States Looking To Revamp Medicaid Expansions

Dr. Tom Price is the new secretary of Health and Human Services and the future of Medicaid under Dr. Price will be revealed soon, as the HHS has to decide if Arizona and Kentucky can remodel their efforts to expand Medicaid. States like Indiana, Arizona, Montana, Michigan, Iowa, and New Hampshire currently operate their Medicaid…

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AAFP Responds To The Proposed Payment And Policy Changes By CMS

The American Academy of Family Physicians (AAFP) recently offered detailed recommendations and comments to the officials of HHS. The suggestions submitted by AAFP was regarding CMS’s advance policy of proposed policy and payment changes to the Medicare Advantage and prescription drug plans for next year. In a letter, which was signed by AAFP Board Chair…

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Implementation Of The New Payment Models Delayed By CMS

The Centers for Medicare and Medicaid Services (CMS) has released an Interim Final Rule on March 21, 2017, which delays the effective date of many new Medicare payment models that were developed and introduced by the CMS Innovation Center, along with the introduction of updates to an existing model. To be specific, the Interim Final…

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HHS And President Trump Work Out Plans To Reduce Pharmaceutical Drug Costs

Dr. Tom Price, the newly elected secretary of Health and Human Services Secretary, recently informed a House appropriations subcommittee that HHS is working on a new plan with President Donald Trump. The primary objective of the new plan is to considerably reduce the price of pharmaceutical drugs. Dr. Price stated that the significant increase in…

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Stalled Healthcare Bill Puts Pressure On HHS Secretary

The stalling of the health care bill has put increasing pressure on President Donald Trump and the new Health and Human Services Secretary Tom Price. Together, both of them are presented with the intricate task of managing the law, which remains increasingly unfavorable among most members within the Republican Party itself. In addition, they will…

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CMS Trying To Attract More Doctors And Patients To ACO

Recent reports suggest that the CMS is trying to improve provider and patient participation in Accountable Care Organizations (ACOs). They are planning to improve participation by automating the process to pair patients with the doctors who are participating in the ACO models. This means that in the coming weeks, Medicare beneficiaries will be able to…

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How To Talk To Your Clients About Outsourcing

I get the same question all the time from existing and prospective clients “Do I tell me clients that I am outsourcing their work to India or not?”.   Typically, medical billing companies have contractual provisions whereby the medical providers authorize the billing services to be performed by employees, agents, contractors, and subcontractors of the…

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The Expansion Of Bundled Payment Programs Has Been Delayed By The CMS

In the latest move, the Centers for Medicare and Medicaid Services has delayed several bundled payment initiatives. This includes the implementation of cardiac bundled payment initiatives and the expansion of Comprehensive Care for Joint Replacement Model. In addition to that, this new policy from CMS will also extend Cardiac Rehabilitation Incentive Payment Model’s effective date…

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Doing Business in India

My first trip to India was over ten years ago. I owned a medical billing company and wanted to research the medical billing business process operations (BPO’s) in Chennai. This was a time before digital media had taken over and any company could have an unreliable website. They could make it appear as if they…

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Trump’s 2018 Budget Proposes Highest Priority For Medicaid And Medicare Programs

President Donald Trump’s upcoming fiscal budget for 2018 is expected to direct more funds to curtail many of Medicare and Medicaid frauds, wastages, and abuses. It indicates major changes to Medicare, Medicaid, and the Children’s Health Insurance Program. This new proposal in the upcoming budget is made with the intention of focusing the agency resources…

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