whatley kallas

THE AHA IDENTIFIES WHATLEY KALLAS AS A LAW FIRM WITH EXPERIENCE TO REPRESENT HOSPITALS PURSUING CLAIMS FOR 340B DRUG PAYMENTS AGAINST MEDICARE ADVANTAGE PLANS

The American Hospital Association has issued a Special Bulleting alerting its members contracted with Medicare Advantage plans that they may have claims for reimbursement for underpayments under the 340B Drug Pricing Program. The Special Bulletin advised members: To assist members in this effort, we have identified and spoken with four outside law firm that have […]

THE AHA IDENTIFIES WHATLEY KALLAS AS A LAW FIRM WITH EXPERIENCE TO REPRESENT HOSPITALS PURSUING CLAIMS FOR 340B DRUG PAYMENTS AGAINST MEDICARE ADVANTAGE PLANS Read More »

HHS AUDIT FINDS THAT THE MEDICARE PROGRAM OVERPAID CIGNA-HEALTHSPRING OF TENNESSEE $5.9 MILLION DUE TO CIGNA’S SUBMISSION OF PATIENT DIAGNOSIS CODES NOT SUPPORTED BY MEDICAL RECORDS

The Office of the Inspector General for the Department of Health and Human Services (“OIG”) has issued a report of its audit of Cigna-HealthSpring of Tennessee’s (“Cigna”) submission of diagnosis codes for its Medicare Advantage members to CMS, which entitled Cigna to additional risk adjustment payments under the Medicare program.  The OIG found that the

HHS AUDIT FINDS THAT THE MEDICARE PROGRAM OVERPAID CIGNA-HEALTHSPRING OF TENNESSEE $5.9 MILLION DUE TO CIGNA’S SUBMISSION OF PATIENT DIAGNOSIS CODES NOT SUPPORTED BY MEDICAL RECORDS Read More »

UNITEDHEALTH GROUP’S LOWER THAN EXPECTED MEDICAL COSTS CONTRIBUTED TO ITS STRONG SECOND QUARTER PROFITS, BEATING ANALYSTS’ EXPECTATIONS

UnitedHealth Group’s second quarter 2022 earnings report showed that its medical care ratio (MCR) was 81.5%, lower than its expected MCR of 83%. An insurer’s MCR, which is frequently referred as the medical loss ratio, represents the insurer’s spending on claims compared with its earnings from premiums. United’s lower than expected MCR means that it

UNITEDHEALTH GROUP’S LOWER THAN EXPECTED MEDICAL COSTS CONTRIBUTED TO ITS STRONG SECOND QUARTER PROFITS, BEATING ANALYSTS’ EXPECTATIONS Read More »

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