrive the day before. A ...

MercadoLibre dominates Latin American e-commerce and fintech, building a formidable moat through logistics and financial ...

Legal expert Chris Schulte breaks down why a judge rejected the Department of Labor's proposed wage percentiles and housing ...

Whether IR35 played a part or not, former contractors who've wound up their personal service companies are on the receiving ...

Rentosertib, Insilico Medicine AI drug, reduced predicted biological age across six independently built protein clocks in ...

The San Diego City Auditor’s recent investigation into the Barnes Tennis Center pulled back the curtain on a 35-year deal ...

AI is reshaping product development by moving automation upstream, with narrow agents, human oversight and governance built into every stage.