Reimbursement

PGBA, a BlueCross BlueShield of South Carolina subsidiary company has been awarded a new contract by UnitedHealth Military and Veterans Services (UMVS) to help process TRICARE claims.

The Office of the National Coordinator for Health IT has made available the next version of the Connect gateway software that incorporates the most up-to-date technical standards and descriptions for the nationwide health information network (NwHIN) Exchange to support functions like patient discovery and query and retrieval of documents.

The Centers for Medicare and Medicaid Services released on March 16 its final rule on changes to Medicaid eligibility to support policies that will expand insurance to millions of uninsured Americans and provide simple procedures to gain coverage. Medicaid expansion relies heavily on the use of information technology to automate and coordinate processes.

Mitt Romney is catching grief for a newly discovered interview where he defends the individual mandate in terms of personal responsibility, and cites the government or private payers picking up the tab for an uninsured person's hospital care as "socialism." Whether or not he still stands by that argument, there's good logic to it.

The Centers for Medicare & Medicaid Services' Office of E-Health Standards and Services (OESS) announced Thursday it would postpone enforcement of HIPAA 5010 transactions until June 30, 2012, the second three-month delay since going live on January 1.

Blue Cross Blue Shield of Tennessee (BCBST) has settled a potential violation of HIPAA privacy and security provisions with the Department of Health and Human Services for $1.5 million. It is the first enforcement action resulting from the HITECH Breach Notification Rule.

As part of The Centers for Medicare & Medicaid Services effort to dramatically reduce hospital readmissions by 2013, the agency has announced 23 new organizations that will participate in its Community-based Care Transitions Program (CCTP).

Aetna last week announced that it will enter into a collaborative care model with the Connecticut State Medical Society Independent Practice Association (CSMS-IPA) incorporating more than 500 CSMS-IPA physicians.

The DoD and VA are employing open source in their mammoth joint iEHR to an extent the federal government has not previously attempted –

Aetna and the Connecticut State Medical Society Independent Practice Association have announced a collaborative care model that will incorporate more than 500 CSMS-IPA physicians.