bhoffman | August 25, 2010
Coordination of Benefits Handbook
Medicare clearly has a right of reimbursement of payments it made for medical services when a third party is determined to have responsibility for those expenses. 42 U.S.C. 1395y(b)(2). New Jersey’s collateral source rule provides that if a person receives benefits for injuries from any source other than a joint tortfeasor, those [...]
bhoffman | August 6, 2010
By Richard Wolf, USA Today
WASHINGTON — Savings projected under the landmark health care law signed by President Obama this year have improved Medicare’s financial projections, but Republican critics and even the program’s chief actuary say the new prognosis is too rosy.
Adam V. Russo | July 9, 2010
By Jerry Geisel of Business Insurance, www.businessinsurance.com
WASHINGTON—Employers that feared a $5 billion federal program to reimburse early retiree health care costs would run out of money before they could even file their application received good news last week.
Guidance issued by Department of Health and Human Services makes clear that eligibility for reimbursement through the Early [...]
Adam V. Russo | June 21, 2010
(PLANSPONSOR.com) –
A new report from Mercer suggests that the Patient Protection and Affordable Care Act (PPACA) will result in the U.S. continuing to operate short term with disparate and conflicting approaches to provider payment, outcomes measurement, consumer engagement, and plan administration.
Adam V. Russo | June 21, 2010
President Obama, on March 23, 2010, signed the massive health care reform package approved by the House on March 21, 2010. In a series of votes, the House passed both H.R. 3590, the Patient Protection and Affordable Care Act (the Affordable Care Act) and H.R. 4872, the Health Care and Education Reconciliation Act of 2010 [...]
Adam V. Russo | May 21, 2010
By TODD ACKERMAN HOUSTON CHRONICLE
Texas doctors are opting out of Medicare at alarming rates, frustrated by reimbursement cuts they say make participation in government-funded care of seniors unaffordable.
Two years after a survey found nearly half of Texas doctors weren’t taking some new Medicare patients, new data shows 100 to 200 a year are now ending [...]
Adam V. Russo | May 21, 2010
By JENNIFER HABERKORN
During the health care reform debate, physician lobbies including the American Medical Association, wanted a full overhaul of the Medicare formula, but agreed to back reform after Democrats said they would address it later.
Democrats in Congress have proposed easing a planned cut in payments to doctors under Medicare in an effort to stem [...]
Adam V. Russo | May 12, 2010
The proposed rule takes an “all-or-nothing” approach, where failure to meet any one of the requirements means the provider will not receive an incentive payment.
Letter to Health and Human Services Secretary Kathleen Sebelius
Healthcare providers need additional time and greater flexibility to meet criteria of the Centers for Medicare and Medicaid Services’ proposed electronic health record [...]
Adam V. Russo | March 31, 2010
Roberto Ceniceros
Most self-insured employers have their third-party administrator manage their Medicare reporting and compliance requirements, but others have turned to independents, several sources say.
The independent companies specialize in Medicare Secondary Payer compliance and reporting requirements under Section 111 of the Medicare, Medicaid and SCHIP Extension Act of 2007.
Adam V. Russo | February 9, 2010
In the waning days of 2007, with the cost of health care continually escalating and with more and more of the costs being borne by the United States Government, Congress passed and President Bush signed into law the Medicare, Medicaid and SCHIP Extension Act of 2007 (MMSEA). With the stroke of his pen, the President [...]
Adam V. Russo | January 20, 2010
Roberto Ceniceros
The U.S. government’s first-of-its-kind lawsuit against all parties that settled a pollution liability case signals Medicare’s aggressive push to make sure it does not pay medical expenses when others are to be the primary sources of payment, observers say.
The suit filed Dec. 1, 2009, cites Medicare Secondary Payer provisions in federal law that allow [...]
Adam V. Russo | January 19, 2010
The Office of the Actuary of the Centers for Medicare & Medicaid Services (CMS) recently released two new memoranda on the “Patient Protection and Affordable Care Act,” as approved by the Senate on December 24.
In one memorandum, CMS Chief Actuary Richard Foster discusses the impact the bill would have on costs, savings, and coverage. The [...]
Adam V. Russo | January 15, 2010
By Alvin D. Lurie
January 8, 2010
Copyright 2010, A.D. Lurie
Benefitslink.com
It should first be explained that this article was originally prepared for publication in the third week of December (2009), at which time the Senate was locked in fierce dispute between the Democrats and the Republicans over the health care reform bill, H.R. 3590 (grandiosely titled the [...]
Adam V. Russo | December 15, 2009
With clock ticking, Senate measure proposals in flux
Jerry Geisel
WASHINGTON—Health care reform legislation is inching its way to a Senate floor vote as Democratic leaders continue to wheel and deal to get the support needed to assure passage.
Adam V. Russo | December 15, 2009
Reid Still Looking For 60 Votes
Majority Leader Harry Reid (D-NV) is still seeking support from a number of Senate Democrats who have yet committed to support his healthcare reform package. As reported, a compromise package was negotiated between a select group of liberal and moderate Senate Democrats, which Reid has sent to the Congressional Budget [...]
