New Jersey Healthcare Blog

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Extension of Affordable Care Act Sign-Up Deadlines May Create Insurance Verification Uncertainty For Providers

Last week, the Centers for Medicare and Medicaid Services (“CMS”) issued an interim final rule which requires insurers to provide coverage effective January 1, 2014 through the health insurance exchanges to any individual who selects coverage through December 23, 2013.  In the preamble to the interim final rule, CMS stated that “ an effective coverage […]

UNITED HEALTHCARE ENJOINED FROM TERMINATING PHYSICIANS FROM MEDICARE ADVANTAGE PLANS IN CONNECTICUT

On December 5, 2013, Judge Stefan Underhill of the U.S. District Court for the District of Connecticut issued a temporary restraining order and preliminary injunction against various United Healthcare (“United”) entities that had terminated approximately 2,200 Connecticut physicians as participating physicians in United’s Medicare Advantage program.  After a number of its members received termination letters, […]

Impacts of the Debt Ceiling Agreement on Medicare Providers

While some of the politicians involved in the federal debt ceiling discussions have vowed to protect Medicare beneficiaries from any adverse impact, Medicare providers have been targeted for cuts, which may in the end adversely impact the ability of Medicare beneficiaries to receive treatment.  As part of the debt ceiling agreement struck earlier this week, […]

Diagnostic Testing: Accreditation for Medicare

Physicians, non-physician practitioners and Independent Diagnostic Testing Facilities that furnish the technical component (TC) of advanced diagnostic imaging services will need to become accredited in order to bill the Medicare program for such services after January 1, 2012. Advanced diagnostic imaging procedures are defined as including diagnostic magnetic resonance imaging (MRI), computed tomography (CT), and […]

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