The presence of Medicare Advantage plans in the healthcare marketplace continues to grow. Unless you have been living under a rock, you are aware that healthcare has been a topic firmly positioned at front and center in Washington, D.C. for the past nine months. This past week has been highlighted…
Rural healthcare is under siege from the current language in the looming American Health Care Act (AHCA), which is raising its own issues along with the vulnerability of Medicaid and the ongoing insurance exchange crises under the Patient Protection and Affordable Care Act (PPACA). That said, U.S. Sen. Bernie Sanders…
EDITOR’S NOTE: The Congressional Budget (CBO) on Monday scored the proposed Senate bill reporting 22 million more uninsured by 2026. On June 22, U.S. Senate GOP leadership unveiled the Better Care Reconciliation Act of 2017 (BCRA) to repeal the Patient Protection and Affordable Care Act (PPACA), known colloquially as “Obamacare”…
In early 2017, a federal Judge blocked a Centers for Medicare & Medicaid Services (CMS) interim final rule regarding premium assistance for end-stage renal disease (ESRD) patients. CMS did not technically bar ESRD patients from getting help with premiums. The agency was simply concerned with the inappropriate shifting of this…
With a mission to improve rural healthcare access and outcomes for underserved populations through innovation and promising practices, the role of community health workers (CHWs) is rapidly evolving across rural areas, having been recognized by the U.S. Department of Labor as an essential part of the cost- effective delivery of…
EDITOR’S NOTE: As congressional Republicans and the Trump administration grapple with challenges associated with their efforts to repeal and replace the Patient Protection and Affordable Care Act, talk continues to swirl about the possibility of a single-payer healthcare system. In this exclusive story, Howard Stein offers his personal opinion in…
Section 6411(b) of the Patient Protection and Affordable Care Act of 2010 (PPACA) requires the expansion of the Recovery Audit Contractor (RAC) program to Medicare Part C. While we may refer to either MA as Medicare Advantage (or a more accurate acronym, MAO, for Medicare Advantage Organizations), the simple fact…
The American Health Care Act (AHCA), which was introduced to Congress on March 7 as a repeal and replacement of the Patient Protection and Affordable Care Act (PPACA), narrowly passed the House Budget Committee in a 19-17 vote last Thursday, March 16, sending it to the House Rules Committee. Today,…
EDITOR’S NOTE:Matthew Albright will be the special guest on the March 27 edition of Monitor Mondays. Register now!This story was posted on Tuesday in the ICD10monitor e-News. Matthew Albright oversaw the certification program at the Center for Affordable Quality Healthcare (CAQH) and Committee on Operating Rules for Information Exchange (CORE)…