In CMS
Dec 7th, 2015
Last year’s National Health Expenditures has been released by Centers for Medicare & Medicaid Services (CMS). Overall healthcare spending increased by 5.3 percent in 2014 ($3.0 trillion, or $9,523 per person), according to the study published by the Office of Actuary at CMS. The press release of the results said, “Those rates are below most years prior ...
On November 19, one of the nation’s largest insurers announced they were second guessing their choice to sell coverage in the Affordable Care Act’s individual markets for 11 states. According to MSN, UnitedHealth’s “Losses from the plans this year and next will total more than half a billion dollars.” Although UnitedHealth was late to join ...
Jun 25th, 2015
The U.S. Supreme Court has ruled that federal subsidies are legal under the Affordable Care Act (ACA) for those individuals who purchase insurance from federally run healthcare exchanges. The 6-3 decision in King v. Burwell marks a major victory for proponents of the ACA, or Obamacare. As CNN reported: The income-based subsidies are crucial to ...
In Billing
Jun 15th, 2015
by John Verhovshek, MA, CPC As part of an active compliance program, your practice should take steps to identify and, where appropriate, return overpayments. Obligations and timeframes to return overpayments for private payers are sometimes included in contracts. The Medicare program includes program manual instructions on overpayments. In most cases, overpayments are returned to the ...
In Billing
Apr 13th, 2015
The term “biosimilar” has been popping up a lot lately. What does it mean, and why should you care? What are Biosimilars? Many medications are biological products. In terms of pharmacology, a biological is any substance derived from animal products or other living organisms used to treat or prevent disease. Biological products are manufactured through biotechnology, ...