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CMS Launches The Final Rule For Prior Authorization
On December 29, CMS published a final rule finalizing a prior authorization process for specific durable medical equipment, prosthetics, orthotics...
CMS To Adopt Testing Care Model
In a recent report, CMS said that it was going to adopt a new community based healthcare program for testing....
Enrollment In ACA Proceeds With A Surge
Following a strong start, enrollment in the QHPs sold at Health Insurance Exchanges set up under the ACA has fared...
CMS Confirms Mandatory Medicare Bundled-Pay For Joint Replacement Surgery
CMS finalized the proposed bundle payment system for its hip and knee replacement surgery known as the CCJR model on...
Administration Looks At Some Major ACA Concerns
CMS recently posted on their blog that they intend to stop some of the special enrollment periods for the Federal...
OIG Seeks Suggestions On Safe Harbor Provisions And Special Fraud Alerts
The Office of the Inspector General (OIG) and Department of Health and Human Services (HHS) invited recommendations and proposals from...
UnitedHealth Facing Financial Issues In ACA Healthcare
UnitedHealth’s earnings report reveals it has been losing significant money on the HIEs established under the Affordable Care Act. Consequently,...
District Court Of Appeals Judges In Favor Of Healthcare Provider
December 2015 saw the judgment on a crucial case in the healthcare industry. The case was between a prominent insurance...
Risk Corridor May Be A Problem For Both Insurers And HHS
The ACA is has a requirement for insurance companies and Co-Ops to take part in HIEs, as a way to...