Health Care Reform

Ensuring Healthcare Compliance: Navigating the Complexities

2023-07-14T10:34:45-04:00By |Clinical Analysis, Clinical Operations Improvement, Compliance, Health Care Reform, HIPAA|

Healthcare compliance is a critical aspect of the healthcare industry, ensuring adherence to federal healthcare laws and regulations. It plays a vital role in preventing fraud, abuse, and waste, while upholding ethical standards for patient treatment. However, healthcare compliance is not a simple or straightforward task.

How Insurers Inadequately Report Medicaid Fraud

2018-07-17T16:39:56-04:00By |Health Care Reform, Health Insurance, Health Insurance Exchange|

The Senate released its version (a.k.a. Better Care Reconciliation Act BCRA) of the House's AHCA. Payers and providers adjust as needed because healthcare reforms, like BCRA, AHCA, and ACA, continuously move through state and federal legislatures. Today's blog, pulls together summaries from numerous resources allowing you a quick glimpse or a deep dive into what waits around the corner. Here are 10 instances which can help you better identify when its time to look for a partner.

How Can Medicaid Coverage Combat Opioids?

2018-06-12T19:36:44-04:00By |Health Care Reform, Health Insurance, Health Insurance Exchange|

CMS has released new resources describing how states can leverage Medicaid services and health IT tools to support beneficiaries battling opioid addiction. The organization released an Informational Bulletin to guide states on how to cover critical treatment services for Medicaid eligible infants with Neonatal Abstinence Syndrome (NAS), a postnatal drug withdrawal syndrome occurring primarily among babies exposed to opioids during gestation or shortly after birth.

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