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)…
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…
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…
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…
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…
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…
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.
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.
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
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.