Year Two of the ACA Coverage Expansions: On-the-Ground Experiences from Five States As of Spring 2015, states had completed the second open enrollment period for the new Health Insurance Marketplaces established by the Affordable Care Act (ACA) and most of…
Humana has posted a policy/coding update that will take effect on 9/14/2015: http://apps.humana.com/marketing/documents.asp?file=2642614 Unless otherwise noted below, these updates will be applicable across all of Humana’s product lines (commercial & Medicare): Humana addresses maximum dosages/acceptable diagnosis codes for several drugs…
Survey: Healthcare Finance, Reform Top Issues Confronting Hospitals in 2014 CHICAGO, January 12, 2015—Financial challenges again ranked No. 1 on the list of hospital CEOs’ top concerns in 2014, according to the American College of Healthcare Executives’ annual survey of…
The 340B drug discount program is currently under consideration for changes that will affect hospitals and physicians alike. Hospitals typically would like to keep the program how it is, while physicians are striving for reform. The drug discount program has been giving…
While change is sweeping across healthcare, there is a need of first-class physician leaders. In order to effectively support clinical integration, there needs to be mutual support and trust between physicians and hospitals. Another key issue for leaders to consider…
For the last several years now, anyone in the healthcare provider sector, has heard about or been highly anticipating the move to ICD-10. The upcoming change will obviously require investments to be made, but will be more costly to those…
Meaningful Use With SGR repealed and the Medicare Access and CHIP Reauthorization Act (MACRA) H.R. 2 now in place, Meaningful Use requirements are still very much in place, despite some pivotal adjustments. Attesting to Stage 3 Meaningful Use is still necessary…
On April 1, 2015, the Medicare Physician Fee Schedule (MPFS) was updated using the Sustainable Growth Rate (SGR) methodology as required by current law. The SGR methodology required a 21% decrease in all MPFS payments beginning April 1, 2015. The…
By: Ayla Ellison There are five trends that emerged in 2014 that are likely to prove costly in 2015, according to a recentForbes article by Robert Pearl, MD, CEO of The Permanente Medical Group. 1. Hepatitis C drugs with high…
According to a recent proposal posted by CMS this week, health insurers offering Medicare Advantage plans will see their rates cut by approximately .95 percent in 2016. The finalized payment rates are expected to be final April 6th. Below is…