Reimbursement
In late December, President Obama signed into law the Bipartisan Budget Act of 2013, which includes the Pathway for SGR Reform Act of 2013. While SGR drew most of the media attention, the Act includes a number of other provisions impacting the Medicare and Medicaid programs.
The California Department of Managed Health Care is trying to end the practice of emergency care "balance billing," just as thousands of new HMO members are being created.
Call 2013 the time that ICD-10 stood still. Certain facets of the industry may actually be less prepared than last January, while some organizations made industry-leading strides.
It's been rare that state credit ratings have been driven by Medicaid budgets, but that could be changing.
Despite the noise around the higher cost of some health plans on the exchanges, rate increases generally have more to do with the trend of steadily higher medical costs than with provisions of the Affordable Care Act.
Global pharmaceuticals and healthcare products company Abbott Laboratories has agreed to pay the United States $5.475 million to resolve allegations that the company violated the False Claims Act by paying improper kickbacks to induce doctors to use some of its products.
President Barack Obama gave doctors a holiday gift of sorts at the end of the year when he signed the Pathway for SGR Reform Act, sparing physicians and other practitioners who treat Medicare patients from the 24 percent payment reduction previously slated to take effect the first of the year.
Humana and Minnesota-based Healthsense, a provider of aging services technologies, have enrolled Medicare members with chronic health conditions in a pilot to measure the impact that in-home sensors and remote monitoring technology have on improving health outcomes and reducing frailty and fall-related hospital admissions.
Medicaid directors in the 25 states, plus D.C., expanding eligibility are cautiously optimistic of the benefits, but they're also expecting new costs from some potentially overlooked areas and they're not entirely trustful of Congress.
While the past year was relatively tame regarding ICD-10, at least in regard to the mad scramble some expect leading up to October 1, 2014, there were some significant developments.