Read more about the article MACRA : “A” is for Access and “C” is for Children
MACRA's vision is that early interventions with children are key to reduce costly chronic diseases later in life. For this to work, education, access and health data interoperability are imperative.

MACRA : “A” is for Access and “C” is for Children

MACRA Changes Health Care Economics with a Focus on ChildrenMACRA Background: A final rule released on Oct. 14, 2016 by the Centers for Medicare and Medicaid Services (CMS) details the final…

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Value Based Insurance Design New Clinical Categories for MA Plans

The Centers for Medicare & Medicaid Services (CMS) is announcing refinements to the Medicare Advantage Value-Based Insurance Design (MA-VBID) model. Beginning January 1, 2018, CMS will add rheumatoid arthritis and dementia…

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Dual Eligibles for Medicare, Medicaid come under fire

  Dual Eligibles for Medicare, Medicaid cost too much.   The administration that created the Patient Protection and Affordable Care Act with Medicaid expansion as a centerpiece to cover more low-income insureds…

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CMS Moves forward with CPC+ that Includes PMPM to PCPs

According to CMS, the Original Comprehensive Primary Care (Original CPC) Model, is being replaced with the Comprehensive Primary Care Plus (CPC+) which is intended to allow health care provider practices to apply for one of two program tracks, with increasing payment and care redesign expectations from Tracks 1 to 2.

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Expert Witness for Future Medical Costs in Life Care Plans

In our experience, one strategy is to work within the Superior Court or State Court level and then appeal to a higher court perhaps at the Federal level. Some courts have elected not to hear testimony regarding future care costs under the Affordable Care Act, only to find that it is the law of the land and now has an impact. There are also unintended consequences in product liability cases. Third party liability and subrogation may also be affected.

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CMS Merit Based Incentive Payment System (MIPS) in 60 Day Comment Period, Sunsetting of Meaningful Use

New Federal healthcare industry payment models, based on the April 27th release of a proposed rule, present MIPS, MACRA, and APM methods for calculating healthcare reimbursement. The document proposes once…

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Interoperability in Healthcare: Are Anti-Competitive Forces Limiting Innovation and Patient Benefits?

According to a physician in Utah, Health Information Exchanges don't work very well yet. Dr. Raymond Ward, MD is a member of the Utah State Legislature.  "When I try to…

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Expert Witness Medicaid Expansion Affordable Care Act

As an expert witness I am regularly requested to provide opinions regarding the value of medical care under the Affordable Care Act. A misunderstood and often overlooked centerpiece of the Patient Protection and Affordable Care Act—often referred to as “Obamacare” or "ACA"—is the expansion of Medicaid eligibility to people with annual incomes below 138 percent of the federal poverty level.

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Whitehouse Requests Updates to Regulatory Framework For HIPAA Compliant Precision Medicine

Precision medicine targets disease at a genetic level for groups of patients with specific attributes.  Sharing patient data at the point of care introduces new opportunities and new HIPAA Privacy…

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Affordable Care Act Expert Witness Work Requires Attorney Education

In my work as an expert witness regarding the Patient Protection and Affordable Care Act (also known as the "ACA" or "Obamacare"), I find that more medical malpractice and personal industry cases as well as cases involving requirements for insurance coverage for self-insured employer's employees encompass ACA in their scope. The ACA may change the economics of healthcare as they apply to a legal matter involving damages, value of care, or insurance coverage and benefits.

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Employer Deadlines for Insurance Under the Affordable Care Act Extended by IRS

The deadline for employers to electronically file the so-called 1094 forms for 2015 which provide coverage information to the IRS was extended to June 30, 2016 from March 31, while non-electronic form reporting was delayed to May 31, 2016 from Feb. 29.

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