Reimbursement

Nearly a year after providing guidance that broadly defined essential health benefits (EHBs), the U.S. Department of Health and Human Services on Tuesday put some meat on the bones with a detailed set of proposed rules that will determine the required components that must be offered beginning in 2014 through all non-grandfathered health plans.

In an effort to control costs and get people covered by health insurance, the Affordable Care Act offers a number of options for covering low-income people. Among those options is the Basic Health Program, which some say will save money and others say will kill health insurance exchanges.

With the passage of a ballot initiative this month, Massachusetts became the latest state to allow the use of marijuana for medical purposes, joining 17 others and the District of Columbia.

In the late 1990s, New York City small businesses saw surging healthcare costs and many small business employees were going without insurance. As part of broader efforts to warm the city's business climate, in 1999 mayor Rudolph Giuliani awarded a $1 million grant to the New York Business Group on Health to create the not-for-profit insurance exchange HealthPass New York.

Pharmacists at 25 Rite Aid stores in greater Cleveland are offering diabetes control programs, as a part of UnitedHealth Group's community-based diabetes management and prevention initiative.

GOP governors mull exchange options; NAIC compiling list of questions for HHS on HIX implementation; and Conn. group urges state exchange to be an "active purchaser" in this week's HIX Digest.

The U.S. Department of Health and Human Services (HHS) will need to place a lot of emphasis on implementing the Affordable Care Act (ACA) in the coming year, according to the Office of Inspector General's (OIG) annual summary of management and performance challenges facing the agency, released this week.

More than half of all Medicare claims denial appeals are overturned by administrative law judges according to a recent report by the Office of Inspector General.

Data released last week for the S&P Healthcare Economic Composite Index shows that the average cost of healthcare services increased 5.06 percent over the preceding 12 months ending in September, a significant drop from the annual growth rate of 5.7 percent reported in August.

More than half of all Medicare claims denial appeals are overturned by administrative law judges according to a recent report by the HHS Office of the Inspector General.