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Letter of the Law

Several health plans sue government over ACA payments
Several health plans sue government over ACA paymentsSeveral lawsuits have been filed by qualified health plans offering coverage on the Affordable Care Act health insurance exchanges.
Seven healthcare questions the candidates aren’t answeringClinton and Trump are keeping mum about some healthcare issues, and that’s raising some critical questions. Managed Healthcare Executive asked industry experts to comment on what topics presidential candidates are being quiet about, and why they suspect they’re not talking about them.
Ransomware attacks present growing threat for hospitalsCyberattacks based on ransomware—hacking into a computer system and holding it hostage until the victim pays to regain access—are on the rise.
Cybersecurity mistakes plans, providers should avoidHealth plans and healthcare organizations are increasingly facing threats from cyber criminals. Here's how to better protect your organization.
SCOTUS Ruling on False Claims Act has big implicationsThe industry is awaiting the Supreme Court’s ruling on Universal Health Services v. Escobar. This case concerns the viability of the “implied certification” theory of legal falsity under the False Claims Act.
Regulators react to debate over narrow networksNew regulations will check the drive to narrow networks, just as the business case for forming them grows more compelling.
Six ways Trump’s healthcare plan differs from ObamacareRepublican presidential candidate Donald Trump recently unveiled his 7-point healthcare plan. Find out more.
Supreme Court decision impacts price transparency effortsAs a result of a recent case decided by the U.S. Supreme Court, advocates of healthcare transparency may need to adjust their data collection strategies.
Payer risk adjustment strategies: Getting paid soonerMedicare Advantage plans that are slow to submit risk adjustment data are at a big disadvantage.
New CMS rule could significantly impact Medicaid managed careCMS regulation will lead to major changes in Medicaid managed care programs; changes that focus on quality improvements, increased transparency and accountability, and strengthened state and federal oversight.