In an August 9, 2018 proposed rule, the Centers for Medicare & Medicaid Services (CMS) seeks to redirect the Medicare Shared Savings Program (MSSP) on so-called “Pathways to Success.”
Telehealth Trend: Are Your Claims Reimbursable Under Medicare?
With the global telehealth market projected to more than quadruple in value over the next five years, even slow-moving government payors have responded to the pressure to expand reimbursement options for telemedicine services. But reimbursement woes continue to top the list of concerns voiced by providers, and the U.S. Department of Health and Human Services, Office of Inspector General (“OIG”) is keeping a watchful eye on reimbursement-related growing pains. On April 30, 2018, OIG released a report that identifies the impact of some of these growing pains on Medicare claims payments.
Texas Governor Signs Legislation Expanding Balance Billing Mediation and Other Protections
On May 23, 2017, Texas Governor Greg Abbott signed Senate Bill (SB) 507, expanding the current law dealing with “balance billing.”
Balance billing occurs when an insured patient receives care from a physician, hospital or other healthcare provider, who is not part of a patient’s health plan provider network. The out-of-network provider then bills the
Improving Physicians’ Negotiation Skills
Since the first managed care plans were introduced, relationships between physicians and payers have been rocky. It has not been uncommon for controversies between the two sides to result in lawsuits, contract terminations and regulatory intervention. Both sides recognize that each needs the other to survive — payers must populate their networks with sizeable numbers of physicians, while physicians must contract with payers to get reimbursed for patient care.
SXSW 2017 –Dare Enter the World of the FDA?
The weather has cleared and SXSW is well underway! The HBInnovate team has been sharing its experiences via Twitter and blog, keeping everyone up-to-date on the innovations and creative ideas on display.
Hot at SXSW continues to be healthcare products and services that rely upon a phone or tablet. Everyone sees the tremendous potential phones and tablets have in supporting our health and wellness. One of the most common concerns from healthcare startups has been how to do roll-out products and services compliant with The Food and Drug Administration (FDA).
Physician Payments Sunshine Act
On February 1stthe long overdue final rule of the Sunshine Act was released. The Act aims to increase transparency relating to payments and investments held by physicians and teaching hospitals. For those many physicians who have entered into some type of contractual relationship with a manufacturer, taking the time to familiarize themselves with