Regional health insurers and many other small co-op plans incurred big charges under the Affordable Care Act’s risk adjustment program. The year 2015 is the second year of risk...
The commenting period set by CMS on the MACRA implementation has ended now. Following that, the American Academy of Family Physicians (AAFP) asked the Centers for Medicare & Medicaid...
The Centers for Medicare & Medicaid Services recently announced that 196 practices would be participating in their proposed Oncology Care Model (OCM). CMS says that OCM is designed to...
CMS invited comments on the proposed Medicare Access and CHIP Reauthorization Act (MACRA) last month, and received hundreds and thousands of remarks on the same. Most noted comment, however,...
The Department of Health & Human Services (HHS) plans to clear all backlogs under their new rules. HHS estimates that the Notice of Proposed Rulemaking (NPRM) on proposed changes...
The American Academy of Family Physicians (AAFP) recently joined hands with four other organizations in its attempt to expand the ranks of primary care physicians to where they are...
The Zika Virus, as we know, can infect a person via a mosquito bite and lead to serious health issues such as dengue, fever, conjunctivitis, pain in the muscles...
The Subcommittee on Oversight and Investigations conducted a hearing last month to analyze frauds and abuse within the federal healthcare programs. The hearing was chaired by Tim Murphy (R-PA-...
Latest report on EHR adoption and interoperability was released by Office of the National Coordinator for Health Information Technology (ONC). Information that was collected from non-federal acute care hospitals...
This is an election year for America and the expectations of Congress passing legislations are high. But against the expectations, Congress is willing to pass a bill that addresses...
The merger between the two major insurance companies, Aetna and Humana, face new challenges. Despite that, CEOs of the two companies remain confident that the merger will be completed...
The Department of Health and Human Services (HHS) released their regulatory agenda recently, which applies to all pending regulatory actions. This included the Medicare Part B Drug Payment Model...
CMS recently released a final interim rule that eases some restrictions laid on CO-OP health insurers. Experts believe that it is an attempt by CMS to keep CO-OPs from...
The Department of Labor (DOL) recently published a new rule for overtime payments in the country. The finalized rule increases the threshold for overtime payment eligibility, and expands the...
The Office for Civil Rights (OCR) recently came up with an explanation about the charges an HIPAA Covered Entity includes in a patient’s medical bill for having access to...
Insurance providers in the United States recently filed their proposed health plan exchange rates for the next year to state and Federal regulators. Where most of the proposed bids...
The Department of Health and Human Services (HHS) recently announced a new initiative, namely ‘A Bill You Can Understand’, in order to simplify the medical billing process and help...
RAC or Recovery Audit Contractor program was designed by CMS in 2007 to control overspending in Medicare Parts A and B. Since then, it has been focusing on auditing...
The House Ways and Means Committee proposed a bill last month, aimed at improving the current hospital payment policies. The bill, named Helping Hospitals Improve Patient Care Act (H.R....
A group of selected HBMA members, along with the HBMA GR Committee, is reviewing the proposed rule by CMS that details how it would implement the new Medicare value-based...