As I’m sure you all have heard by now, a federal judge in Texas ruled on Friday, December 14th, that the entire Affordable Care Act was unconstitutional because the individual mandate had been reduced to zero. Some believe this will be reversed on appeal. Others feel validated by the ruling. While the law remains intact […]
A federal judge’s ruling against the Affordable Care Act last week has providers facing the unnerving prospect of a future without the landmark law to which they have spent years adapting. On Friday, Judge Reed O’Connor of the Federal District Court in Fort Worth struck down the ACA in a lawsuit brought in part by […]
Return readers will be happy to hear that the CMS is delaying its changes to E&M payments. In the 2019 Medicare Physician Fee Schedule Final Rule, the CMS stated it will not be reducing E&M payments from five levels to two, but to three levels, and that it will not be doing it until 2021. […]
Three more states voted in this previous election to expand Medicaid. Virginia will be going forward with Medicaid expansion on January 1, 2019. Though Medicaid reimburses you at a very low rate, they will pay more than most self-pay patients and the cost to collect is much lower. The payer mix shifting from uninsured to […]
A simple way to lose out on patient service reimbursement is to send a bill to a commercial or government payer and then sit on your hands waiting for their response. Though it may seem elementary, it is important to set strategic follow-up standards for business office staff after bills have been sent out the […]
Thursday, September 28, 2017
2:00 pm Eastern Time
With wholesale repeal and replacement of the Affordable Care Act stalled for the time being, states have little recourse but to focus on their own waiver programs as avenues for reforms. The political standoff in Washington may have avoided, or postponed, massive cuts to state Medicaid programs, but U.S. House and Senate bills eviscerating the program are also giving state policymakers pause when making their own waiver changes. At the same time, the U.S. Department of Human Services is pushing to streamline and shorten the Medicaid waiver process.
Meanwhile, a recent proposal from HHS to cancel the Episode Payment Model and roll back the Comprehensive Care for Joint Replacement program has also cast doubt on the Trump administration’s attitude toward value-based care models. Voluntary bundled payment models, either created by CMS or submitted through the Physician-Focused Payment Model Technical Advisory Committee, will replace mandatory demonstrations produced during the Obama administration. While the current shifts at the federal level, large employers in the commercial sector will continue to drive interest in direct contracts with integrated delivery networks and independent specialists for procedure-focused bundled payments.
This webinar will explore:
- What is the status of Medicaid managed care in the current political climate?
- What is the outlook for further changes to the Medicaid program at the federal level?
- How are states responding to uncertainty from Washington when it comes to implementing their own waiver programs?
- How could future voluntary bundled payments resemble existing programs in Medicare, and how could they differ?
- How can bundled payments offer providers a competitive advantage in a market?
The Centers for Medicare & Medicaid Services is currently soliciting comments from the public on potentially large changes to the skilled nursing facility (SNF) prospective payment system (PPS) methodology. In an Advance Notice of Proposed Rulemaking (ANPRM), CMS is looking to update how SNFs are reimbursed while requesting comments from the public before issuing a […]
Open enrollment for this, the fourth year of the insurance marketplace, opened on November 1st. On November 8th, Donald Trump, a candidate who ran on the promise of repealing and replacing the Affordable Care Act (ACA), was elected president. What does this mean for the healthcare system going forward? Though it is foolish to try […]
The Centers for Medicare & Medicaid Services (CMS), the federal agency that administers Medicare and Medicaid, announced on September 8 a new rule intended to strengthen provider preparedness for natural and man-made disasters. The rule will apply to all healthcare facilities participating in the government-run programs, which account for about 60% of hospital care, according […]