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 ...
In CMS
Jun 18th, 2012
A May 2012 Office of Inspector General (OIG) report provides coders with an excellent reminder of two golden rules: 1) If it isn’t documented, it wasn’t done; and 2) Never code unconfirmed diagnoses. The purpose of the OIG investigation was to determine whether the diagnoses that PacifiCare of Texas, a Medicare Advantage (MA) organization owned ...
In CMS
Mar 12th, 2010
Health insurance executives and commissioners gathered in the Roosevelt room at the White House with Health and Human Services (HHS) Secretary Kathleen Sebelius March 3 to discuss insurance rate hikes that have occurred or are set to occur across the country. According to an HHS Assistant Secretary for Public Affairs (ASPA) pool report, the meeting ...
Mar 1st, 2010
Health and Human Services (HHS) Secretary Kathleen Sebelius sent a letter Feb. 24 to the heads of five insurers—UnitedHealth Group, WellPoint, Aetna, Health Care Service Corporation and CIGNA—inviting them along with leaders from the National Association of Insurance Commissioners (NAIC) to discuss planned premium increases across the country. HHS Secretary Invites Insurers to Discuss Rate ...
Nov 13th, 2009
Health insurers will soon have a new, independent database to use for determining out-of-network payment rates for physicians. Not-for-profit company FAIR Health Inc. and an Upstate New York research network headquartered at Syracuse University are charged with the task of developing the new database. New Out-of-Network Physician Pay Dbase is FAIR was last modified: July 5th, ...