Policy and Legislation
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.
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.
At a time when the nursing home industry is lobbying Congress to avoid cuts in Medicare payments, a federal watchdog agency is reporting that taxpayers overpaid nursing homes $1.5 billion.
In an effort to accelerate the development of innovative care models within their respective health systems, Piedmont Healthcare and WellStar Health System announced earlier this week the joint formation of the Georgia Health Collaborative, the first such organization in the state.
President Barack Obama and House Speaker John Boehner, R-Ohio, say they want to avert the fiscal cliff, that toxic mix of expiring tax breaks and automatic spending reductions set to begin in January. If Republicans make concessions on taxes, Democrats and the president say, they'll move on entitlements, such as Medicare and Medicaid, as part of a larger deal to reduce the federal deficit.
Litigation or threatened litigation in the senior care space is an ever-present facet of running a senior care business. An online panel discussion on Nov. 8 addressed ways in which boards of senior care businesses can avoid, or at least manage, legal trouble.
With Medicare enrollment and spending set to grow in the coming decades, the program needs to better spread risk and incentivize value and also needs a better statutory definition of cost-benefit considerations, researchers argue in the latest issue of the New England Journal of Medicine.
Despite President Barack Obama's victory over Republican challenger Mitt Romney, a significant amount of work must be accomplished in the next four years to ensure that the next president cannot uproot the ACA via "repeal and replace."
Because healthcare providers operate in a highly regulated industry, most recognize that it is more a question of when, rather than if, they will be subject to a government investigation.