Anthem-Cigna Merger Face More Hurdles

Insurance behemoth, Anthem lost their appeal of the February decision of a Federal Judge to block their 54 billion-dollar merger with Cigna. A three-judge panel rejected the appeal by Anthem, and the Department of Justice blocked their merger in the U.S. District Court noting the projected effect of the merger on competition in the market. Anthem claimed that their merger with Cigna would result in administrative efficiencies that can lead to decreased insurance premium for the users. However, neither the U.S. Court of Appeals nor the U.S. District Court agreed with the claims…Read more …

MedPAC Congress Report Suggests Increase Of Payment Rates For Physicians

The Medicare Payment Advisory Commission (MedPAC) released their newest reports to the Congress last month. MedPAC is an independent Congressional agency that is set up to counsel the Congress regarding various issues that affect the Medicare program. One of the major recommendations put forward by MedPAC for physician fee schedule payments include the increase of payment rates for physician and many other professional health services by the Congress with the stipulated amount mentioned for the calendar year 2018. In the report, several key issues like Medicare information and the overall health spending along…Read more …

Two Health Reform Bills Passed By The House Republicans

Even though the House Republicans were not successful in passing the American Health Care Act (AHCA), they did pass two major health reform bills recently in their efforts to make healthcare in the US better. The reform bills passed by the House Republicans concentrate on separate issues from the Affordable Care Act (ACA). A three-phase strategy was earlier proposed by the Republicans in order to replace and repeal ACA. According to the proposal, the first phase will be the budget reconciliation process whereas the second phase will see regulatory changes by the federal…Read more …

The Need Of Credit Balance Resolution

Experts say that credit balancing is the “stealth aircraft of hospital patient accounting,” as credit balance is a liability that is hidden in the account receivable folder. Credit balancing is very important because the liability carries with it serious and real, compliance, and financial risks. It is the responsibility of your medical billing service to manage these risks for you. Medical billing industry data shows that more than fifty-five percent of the credit balances are caused because of incorrect allowances posting. Federal Register issued rules on credit balancing in March 2016 and as…Read more …

AAFP Responds To The Proposed Payment And Policy Changes By CMS

The American Academy of Family Physicians (AAFP) recently offered detailed recommendations and comments to the officials of HHS. The suggestions submitted by AAFP was regarding CMS’s advance policy of proposed policy and payment changes to the Medicare Advantage and prescription drug plans for next year. In a letter, which was signed by AAFP Board Chair Wanda Filer reacted to certain proposals of the CMS that were related to three main issues such as network adequacy determinations, Medicare Part D formulary submissions, and quality measures. Quality Measures In an advance notice published by CMS,…Read more …