Is Parity Possible? New Questions Arise
Is Parity Possible? The Mental Health Parity Act was signed into law in September 1996. It states that services treating mental and substance abuse disorders and medical-surgical conditions must be the same, including coinsurance, co-payments and limits on days and visits. New Questions Arise There is quite a bit of controversy about whether parity is […]
Building State Exchanges – And the Challenges
Some of the top obstacles states will face as they create insurance exchanges as dictated by the Affordable Care Act under healthcare reform.
Reliance on Medicaid Managed Care Grows
According to a new national survey, more and more states are relying on Medicaid managed care plans, and the federal healthcare reform law hasn’t even been fully implemented yet. These states anticipate turning to Medicaid managed care organizations (MCOs) as a way of handling budgetary pressures as well as dealing with the estimated 16 million […]
ACA – Paved with Good Intentions…
The idea behind the Affordable Health Care Act (ACA) is noble and true. The implementation may be a bit more complicated.
The Affordable Care Act – The Communication Obstacle
Over the next three years, as part of the ongoing healthcare reform initiative the Affordable Care Act (ACA) will be rolled out. As this Let’s discuss the most common Affordable Care Act obstacles hospitals are encountering. Communication Obstacles Surrounding The Affordable Care Act
Affordable Health Care Act: In A Nutshell
The basics of the Affordable Care Act, including some the provisions to help clarify the main legislation in the world of healthcare reform.
The Billion Dollar Cost of Fraud
Fraud Prevention Initiative
Healthcare fraud and abuse affect everyone in the healthcare system and interfere with Medicare’s ability to serve future generations. To address this growing problem, the federal government continues to attempt to recover improper payments and prevent fraud. The federal government’s recovery of a record $4 billion last year from people who attempted to defraud seniors […]
RAC Audit Overview
Fraud and Abuse-False Claims Act in Healthcare
The False Claims Act, as we discussed in our prior post, encompasses any government spending program. Our focus will be on the FCA as it specifically relates to healthcare fraud and abuse. What is The False Claims Act? The FCA was amended again in 1993. Within that amendment, the Attorney General announced that pursuing health […]