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18 Jun 2020, 1:24 pm
Implicit in the arguments made by many Medicare Advantage Organizations (MAOs), health plans, hospital networks and other defendants in response to whistleblower and government False Claims Act complaints is that the alleged misconduct—falsifying diagnosis data so that CMS overpays for patients enrolled in an MA plan—involves just a technical record-keeping or administrative dispute with CMS and no actual victims. [read post]
4 Nov 2021, 7:03 pm
To this end, they will often attempt to take advantage of the corporate form and the limited liability it offers. [read post]
23 Mar 2021, 9:28 am
Important Point: The Flexible Changes Are Not Automatic The changes in #1-7 above are not automatic and employer-action is required to take advantage of any of the flexible options. [read post]
4 Oct 2022, 7:00 am
Specific businesses can get an advantage by stiffing their employees or the public. [read post]
26 Oct 2017, 11:55 am
Promote access “in the near term” to association health plans and short-term, limited-duration insurance (both of which are exempt from certain ACA benefit mandates), and tax-advantaged health reimbursement arrangements. [read post]
23 Apr 2013, 11:25 am
Add up those extra payments and they amount to a $16-billion-a-year subsidy for the health insurance industry. [read post]
18 Nov 2018, 8:30 pm
Self-insured employer and union sponsored health plans, health insurers and other health care payers, health care providers, managed care and practice management service providers and others structuring or working with preferred provider or other managed health care contracts should weigh the potential implications on their health plan provider agreements and managed care practices of the antitrust lawsuit jointly brought by the U.S. [read post]
5 Feb 2016, 2:35 pm
In a recent article in the Wall Street Journal, Anne Tergesen points out that Health Savings Accounts (HSAs) come with more tax advantages than 401(k)s and individual retirement accounts (IRAs) when used to cover medical costs, a large expense for retirees. [read post]
31 Aug 2013, 10:33 pm
For Help or More Information If you need help understanding or dealing with these impending notification requirements, with other 2014 health plan decision-making or preparation, or with reviewing and updating, administering or defending your group health or other employee benefit, human resources, insurance, health care matters or related documents or practices, please contact the author of this update, Cynthia Marcotte Stamer. [read post]
20 Oct 2009, 11:00 am
Health care and emergency medical workers. [read post]
25 Jun 2014, 2:20 pm
Among other things, MedPAC addresses ways to align Medicare fee-for-service (FFS), Medicare Advantage, and accountable care organization policies on payment, risk adjustment, and quality measurement. [read post]
29 Jan 2016, 12:15 pm
As Allison Bell reports, it's a three-legged, free market approach based on three primary components:■ Use refundable age-based tax credits to help people pay for health coverage.■ Increase use of health savings accounts (HSAs). [read post]
23 Mar 2021, 11:30 pm
Sean Morrison is a palliative care leader and can readily cite the many advantages of palliative care. [read post]
5 May 2016, 4:22 pm
On May 6, 2016, CMS will publish a final rule to update Medicaid and Children’s Health Insurance Program (CHIP) managed care regulations to more closely align with Medicare Advantage (MA) and private health plan standards, promote quality, and strengthen the actuarial soundness of payment provisions. [read post]
17 May 2011, 4:29 pm
" Stamping out the attitude of doctor superiority is important for everyone in the health care system, especially patients. [read post]
30 Oct 2008, 7:22 am
The almighty dollar David Hamilton, blogging at BNET's Health Care Industry, tells us that trouble with Mammon drives for-profit HMOs to drive up Medicare Advantage premiums. [read post]
18 May 2012, 11:12 am
Accordingly, health plans receiving early retiree or other program subsidies, participating as Medicare Advantage plans, receiving subsidies or other federal funds, or coordinating benefits with these and other federal programs should prepare for possible federal review and, if applicable enforcement. [read post]
6 Sep 2020, 8:11 pm
As scholars of public policy have pointed out, “The core distinction … between partisan advantage seeking and political decision making is that partisan advantage-seeking is concerned primarily or solely with providing a benefit, or rent, to the gov [read post]
21 Jun 2012, 8:06 am
Consumers depend on their insurance company to protect them during times of need, whether they experience tragedy that involves auto, health, life, dental, or another form of insurance policy. [read post]
2 Mar 2018, 12:48 pm
Drivers over 65-year-old often suffer from various health conditions that can affect driving. [read post]
