Since most of the cost containment and settlement solutions vendors do charge the plan, this actually works against the health plan's ability to manage their expenses and comply with regulations. Health plans should look to solutions that support the MLR calculation and regulations, and maximize the speed and the amount of reimbursement to the provider.
We believe we can save health plans and self-funded employers 15% or more, and accelerate claims payments to providers from 90 days to 7 days. If you can do that, you can get the CFO of the healthcare organization to consider investing in the future, which includes all of the regulatory compliance work for ICD-10 and related initiatives.
Delaying ICD-10, AMA believes will help preserve its relevance, and its control over physician compensation. Sadly it seems that AMA hasn't served its own members well, or the healthcare industry. ICD-11 won't "arrive" in a year or two. Our health system needs to digest it and then determine when and how to move to it. While ICD-11 has some intriguing benefits, it is a long way off. The base version from WHO is expected in May 2015. After that, the United States will probably need another two years for development of the US version. The earliest it would be available for study would be 2017, and we would need another 4 years to implement it – so that brings us out to 2021, way too far in the future.
We do not support a delay in ICD-10. The delay hurts not only those who have invested dutifully to meet the CMS mandate on time, but it hurts independent contractors, small businesses, and Healthcare IT vendors who fill knowledge gap in Covered Entities who don't have the staff internally to meet this mandate.
EMR Certification (also called EHR certification) of electronic medical records or electronic health records is required for any vendor to be listed in the ONC Certified HIT Product List. We provide assistance on the certification process.
Almost everyone who studies the problem agrees that longitudinal health records are beneficial, but as I look into how HHS is hoping to do this, there are gaps that aren't being addressed.
On April 9, 2012 at 10:10am Pacific / 1:10pm Eastern time the Centers for Medicare and Medicaid announced a one year delay in ICD-10 to October 1, 2014.
PPACA - "the more conservative approach would be salvage rather than throwing out everything."
Edwin Kneedler argued on behalf of the Obama Administration. He argued that if the minimum coverage provision should fall, the guaranteed-issue and community rating rules should fall as well as “that is one package that Congress deemed essential.”
We remain hopeful that the electronic efficiencies of PPACA remain, such as Meaningful Use of Electronic Health Records, whatever the final outcome.
The Patient Protection and Affordable Care Act (PPACA) may not stand in whole or in part, depending on the severability determination of the Supreme Court.
An amicus curiae or "friend of the court" brief focused on whether the Court may leave PPACA in effect even if it determines that requiring all Americans to purchase health insurance or pay a penalty is unconstitutional.