America’s Health Insurance Plan (AHIP) is the biggest lobbying group in the health insurance industry in USA. It is reported that most of the leading healthcare insurance companies in...
The administration is certainly laying out a plan for the post-SGR period. With the Medicare Access and CHIP Reauthorization Act of 2015 passed, the Medicare program will be moving...
The Affordable Care Act was enacted in 2010 and it is highly regarded as the signature piece of legislation under Obama Administration. Nevertheless, the Republicans in America have been...
On December 29, CMS published a final rule finalizing a prior authorization process for specific durable medical equipment, prosthetics, orthotics and supplies (DMEPOS), which are frequently seen by the...
In a recent report, CMS said that it was going to adopt a new community based healthcare program for testing. The purpose of the testing is to see how...
Following a strong start, enrollment in the QHPs sold at Health Insurance Exchanges set up under the ACA has fared vitally. As of December 2015, over 8.3 million people...
CMS finalized the proposed bundle payment system for its hip and knee replacement surgery known as the CCJR model on November 16. Even though the final rule makes some...
CMS recently posted on their blog that they intend to stop some of the special enrollment periods for the Federal HIE. Insurers around the country find this news welcoming....
The Office of the Inspector General (OIG) and Department of Health and Human Services (HHS) invited recommendations and proposals from the public on improving OIG Special Fraud Alerts and...
UnitedHealth’s earnings report reveals it has been losing significant money on the HIEs established under the Affordable Care Act. Consequently, the insurance provider is considering withdrawing from the Exchanges...
December 2015 saw the judgment on a crucial case in the healthcare industry. The case was between a prominent insurance service and a healthcare provider, about the assignment of...
The ACA is has a requirement for insurance companies and Co-Ops to take part in HIEs, as a way to return part of their profits to the Federal government...
The Centers for Medicare and Medicaid Services issued its annual proposed rule on 20 November 2015. Therein, the agency summarizes the criteria for health insurance plans which will be...
The ACA open enrollment is proceeding. Health insurance claimants for plans sold on the federal and state HIEs are enrolling at present, and there is very little time left...
The Centers for Medicare and Medicaid Services (CMS) insists that Exchange Sold Health Plans should be based on a set of requirements. As such, it has released a list...
In a latest move, the Centers for Medicare and Medicaid Services (CMS) have decided to seek opinions from public on improving Medicare Administrative Contractor (MAC) contracts. As part of...
The move to ICD-10 has apparently evaded most of the obstacles healthcare stakeholders predicted. Despite that, HBMA members have uncovered many challenges in the transition to the new coding...
The US Senate passed a crucial bill on 18 December 2015, on the last legislative day of year. The bill titled ‘Fiscal Year 2016 Omnibus Appropriations’ is designed to...
The CMS recently put out a report on the main healthcare concern in the US, which happens to be aggregate annual spending. With the preceding five years of growth...