Politics, Medicaid, and Mandates for ICD-10 Implementation

Some states are considering exiting the federal Medicaid program. Texas and other states are in the news regarding a potential Medicaid opt-out as is South Carolina.

We believe this is not practical and is probably more of a political stand than anything else.   Given the large percentage of costs that the Feds pay, it is not clear how the States could fund their programs.  What would happen to those on Medicaid?   What is clear is that the tension over spending on health care is moving to a new level.

In light of new regulatory measures, health plans and providers need smart strategies comply with ICD-10 and the underlying EDI standard HIPAA 5010.   An Assessment and Implementation plan developed by your in-house team in collaboration with experienced advisors is one good way to reduce the risk of spending more than you  have to to meet these mandates by October 1, 2013.

.

Michael Arrigo

Michael is Managing Partner & CEO of No World Borders, a leading healthcare management and IT consulting firm. He serves as an expert witness in Federal and State Court and was recently ruled as an expert by a 9th Circuit Federal Judge. He serves as a patent expert witness on intellectual property disputes, both as a Technical Expert and a Damages expert. He leads a team that provides Cybersecurity best practices for healthcare clients, ICD-10 Consulting, Meaningful Use of Electronic Health Records. He advises legal teams as an expert witness in HIPAA Privacy and Security, medical coding and billing and usual and customary cost of care, the Affordable Care Act and benefits enrollment, white collar crime, False Claims Act, Anti-Kickback, Stark Law, Insurance Fraud, payor-provider disputes, and consults to venture capital and private equity firms on mHealth, Cloud Computing in Healthcare, and Software as a Service. He advises self-insured employers on cost of care and regulations. Arrigo was recently retained by the U.S. Department of Justice (DOJ) regarding a significant false claims act investigation. He has provided opinions on over $1 billion in health care claims and due diligence on over $8 billion in healthcare mergers and acquisitions. Education: UC Irvine - Economics and Computer Science, University of Southern California - Business, studies at Stanford Medical School - Biomedical Informatics, stutdies at Harvard Law School - Bioethics. Trained in over 10 medical specialties in medical billing and coding. Trained by U.S. Patent and Trademark Office (USPTO) and PTAB Judges on patent statutes, rules and case law (as a non-attorney to better advise clients on Technical and Damages aspects of patent construction and claims).

Leave a Reply