Government Coercion As A Vehicle To Alter Healthcare
The front page of the New York Times on Tuesday, October 18, 2011 stated that the Massachusetts Legislature, which previously mandates health insurance for all, has now moved into its next stage of attempting to contain the cost of healthcare. One way of containing the cost that has been applied around the globe is to […]
Healthcare Reform Developments
Over the last several weeks different events have occurred which will have an impact on the new healthcare system under the Affordable Care Act (ACA). There has been an acknowledgement and recognition by CMS officials that the portion of the ACA known as the CLASS Act is actuarially unsound and cannot be realistically implemented. What […]
Breaking News: CMS publishes Final ACO Regulations
Today was a busy day indeed for CMS. The agency has released the following: (1) the final Shared Savings Program regulations for ACOs; (2) a solicitation for participation in a new Advanced Payment Model designed to provide upfront payments to certain ACOs to assist with upfront infrastructure costs; and (3) a proposed rule implementing reforms […]
October 17, 2011 Regulatory Developments
Here are the most recent healthcare related regulatory developments as published in the New Jersey Register on October 17, 2011: On October 17, 2011 at 43 N.J.R. 2641, the Department of Human Services published notice of its proposed repeal of its regulations which require Medicaid and New Jersey FamilyCare beneficiaries or their representatives to sign […]
OIG Exclusion List Updated
Earlier this month, the Office of the Inspector General (“OIG”) of the U.S. Department of Health and Human Services updated its List of Excluded Individuals and Entities (LEIE). This announcement should serve as a reminder to all Medicare providers to check their employees and contractors against the LEIE database to make sure they have not […]
September 19, 2011 Regulatory Developments
Here are the most recent healthcare related regulatory developments as published in the New Jersey Register on September 19, 2011: On September 19, 2011 at 43 N.J.R. 2411, the Department of Banking and Insurance published notice of its proposed amendments to its rules governing health benefit plans’ internal claims and appeals processes as well as […]
Sustainable Growth Rate (SGR)
Both the American Hospital Association and the American Medical Association (together with numerous physician specialty organizations) , have submitted letters to the Medicare Payment Advisory Commission (MedPAC) in response to a “Proposal” which MedPAC adopted yesterday, on various issues. MedPAC Proposal freezes payments for certain primary care services and reduces reimbursement for all other “specialist […]
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