Blogs in Industry News

Health insurance, healthcare reform and the double game

 March 18, 2010 Ed Howe
Healthcare reform seemed to be on the ropes earlier this year. But lo and behold, insurance companies raised rates enormously in the individual market. MORE
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Fraud referrals from RACs likely

 March 18, 2010 Carla Engle
The RACs will now be responsible for referring to CMS any cases of potential fraudulent activity identified during the course of their own improper payment investigations. MORE
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The CDC today

 March 17, 2010 Effect Measure
When Thomas Frieden took over as CDC Director less than a year ago, I didn't know what to think. The CDC is an agency under a lot of budget stress and choices have to be made. MORE
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An uncertain future for Medicare patients

 March 12, 2010 Ed Howe
In recent months the Mayo Clinic announced their primary care facility near my home in Phoenix would no longer be accepting Medicare. Then the fun began. MORE
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Life in the trenches of the health insurance business

 March 11, 2010 Stephanie Cohen
This month’s health insurance nightmare: You believe the cost of your policy is too high and the benefits too low. MORE
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RACs roll with OIG

 March 09, 2010 Cheryl Servais
We all suspected it, but now it's official: RACs will be providing information to CMS for follow-up on cases of possible fraud. MORE
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The issue has become arrogance, not healthcare

 March 08, 2010 Robert Laszewski
Away from Washington, people I talk to are just amazed at what the Democrats are in the process of doing on healthcare. MORE
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Health Reform Could Harm Medicaid Patients

 March 08, 2010 Edward Miller
Both the House and Senate health-care reform bills call for a large increase in Medicaid—about 18 million more people will begin enrolling in Medicaid under the House bill starting in 2013, Centers for Medicare and Medicaid Services (CMS) Actuary Richard Foster estimates. MORE
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Hospitalists and the patient experience

 March 02, 2010 Mike Stephens
The growing shortage of general internal medicine physicians is occurring at a time when an aging population will require more, not fewer, to provide primary care. MORE
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New CERT report shows high error rate in DME claims

 March 02, 2010 Barbara Vandegrift
Medically unnecessary services topped the list of claim errors in the latest comprehensive error rate testing (CERT) report compiled in November 2009 and released last month by the Centers for Medicare & Medicaid Services. MORE
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Why medical costs can be so high

 March 01, 2010 Kester Freeman
Have you ever wondered exactly what you or your insurance provider are being charged for after you have been hospitalized? MORE
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The President's healthcare plan: Not a game changer

 February 23, 2010 Robert Laszewski
It is hard to see how the healthcare plan the President released on Monday changes anything. MORE
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No Country For Young Nurses

 February 22, 2010 Olga Khazan
For years, nursing schools lured students with the promise that they would be snapped up by prestigious hospitals upon graduation, remunerated for their hard work with good pay and enviable job security. And they were right - until now, that is. MORE
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Physicians and rehab facilities are now RAC targets

 February 19, 2010 Ernie De Los Santos
Analysis of the newly posted issues from Connolly Healthcare and Health Data Insights reveals that for first time Rehabilitation Facilities and Physician Practices are now more heavily targeted than before. MORE
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Anthem Blue Cross and too much greed

 February 18, 2010 Don Ammon
As a retired healthcare leader, I find the current proposal by Anthem Blue Cross to raise rates in California by 39 percent for some 700,000 subscribers quite unbelievable. MORE
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A hospital executive's advice to Obama

 February 17, 2010 Ed Howe
From the vantage point of having run a large U.S. healthcare system, I can see that certain strategic changes are needed in order to make President Obama’s healthcare reform goals a reality. MORE
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Newest PEPPER data now available for hospitals

 February 16, 2010 Barbara Vandegrift
There's a new PEPPER report, and those who know that the acronym isn't just an all-around-useful kitchen spice can now go to My Quality Net to obtain a copy. MORE
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Health insurance companies shouldn't exist

 February 15, 2010 Effect Measure
2009 was a dismal year, economically speaking - unless you were a health insurer. MORE
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Connolly posts 19 new DRG validation issues

 February 11, 2010 Ernie De Los Santos
Connolly Healthcare, the RAC for Region C, has posted 19 new approved issues for Complex Review on their RAC Issues page. MORE
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Complaint-based process presents major problems for HIPAA transaction code set adoption

 February 10, 2010 Randal J. Roat
The very nature of the process for reporting violations of HIPAA Transaction and Code Sets serves only to deter their adoption, making complaints meaningless. MORE
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