MMSEA PAID ACT and SMART Act
PAID Act Plus SMART Act Requires NGHPs to Report or Pay Penalties The Medicare, Medicaid and SCHIP Extension Act (MMSEA) of 2007 contains mandatory insurer reporting in Section 111 for…
What Does Medicare Cover Under Part B?
1. What Does Medicare Cover under Part B? What does Medicare cover? Medicare is health insurance for: People 65 or older Under 65 with certain disabilities People of any age…
Medicare Future Sounds Like Medicare Past
Forbes published an article on December 11, 2019, after interviewing the Administrator of the Centers for Medicare and Medicaid Services (CMS), Seema Verma. Ms. Verma itemized three focus areas: the lack…
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…
ICD-10 Readiness Compromised by ICD-10 Revenue Cycle, Analytics Vendors
We find that most analytics and revenue cycle companies are ignoring the future role coordinated medical coding will have, the transition to ICD-10, and the clinical documentation and processes on the revenue cycle. The ICD-10 transition will re-write the book on revenue cycle management (RCM). RAC audits and Electronic Medical Records (EMRs) will be subject to a new paradigm with ICD-10.