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One in Two Americans with Work-Based Insurance Worries That Healthcare Costs Could Lead to Bankruptcy

Health Populi

workers with private insurance more likely report poor access to health care, greater costs of care, and lower satisfaction with care versus people covered by public health insurance plans — whether Medicaid, Medicare, VHA or military coverage. Health Populi’s Hot Points: U.S. households.

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Will CMS’s Proposed Rule on “Identified Overpayments” Increase Reverse FCA Cases?

Healthcare Law Today

” The currently proposed provision has similar effect to the language CMS proposed in 2012 and, after consideration of comments, ultimately rejected in the 2014 Final Rule (Medicare Advantage and Part D) and 2016 Final Rule (Medicare Part A and Part B). The public has until 5 p.m.

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Starting This Year, Health Care Providers Will Be Short Changed in Medicaid Reimbursements

The Health Law Firm

However, for the past two years, Medicaid programs have been required to reimburse primary care providers at Medicare levels, which is typically higher. The rate increase was part of the Affordable Care Act (ACA) as an incentive for providers to participate in Medicaid. However, that rate increase expired December 31, 2014.

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Fifth Circuit Upholds ACA Risk Adjustment Program

Healthcare Law Blog

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. United States Dep’t of Health & Hum. 20-50963, 2022 WL 807554, at *1 (5th Cir. The Risk-Adjustment Program.

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Administrative Simplification and ICD-10: Streamlining Health Care Operations

CMS.gov

By: Christine Stahlecker, Director, Administrative Simplification Group, Office of E-Health Standards and Services, Centers for Medicare & Medicaid Services. Visit our ICD-10 website for the latest news and resources to help you prepare for the October 1, 2014 , deadline.

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Day 3 Notes from the 42nd Annual J.P. Morgan Healthcare Conference

Healthcare Law Blog

John Kao, CEO of Alignment Healthcare, shared today that only 12% percent of their Medicare Advantage membership accounts for approximately 74% percent of their institutional cost (hospital and facility costs), while conversely their “healthy” membership of 74% accounted for only 5% of their institutional costs.

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New State Relief and Empowerment Waiver Guidance Gives States Tools to Help Fix Broken Health Insurance Markets

CMS.gov

Administrator, Centers for Medicare & Medicaid Services. After the Affordable Care Act’s (ACA) regulations took effect, we have witnessed a serious deterioration of the individual market across the country because of skyrocketing costs and the withdrawal of insurance plans. keya.joy-bush@…. Mon, 10/22/2018 - 16:57. Seema Verma.