Healthcare Finance Staff
A health law insurance program that was expected to boost consumer choice and competition on the marketplaces has slipped off course and is so far failing to meet expectations.
A coalition of civil rights advocates Tuesday called for a federal investigation of California's Medicaid program, alleging that it discriminates against millions of low-income Latinos by denying them equal access to healthcare.
Congress on Wednesday is considering legislation to allow physicians working in ambulatory surgical centers to receive the same payment incentives for meaningful use of electronic health records as doctors in other settings.
Under current law, reimbursement for biosimilars is calculated by a single code. Six physician groups that represent a wide swath of biologic-prescribing physicians, want to change that by urging Congress to press the Centers for Medicare and Medicaid Services to make unique codes for biosimilar medicines for billing and payment purposes.
As the December 15 deadline for January healthcare coverage neared, California's insurance exchange intensified efforts to sign people up in pockets of the state with exceptionally high numbers of uninsured residents. Covered California targeted such "hot spots" as San Francisco's Mission district, and Oakland's Fruitvale neighborhood, officials said.
As patients face high deductibles, price is a major topic that's put pressure on healthcare providers to offer price transparency, even though what a hospital charges can be far different from what a patient actually owes after their insurance covers some of the costs.
Among uninsured individuals who are not exempt from the Affordable Care Act penalty, the average household fine for not having insurance in 2015 will be $661, rising to $969 per household in 2016, according to a Kaiser Family Foundation analysis.
State insurance exchanges are healthy financially even without the federal funding that ran out this year, a top Obama administration official told a House subcommittee Tuesday. But that official refused to predict if any of the remaining 13 state exchanges would eventually need to shift to the federal exchange.
Triple-S Management Corporation has agreed to settle potential HIPAA violations with the U.S. Department of Health and Human services to the tune of $3.5 million, after repeatedly failing to put safeguards in place for its beneficiaries' PHI.
The boundary between being a provider and a payer is blurring as hospitals face more risk, according to Joe Nichols of Health Data Consulting, prompting health systems to make changes to keep from losing too much money.