article thumbnail

Failures of Imagination in Public Health Policy

Bill of Health

Failing to anticipate litigation that challenges our efforts, such as with the ACA or the upcoming attempt to “codify Roe v. That is why the ACA’s Medicaid expansion doesn’t exist in 11 states , why the penalties for failing to have insurance under the “individual mandate” has been set to $0.00. Emphasis added.)

article thumbnail

Edifecs Acquires Risk Adjustment Solution Health Fidelity – M&A

HIT Consultant

What You Should Know: – Today, global health IT company, Edifecs announced it has entered a definitive agreement to acquire Health Fidelity, a San Francisco-based tech provider. Together, the companies will offer health plans and provider customers with the most complete risk adjustment solution in healthcare. Edifecs , Inc.,

ACA 52
Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Computer glitches and human error still causing insurance headaches for Californians

Healthcare It News

Since California expanded health coverage under the Affordable Care Act, a large number of people have been mistakenly bounced between Covered California, the state’s marketplace for those who buy their own insurance, and Medi-Cal, the state’s Medicaid program for low-income residents. “This shouldn’t be happening.

article thumbnail

HHS Issues Proposed Rule to Provide Clarity on Rights of Conscience in Healthcare

Healthcare Law Blog

Medicaid and Medicare The Balanced Budget Act of 1997, Public Law 105–33, 111 Stat. The Medicaid and Medicare statutes also contain conscience provisions related to the performance of advanced directives, religious nonmedical healthcare providers and their patients.

ACA 105
article thumbnail

What Is Medical Billing Compliance?

Compliancy Group

This is why a regular review of these contracts is essential so that providers and administrators can clear up uncertainties in the terms or conditions, remain compliant, and ensure the payer is engaging in fair practices.

article thumbnail

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

Healthcare Law Today

As written, the proposed rule would remove the existing “reasonable diligence” standard for identification of overpayments, and add the “knowing” and “knowingly” FCA definition.

article thumbnail

Who Is Responsible For Compliance In Healthcare?

MedTrainer

The answer has as many layers as the definition of compliance itself. But that’s only one aspect of this complex – and sometimes confusing – process. Just as perplexing is who is responsible for compliance in healthcare organizations.