New Proposed Rule By CMS To Improve Health Insurance Choices For Patients

The Centers for Medicare & Medicaid Services (CMS) has recently issued a proposed rule for 2018, and the rule proposes new reforms that are crucial to stabilize the small group and individual health insurance markets to protect patients. It is reported that the proposed rule will make changes to special enrollment periods, guaranteed availability, the annual open enrollment period, essential community providers, network adequacy standards, and actuarial value requirements. CMS has also announced upcoming changes to the timeline of the qualified health plan certification. “Americans participating in the individual health insurance markets deserve…Read more …

Senator Charles Schumer Expresses Concern In GOP Medicare Plans

The U.S. Senator Charles E. Schumer (D-NY) recently voiced his concerns about the changes made to Medicare by the members of the congress. This even included replacing Tom Price, the current Health and Human Services Secretary, whose proposals include turning Medicaid into a voucher based, privatized system as well as cutting Medicaid. The Medicare program has earned 3.3 million New Yorkers as beneficiaries last year. According to reports, approximately 370,713 senior citizens in the Hudson Valley have enrolled in Medicare. The Senator states that he will fight for making Medicare protected and strengthened…Read more …

House Republican Leaders Put Forward Their Plans To Replace Obamacare

House Republican leaders recently presented an outline of their strategies to replace the Affordable Care Act or Obamacare to their rank-and-file members. The newly presented plans rely heavily on tax credits for financing the insurance purchases and on significantly reducing the federal payments to 31 states, which expanded the Medicaid eligibility. Paul D. Ryan, the Speaker and 2 House committee Chairman, stood along with HHS’s new secretary, Tom Price to prepare the Republican lawmakers for a week-long Presidents’ Day recess, which included anxious and angry questions regarding the fate of the health law.…Read more …

CMS Seeking Proposals For 2018 Medicare Plans

Medicare Advantage and Medicare Part D prescription drug plan programs managers are taking steps to ensure the programs stay the same for the next year as well. The 2018 Advance Notice packet for the programs issued by the managers appears roughly like the Medicare program advance notice packets that were posted earlier. There have been numerous predictions by the Centers of Medicare and Medicaid Services regarding the proposed program changes. Accordingly, the proposal will aid in increasing the issuer’s 2018 revenue by an average value of 0.25 percent; although, it is slightly lower…Read more …

Tom Price Takes Charge As The New Secretary Of HHS

Rep. Tom Price (R-GA) was named as the new secretary of the Department of Health and Human Services recently after a 52-47 vote in favor of Price. Nominated by President Trump, Price has always been a strong supporter of Republicans who wanted to revoke or reform Obamacare. The immense experience that he has gained by working as an orthopedic surgeon has allowed him to weigh in many suggestions on reforming healthcare. In a recent statement, House Speaker Paul Ryan said, “Having Dr. Tom Price at the helm of HHS gives us a committed…Read more …

Federal Court To Keep The ACA Claims Of The Carrier Alive

Recently, a judge at the US Court of Federal Claims declined immediate help to a Lake Oswego, Oregon-based health insurer seeking more than twenty one million dollars in payments from a troubled ACA program. However, the judge thinks that she can rule on if the Affordable Care Act program owes the insurer money. The judge, Margaret Sweeney, approved some parts of the complaint that was filed by Health Republic Insurance Company and rejected the others. Health Republic was a provider based in Lake Oswego, Oregon, and they started to shut down in part…Read more …

Meaningful Use Reporting Deadline For EPs Extended

The Centers for Medicare & Medicaid Services (CMS) has postponed the deadline for the attestation to Meaningful Use by Eligible Physicians. The deadline was fixed at February 28, but now it is postponed to March 13, 2017. The deadline for Eligible Hospitals was also postponed by CMS recently. The Electronic Health Records program of Medicare, commonly called as Meaningful Use, is now phased out for the physicians. However, Eligible Physicians will still need to report on Meaningful Use measures for the year 2016. This is to avoid the 3% penalty in 2018. It…Read more …

GAO Suggests CMS To Ensure Effective Use Of Medicaid Provisions

The Centers for Medicare and Medicaid Services (CMS) has taken the necessary steps in ensuring enough incentives for the states. This ensures that the billions of dollars received for the provision of Medicaid Managed Long Term Services and Supports (MLTSS) are put to use effectively. The Government Accountability Office (GAO) has made this official through their findings in a recent report. Nonetheless, the GAO stated that the MLTSS programs could allow the states to increase the community-based care and lower association costs, if the designs for the payment structures are proper. They also…Read more …

HSS Draft Rule To Address Insurance Market Issues Receives Mixed Reviews

A leaked rule from HHS, that is aimed to help stabilize the individual insurance market, reveals the narrow limits of Trump Administration on healthcare reform. It is reported that HHS has submitted a proposed rule to the Office of Management and Budget, but the details of the rule is not yet released. Only two different draft versions of the rule are now available. It is rumored that the provisions in the leaked rule are in consistence with the changes that are sought by the insurers to have an improved balance of sicker and…Read more …

MACRA And MIPS Preparation – What You Need To Know

CMS released the final rule that calls for significant legislative changes to the Medicare Access and CHIP Reauthorization Act (MACRA) in October 2016. MACRA repeals the Medicare Part B Sustainable Growth Rate (SGR) reimbursement formula and replaces it with Merit-Based Incentive Payment System or MIPS. As per MIPS, 85% of the Medicare reimbursements must be tied to quality. To accomplish this, the health care providers should take part of an Alternative Payment Model or the Merit-based Incentive Program System (MIPS). MIPS will measure Medicare Part B providers in four different categories. The providers…Read more …