CMS Proposes Criteria For 2017 Exchange Plan

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 sold in the 2017 plan year. On top of the several highly technical insurance disputes, the proposed rule is meant to set up a new policy,…

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ACA Open Enrollment Proceeding Full Ahead

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 for individuals who have yet to select a plan for 2016. Following a solid initial two weeks compared to what has been seen in previous years,…

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CMS Releases Draft Letter On Exchange Sold Health Plans

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 of requirements that these plans should be based on for the year 2017. The draft letter of the requirements is given out to the issuers in…

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CMS Seeks Public Opinion On Improving MAC Contracts

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 process, it issued an official Request For Information (RFI) in the Federal Register. The decision is said to help CMS in monitoring the MAC contracts.…

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Issues Arise In Processing ICD-10 Claims

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 system. Members of the association have encountered issues at the Medicare Administrative Contractor level, with claims having to do with National Coverage Determinations, and Local Coverage…

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US Congress Passes Fiscal Year 2016 Omnibus Appropriations Bill

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 fund the federal government activities thorough the fiscal year 2016. The bill was passed at the House the previous day. President Obama signed the bill into…

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CMS Releases Annual Report On Spending In Healthcare

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 noticeably low in this area, the Centers for Medicare and Medicaid Services (CMS) has announced that it has once again climbed in 2014, by 5.3 percent.…

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Draft Plan For Clinical Quality Measure Development Released By CMS

Accuracy is one of the biggest challenges faced these days in the medical billing sector. CMS introduced a draft plan last week; describing the methods, it is going to follow in order to develop quality measures in the clinical sector. The suggestions made in the plan are to be used by Alternative Payment Models (APM)…

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GAO Report Observes Growing Trend Of Consolidation Practices Among Hospitals

The report issued by the Government Accountability Office (GAO) to the Congress turns out to be in favor of neutral payments. The report addressed the increasing trend of consolidation within the healthcare industry. There is growing number of instances where physician practices merge with other entities or hospitals purchasing physician practices. According to the report,…

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