House Committee Wants CMS To Focus On Fraud Prevention In Medicaid Program
The House Oversight and Government Reform Committee’s Subcommittee on Government Operations recently held a hearing to examine the program integrity efforts of different Federal Agencies, who were vulnerable to fraud and abuse. The committee held discussions with the witnesses from Social Security Administration (SSA), Department of Treasury (DOT), Department of Health and Human Services (HHS),…
Civil Monetary Penalties Updated By HHS
The Department of Health and Human Services (HHS) has now released a interim final rule that increases the maximum Civil Monetary Penalty (CMP) amounts for those agencies that are within the HHS. This was an action that was required by the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015, and apart from the…
CMS Launches New Initiative To Improve Clinician Experience
In a recent announcement, CMS declared their plans to launch a provider engagement initiative to improve the clinician experience in the Medicaid program. Reports indicate that the development of value-based care models under the MACRA and Affordable Care Act might be the main reason behind this initiative. CMS pointed out that the patient experience has…
CMS To Launch A Tool To Assess The Impact Of MACRA
The Centers for Medicare & Medicaid Services is planning to launch a new tool to help clinicians assess the potential impact of Merit Based Incentive Program (MIPS) on their reimbursement. The tool is also aimed to help them evaluate their performance under the system and offer tips to improve their scores. Report say that the…
CMS Releases A Website For Submitting Contraceptive Claims
According to the Departments of Health and Human Services (HHS), Labor, and Treasury, full range of FDA-approved contraceptive services should be provided to the enrollees in the group health plans without cost sharing. However, eligible organizations that oppose to provide contraceptive services due to religious reasons are exempted from providing, arranging, and making payments for…
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…
CMS’s Proposed Star Rating Delayed Due To Opposition From Hospital Groups
CMS recently published a data showing how their yet to release Star Rating system will rate a hospital based on properties such as status and size. The agency is planning to post overall hospital star ratings soon on their Hospital Compare website. “We hope that by releasing our analysis of the impact of the overall…
Aetna-Humana Merger Going Forward Despite Challenges
The merger between the two major insurance companies, Aetna and Humana, face new challenges. Despite that, CEOs of the two companies remain confident that the merger will be completed by the end of the year. Aetna is the third largest health insurer in the US, and Humana ranks No. 4 in the list. According to…
Transgender Youths Should Get Better Healthcare
A recent study claims that better trained physicians can improve the quality of care provided to transgender youths. As per the researchers, many pediatricians in the country do not get enough training for gender-affirming healthcare, and so, only a few of such patients actually get proper services. The research team also came up with a…
Some Essentials For Effective Medical Billing
The current outlook for healthcare reimbursement is commonly regarded as tricky. These days, insurance companies and other payers follow an increasingly complex system, which confuses providers through convoluted rules, processes, etc. The obstacles they are served in the process include denials, underpayments, and misplaced or ignored claims. For doctors, it has gotten harder to get…
