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Following a whistleblower’s assertion that UnitedHealth Group was inflating Medicare diagnoses in order to get more money from the Medicare program, the US Department of Justice has filed a lawsuit alleging the company knowingly inflated risk adjustment payments by making beneficiaries seem sicker than they were.
John Fox, MD, MHA, associate chief medical officer of Priority Health, provides a payer perspective regarding clinical pathways in lung cancer and incentives for adhering to them.
This week in managed care, the top stories included a surprising shake-up in leadership at Molina Healthcare; feedback for the Oncology Care Model; and Healthy Vision Month is focusing on women.
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