Tuesday, July 7, 2015

  • Regulators at the Federal Trade Commission and the Department of Justice will scrutinize any potential mega mergers among health insurance companies for signs of market dominance and the attendant risk of higher costs.

  • "To think we can implement this huge undertaking all on one day is simply ridiculous," says the former president of the Medical Association of the State of Alabama.

  • Not only is the practice of copying a block of prewritten text and pasting it into a patient record a questionable billing practice, it also creates the potential for adverse patient outcomes.

  • The U.S. Supreme Court's decision settles one argument, but the ruling does not affect all hospitals or patients in the same way-and it doesn't even address other big problems with healthcare access and cost.

  • The Agency for Healthcare Quality Research says its mission "is to produce evidence to make healthcare safer, higher quality, more accessible, equitable, and affordable." But that mission may soon be over.

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NEWS

by JOHN COMMINS | 07/07/2015

Market consolidation by health insurers is raising the specter of anti-competitive behavior and fears of patient harm among physicians, hospitals, and health systems.


by STEVEN ANDREWS | 07/07/2015

For one year after implementation of ICD-10, CMS will not deny or audit claims just for specificity, as long as the code is from the appropriate family of ICD-10 codes. Similarly, physicians will not be penalized for the value-based payment modifier or Meaningful Use due to specificity of diagnoses.


by STEVEN ANDREWS | 07/06/2015

CMS proposes that for stays expected to last less than two midnights, an inpatient admission would be acceptable on a case-by-case basis. Enforcement of the two-midnight rule would shift to quality improvement organizations from recovery auditors.


by ALEXANDRA WILSON PECCI | 07/06/2015

A proposal to set a floor and a ceiling on health insurance payments is an effort to eliminate disparities, but the Massachusetts Hospital Association's noard of trustees calls the bill "overly simplistic."


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ANALYSIS


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