January 1, 2017-December 31, 2017 | Performance period for 2019 payment (can report data for any 90-day period this year) March 31, 2017 | First APM snapshot; (also June 30 and Aug. 31) April 1–June 30, 2017 | Registration period for submitting data…
Blue Cross Blue Shield just announced that they’re pulling out of 85 counties, over half of the counties in Georgia including Chatham county. This provider is the largest health insurer in the state of Georgia. The decision stems from…
Transitional Care Management (TCM) bolsters the involvement of primary care physicians in the coordination of post-discharge care to reduce readmission. Patients with moderately complex diagnoses are eligible to receive TCM services during a 30-day window after their discharge from an…
There continues to be developments regarding the proposed mergers between Anthem/Cigna and Aetna/Humana. Yesterday, the Justice Department reported will likely file lawsuits this month to halt both proposed mergers. If the Justice Department does take action, it may significantly delay…
The Government Accountability Office recommends that Congress removes the financial incentives the government pays hospitals as part of the 340B drug program. The GAO is concerned that this financial encouragement results in over-prescribing of medications at Disproportionate Share Hospitals (DSHs),…
By: Sara Rosenbaum Despite its monumental achievement, the Affordable Care Act (ACA), like any landmark piece of legislation, was only the beginning. Its aim was grand, but even putting aside the wild circumstances of its enactment, it was evident that effective…
Recently, physicians and physician advocates have pressed for legislation allowing an ICD-10 Grace Period that has been introduced as HR 2652 Bill. Specifically, “In carrying out regulations providing for the replacement of ICD–9 with ICD–10 as a standard for code…
Just a month ago, the endeavor to pass a bill that would require Georgia insurances to cover those with autism appeared to be dead. However, through the efforts of child advocates and legislators a reworked bill (House Bill 429) was…