CMS Temporarily Stops Accepting Auto-Enrollment Proposals From Health Insurance Companies
The CMS has decided to temporary discard all new proposals from health insurance companies, who are seeking to enroll their Medicaid or commercial patients directly into their own Medicare Advantage plans. The federal agency stated that 29 Medicare Advantage companies which includes UnitedHealth Group, Aetna, and many other Blue Shield and Blue Cross insures can…
California Passes “Surprise” Medical Bill Law
After months of active debate, California has became the latest state to adopt a law to protect the commercially insured users from unexpected out-of-network medical bills. With this move, California has joined many other states that have adopted a so-called “surprise” medical bill law. California’s bill A.B. 72 will take effect on January 1, 2017,…
CMS Plans To Ease First Year MACRA Reporting Requirements
CMS had announced the criteria for participation in Merit-based Incentive Payment System (MIPS) back in July. From January 1, 2017, CMS will start the process of replacing the Medicare Sustainable Growth Rate Formula (SGR) methodology that is used to find the annual updates to Medicare Physician Fee Schedule (MPFS), with a “value-based” payment model that…
Value Based Reimbursement Demands Aligning Physician Productivity Goals And Patient Experience
Even though majority of the healthcare providers and organizations are working to find ways to restructure physician productivity strategies, payers are pushing for better value-based reimbursement adoption. As healthcare providers aim to meet the unique requirements that are necessary for performance-based payments, Cathryn Connolley, managing partner at SystemCare Health, has advised healthcare organizations to align…
Health Insurance Portability And Accountability Act Celebrates Its Twentieth Anniversary
The Health Insurance Portability and Accountability Act (HIPAA) was made a law on 21 August 1996. HIPAA is still the law with jurisdiction over privacy and security of personal health information (PHI) and governing authority for the electronic transactions, even after twenty years. However, many changes have taken place in these twenty years. This period…
ACA Plans Will Remain Affordable To The US Citizens
The ruling party has reacted to the bad news that is circulating against Affordable Care Act marketplaces for quite some time now. The news indicates that ACA marketplaces have been facing serious challenges as a few of the insurers have quit the program, and the premium rates are on the rise as well. However, the…
Hospital Star Rating System Published By CMS Despite Oppositions
The new hospital star rating system was released by CMS last month, despite of the attempts from hospital advocacy groups to stop publishing the star ratings. The hospital ratings were published on the Medicare Hospital Compare website. As per the rating system, hospitals are awarded with a score in the scale of five stars; five…
Democrats Demand FDA And CMS To Submit Report On Theranos
The health technology startup, Theranos, face another major challenge, as the Democrats have demanded the US Food and Drug Administration (FDA) and Centers for Medicare and Medicaid Services (CMS) to submit their investigation details on the project. In the letters that were sent to FDA Commissioner Robert Califf and CMS Acting Administrator Andrew Slavitt, the…
HHS Joins Hands With International Partners To Develop New Antimicrobial Products
The United States Department of Health and Human Services (HHS) is collaborating with international players for combating antibiotic resistance and for developing and discovering new antimicrobial products. HHS has formed a new group, called Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator or CARB-X, working with AMR Centre of Alderley Park, Wellcome Trust of London, and Boston…
ONC Announces The First Winners Of Data Sharing App Challenge
ONC recently announced the Phase 1 winners of their Consumer Health Data Aggregator challenge. The objective of the app challenge was to make it easier for both patients and providers to access and share health care data. Applicants were assigned with the task to develop apps that are capable of more robust data sharing methods…
