Health Populi

JULY 31, 2019

Let’s start with an overall context statistic from this poll: that is that 86% of insured U.S. adults like their health insurance plan rating it “excellent” (39%) or “good” (47%). The most favored public plan is Medicare, beloved by 83% of Americans, where Medicaid is favored by 75% of people.

ACA 56

ACA Health Care Reform Health Insurance Medicare 56

Health Populi

MARCH 27, 2019

Health insurance was on the collective minds of American voters in the 2018 midterm elections. Health care, broadly defined, drove many people to the polls voting with feet and ballots to protect their access to a health plan covering a pre-existing condition or to protest the cost of expensive prescription drugs.

Health Insurance 93

Health Insurance ACA Governance Medicare 93

Center for Health Insurance Reform

MARCH 31, 2022

In the proposed Notice of Benefit and Payment Parameters for 2023, the Centers for Medicare & Medicaid Services asked for feedback on how to promote health equity through ACA marketplace operations and plan certification standards.

ACA 94

ACA Health Insurance Medicaid Medicaid 94

Health Populi

SEPTEMBER 12, 2019

The big headline in this poll following last night’s third Democratic Presidential debate is that 55% of Democrats and Democrat-leaning Independent voters prefer a candidate that will build on the Affordable Care Act (ACA) versus a President that would replace the ACA with a Medicare For All plan (M4A).

ACA 52

ACA Medicare Medicare Medical Billing 52

Health Populi

JUNE 18, 2021

with employer-sponsored health insurance worry that a major health event in their household could lead to bankruptcy, according to research gathered by West Health and Gallup in Business Speaks: The Future of Employer-Sponsored Insurance. Health Populi’s Hot Points: U.S. One-half of U.S.

ACA 133

ACA Health Insurance Medicaid Medicaid 133

Jane Sarashon

FEBRUARY 27, 2024

NABIP, whose members represent professionals in the health insurance benefits industry, drafted and adopted a new American Healthcare Consumer Bill of Rights launched at the meeting. Health Populi’s Hot Points: Is there an American Civil Right for health care?

ACA 113

ACA Prescription Drug Pricing Health Insurance Hospitals 113

Bill of Health

FEBRUARY 27, 2023

This pervasive structure for public health and health care laws caused problems before the New Roberts Court, but COVID-19 politics highlighted the degree to which state officials are turning away from partnering and toward what I call the “state veto.” It would also offer some defense against clear statement rules on steroids.

Public Health 246

Public Health COVID-19 Medicaid Medicaid 246

Compliance Now

JANUARY 13, 2022

The Biden Administration recently announced the new out-of-pocket (OOP) limits that will apply to group and individual health plans during the 2023 plan year, as well as the Patient-Centered Outcomes Research Institute (PCORI) Fee for plan or policy years ending on or after October 1, 2021, and before October 1, 2022. This is a $.13

ACA 113

ACA Health Insurance Medicaid Medicaid 113

Healthcare Law Blog

APRIL 6, 2022

On April 1, 2022 , the Centers for Medicare & Medicaid Services (“CMS”) announced states may seek to extend Medicaid postpartum coverage from 60 days to one year through a new state plan option offered by the American Rescue Plan Act (“ARPA”). This option is available for five years and ends on March 31, 2027.

Medicaid 52

Medicaid Medicaid ACA Public Health 52

Healthcare Law Blog

MARCH 25, 2022

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger insurers. Once the new rules were published, Vista Health Plan, Inc., 2018 Final Rule, 83 Fed.

ACA 52

ACA US Department of Health and Human Services Health Insurance Medicaid 52

Kaiser Health News

JULY 6, 2022

. “There are still some gaps that need to be filled,” said Katie Keith, a researcher at the Center on Health Insurance Reforms at Georgetown University. Medicare covers stool tests or flexible sigmoidoscopies, which screen for colon cancer, without cost sharing starting at age 50. The ACA does set parameters.

ACA 76

ACA Medicare Medicare Medicaid 76

CMS.gov

OCTOBER 22, 2018

New State Relief and Empowerment Waiver Guidance Gives States Tools to Help Fix Broken Health Insurance Markets. Administrator, Centers for Medicare & Medicaid Services. million Americans remain without health insurance. As the ACA regulations took effect, choice plummeted and premiums soared.

Health Insurance 55

Health Insurance ACA Medicaid Medicaid 55

Bill of Health

MAY 12, 2023

Frequently, in these low-wage positions, workers earn just enough to pay for their health insurance premiums and sometimes the associated cost-sharing requirements. And if a person’s employer offers insurance benefits which exclude IVF, she does not qualify for premium subsidies on the exchanges.

ACA 241

ACA Medicaid Medicaid Health Insurance 241

Compliancy Group

MARCH 19, 2024

Also, all insurance and Medicare or Medicaid claims must only include charges for services and treatments ordered and deemed necessary. Department of Health and Human Services (HHS) enforces laws relevant to patient care, healthcare delivery and billing, and workplace safety in the U.S. name, phone number).

Regulatory Compliance 52

Regulatory Compliance Compliance US Department of Health and Human Services ACA 52

Health Populi

JANUARY 24, 2019

The first chart notes important nuances under the majority support for a national health plan which, in this case, asked whether people favored a plan “sometimes called ‘Medicare for all.'” ” I note that note all national health plan designs would need to be tied to Medicare. from a low of 10.9

ACA 62

ACA Medicare Medicare Health Insurance 62

MedTrainer

JANUARY 12, 2024

The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation. Compliance efforts expanded to encompass EHR security.

Compliance 52

Compliance HIPAA Telemedicine ACA 52

Healthcare Law Blog

JANUARY 26, 2023

The PHS Act requires post-graduate physician training programs that do not perform induced abortions to be deemed accredited and protects governmental payments provided as reimbursement for carrying out health related activities. Medicaid and Medicare The Balanced Budget Act of 1997, Public Law 105–33, 111 Stat.

ACA 105

ACA Medicaid Medicaid Compliance 105

MedTrainer

NOVEMBER 15, 2023

Department of Health and Human Services The United States Department of Health and Human Services (HHS) is the primary federal agency responsible for protecting the health of all Americans and providing essential human services. Office for Civil Rights The Office for Civil Rights (OCR) is another branch of HHS.

Compliance Framework 52

Compliance Framework Governance Compliance Medicaid 52

Health Populi

JULY 25, 2018

President Trump and his administrative have been trying to make the ACA fail, claim most U.S. Thus, the public holds the POTUS and the Republican party responsible for moving the Affordable Care Act forward… or not, according to the July 2018 Kaiser Health Tracking Poll conducted by the Kaiser Family Foundation (KFF).

ACA 87

ACA Medicaid Medicaid Health Insurance 87

Healthcare Law Blog

MAY 17, 2022

On January 5, 2022, we discussed the Notice of Benefit and Payment Parameters for 2023 proposed rule released by the Centers for Medicare & Medicaid Services (CMS). The 2023 NBPP final rule makes regulatory changes in the individual and small group health insurance markets and establishes requirements for the 2023 benefit year.

ACA 52

ACA Health Insurance Medicaid Medicaid 52

Compliancy Group

JANUARY 3, 2024

Medical billing compliance ensures that providers and administrators engage in ethical and accurate billing practices. It pays to know the law and avoid temptations to cut corners.

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 52

Health Populi

NOVEMBER 5, 2018

In my 11 years of writing every one of over 2,000 Health Populi posts on this blog, I have never, ever mentioned the “f-word” here. In this case, I feel it’s important to capture the Zeitgeist of the Republican Party’s commitment to cutting down the ACA since President Trump took office in January 2017.

Medicaid 76

Medicaid Medicaid Health Insurance ACA 76

Health Populi

FEBRUARY 6, 2020

Among all Americans, the most popular approach for improving the health care in the U.S. isn’t repealing or replacing the Affordable Care Act or moving to a Medicare-for-All government-provided plan. Addressing employer-sponsored health insurance. Reducing system-wide health care costs. Improving Medicare.

Health Insurance 76

Health Insurance Medicare Medicare Medicaid 76

Health Populi

MARCH 1, 2018

If we’re playing a game of “majority rules,” then everyone in America would have the right to affordable health care, according to a new poll from The Commonwealth Fund. The report is aptly titled, Americans’ Views on Health Insurance at the End of a Turbulent Year. The Fund surveyed 2,410 U.S.

ACA 83

ACA Health Insurance Medicaid Medicaid 83

Health Populi

JUNE 28, 2019

Harris and VP Biden on race, busing, and segregation — which in the larger public health context continue to have a direct impact on health equity, health disparities, and socio-economic status. Sanders explained that the vast majority of people will pay significantly less for health care than they do right now.

Medicare 70

Medicare Medicare Health Insurance Governance 70

Health Populi

JUNE 27, 2019

[This, the impact of social determinants of health beyond health care, is the underlying theme of my book, HealthConsuming: From Health Consumer to Health Citizen ]. Elizabeth Warren assertively and transparently backed Bernie Sander’s Medicare for All proposal.

Medicare 85

Medicare Medicare Health Insurance Public Health 85

Health Populi

MARCH 11, 2021

health care, patient assistance programs, Medicare Advantage plans, and the bundling of proven high-value preventive services into the Affordable Care Act. These services are enumerated in Section 2713 in the ACA , prompting Dr. Kavita Patel to assert in the first panel of the day that, “2713 is my favorite number.”

Health Insurance 98

Health Insurance ACA Medicare Medicare 98

Kaiser Health News

JANUARY 19, 2022

” The changes are part of a 400-page proposed rule governing the federal health insurance marketplace and a few states that use the federal platform for their own exchanges. Under the ACA, sliding-scale subsidies are available to help low- and moderate-income people buy coverage.

ACA 72

ACA Health Insurance Licensing Governance 72

Health Populi

MAY 3, 2019

.” I note that, by the time Americans voted in the 2018 mid-term elections, it was no surprise that lower-income Americans were highly concerned about paying higher premiums, most people earning over $75,000 a year were also very worried about covering the costs of health insurance. health care system , Gallup learned.

ACA 72

ACA Doctors Health Care Reform Health Insurance 72

Health Populi

OCTOBER 8, 2019

More savings would accrue through the quicker adoption of value-based payment models, the authors assert, where clinicians take on financial risk for managing population health. The Centers for Medicare and Medicaid Services (CMS) forecasts that prescription drug spending will be the fastest-growing cause of rising health spending by 2027.

Prescription Drug Pricing 104

Prescription Drug Pricing Medicare Medicare ACA 104

MedTrainer

JUNE 28, 2023

From sophisticated Medicare fraud to a rising prevalence of telehealth fraud , healthcare organizations need to be diligent in understanding these threats. The FCA prohibits submitting false or fraudulent claims for payment to government healthcare programs, such as Medicare and Medicaid. Anti-Kickback Statute (AKS).

Fraud 52

Fraud Compliance Governance Compliance Officers 52

Medisys Compliance

NOVEMBER 6, 2023

Compliance with Regulatory Guidelines Ensure that all claims are submitted per all applicable laws and regulations, including the Health Insurance Portability and Accountability Act (HIPAA), the Affordable Care Act (ACA), and the Medicare Fraud, Waste, and Abuse (FWA) laws.

Compliance 59

Compliance Medical Billing Outsourcing Medical Billing ACA 59

Healthcare Law Blog

AUGUST 25, 2022

The expansive legislation includes key health care provisions, including drug pricing reforms, inflationary rebates, Medicare Part D benefit redesign, as well as myriad other updates. Medicare Drug Price Negotiation Program. The Inflation Reduction Act (“IRA”) was signed into law by President Biden on August 16, 2022.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare Law Blog

MARCH 20, 2023

1] In addition to the challenges presented by provider shortages, even when patients are able to locate an available mental health provider, many are hesitant to engage in treatment due to cost uncertainties, which often arise due to limited availability for in-network care and the subsequent need to seek out-of-network care. [2]

Medicaid 52

Medicaid Medicaid Licensing ACA 52

MedTrainer

AUGUST 2, 2023

Federal Government Audits These audits are performed by government agencies such as the Centers for Medicare and Medicaid Services (CMS). They aim to ensure compliance with federal healthcare programs like Medicare and Medicaid, reviewing claims, billing practices, and overall adherence to program requirements.

Compliance 52

Compliance ACA Medicaid Medicaid 52

Center for Health Insurance Reform

DECEMBER 12, 2022

As part of CHIR’s weekly installment of FAQs from our updated Navigator Resource Guide, we highlight questions about the marketplace and reproductive health care. Continue reading → The post Navigator Guide FAQs of the Week: Coverage of Reproductive Health Care appeared first on Center on Health Insurance Reforms.

Health Insurance 72

Health Insurance ACA Medicaid Medicaid 72

MedTrainer

MARCH 28, 2024

Law by law, regulations were added, increasing the complexity of maintaining compliance for healthcare organizations.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52