OIG Regulatory Guidance Standards
OIG Regulatory Guidance from the Office of the Inspector General for U.S. Department of Health and Human Services

OIG Regulatory Guidance Standards

What is OIG Regulatory Guidance in Healthcare? OIG Regulatory Guidance has seven elements and is divided by the healthcare industry sector. The U.S. HHS Office of the Inspector General (OIG)…

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American Health Care Act DOA. What Does it Mean for Medical Cost Litigation?
Paul Ryan failed to marshall enough Republicans to vote for the American Health Care Act

American Health Care Act DOA. What Does it Mean for Medical Cost Litigation?

American Health Care Act supporters, such as Paul Ryan, had to acknowledge that the Act was dead on arrival Friday.  Despite the fact that the Trump Administration presides over a…

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Rand Paul: Affordable Care Act Under Trump Administration “Legalize Low Cost Insurance”
Re-elected Senator Rand Paul interviewed on Fox News Channel November 9, 2016 hints at what changes may be in store under a Trump administration regarding the Affordable Care Act

Rand Paul: Affordable Care Act Under Trump Administration “Legalize Low Cost Insurance”

Senator Rand Paul (R) Kentucky was re-elected on November 8, 2016. In his interview on Fox News Channel Wednesday November 9, 2016 he re-iterated his statement that one of the first…

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Trump Executive Order, ACA No Immediate Impact Promises Simplification and Freer Markets
Trumpcare, President Donald Trumps first executive order regarding the Affordable Care Act

Trump Executive Order, ACA No Immediate Impact Promises Simplification and Freer Markets

The Trump Executive Order, ACA sends more of a message rather than effecting any immediate change.  It signals a reduction in administrative burden to the American healthcare economy. TrumpCare may…

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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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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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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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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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Inpatient Psychiatric Facilities Impacted by Affordable Care Act, ICD-10

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.

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