Feb 13th, 2018
Aetna is under investigation in California for allegedly not following protocol when making coverage decisions. One Aetna member, Gillen Washington, 23, claims it nearly cost him his life. Washington is suing Aetna for breach of contract and bad faith, according to CNN. Case for the Plaintiff Washington, who has common variable immunodeficiency (CVID), claims Aetna ...
In CMS
Jan 18th, 2018
The Centers for Medicare & Medicaid Services (CMS) has extended enrollment periods for those impacted by 2017 hurricanes in Puerto Rico and the U.S. Virgin Islands. This gives them access to health coverage on the Federal Health Insurance Exchange and provides additional time to join, drop, or switch Medicare health and prescription drug plans. The ...
Jul 13th, 2012
Where are the health care jobs now, and where will they be in the future? Georgetown University’s Center on Education and the Workforce just completed a study that indicates the states with the largest number of health care job openings are California, Texas, New York, Florida, and Ohio. Here is some detail: California Number of ...
In Audit
Sep 16th, 2011
If you’re having a hard time getting Medicare to pay for radiologic chest examinations claims, you’re in good company. In Southern California alone, Palmetto GBA recently reported a 46.3 percent charge denial rate. And that was just between the months of February and April of this year. The Jurisdiction 1 Medicare administrative contractor (J1-MAC) recently ...
In Coding
Mar 1st, 2010
Californian hospitals and nurse anesthetists generally agree with Gov. Arnold Schwarzenegger’s decision last summer to opt out of a Medicare provision requiring physician supervision of certified registered nurse anesthetists (CRNAs) in hospitals, but a couple of state physician organizations do not. Whereas the former group says opting out will ensure patient access to anesthesia services, the lat...