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.
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.
Buy insurance by Sunday, January 31, 2016 which is the last day to buy health insurance to avoid a $695 per adult and $347.50 per child penalty, or 2.5% of annual household income whichever is higher
healthcare expert witness work in medical coding and billing, usual customary and reasonable cost of care, HIPAA Privacy, HITECH Act, and Affordable Care act require special considerations
Peyton Manning's privacy was violated by Guyer Institute IF the press is accurately presenting the facts about the patient and the HIPAA covered entity.
CMS stated that its systems are being updated to accommodate ICD-10 NCDs and LCDs. This also resulted in "temporary" suspensions of payments for LCDs.
by Michael Arrigo In my experience serving as HIPAA Expert Witness on HIPAA Privacy and Security advising clients in HIPAA breach litigation cases, one of the most important and challenging…
ICD-10 and Meaningful Use Webinar - Synergies, Workflows Risks and Opportunities Context and Learning Objectives The recent CMS / AMA announcement on ICD-10 implementation; who is now eligible for a…
Section 1886(s)(4)(C) of the Social Security Act, amended by sections 3401(f) and 10322(a) of the Affordable Care Act requires IPFs to report quality data for 6 quality measures starting in fiscal 2013 for Medicare beneficiaries. Beginning in FY 2015, two quality measures are added. Why does this matter in the context of ICD-10? The quality measures will be based on diagnosis and procedures coded in ICD-10 beginning October 1, 2015.
The inefficient markets theory is being reconsidered after the 2007 financial crisis in the U.S. Is it enough to provide the public with data on the cost of a service or alternative ways to purchase it? In healthcare the intersection of price, quality and sources of suppliers alone does not determine whether pricing is appropriate.
Clinicians are in a knowledge management crisis – massive amounts of data but getting the right information to clinicians, IT personnel and others at the right time is the challenge. What was missing from the RAND report were biomedical informatics perspectives.
ICD-1o and ICD-9 dual coding has been proposed in H.R. 3018 so called the Coding Flexibility in Healthcare Act of 2015 (Code-Flex) which aims to provide for a safe harbor…