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Increase in Insurance Rebates Due to ACA Uncertainty

According to a report from the Kaiser Family Foundation, insurers who participate in selling health insurance plans in the Affordable Care Act (ACA) markets have collected more premiums than needed. The report estimates that insurers have collected an excess of $800 million in premiums and are expected to give these premiums back to consumers as [...]

By | 2019-05-09T10:45:20+00:00 May 9th, 2019|Articles, Industry Updates|0 Comments

More Physician Practices are Resorting to Private Equities for Investments

A growing number of physician practices are relying on private equity firms for investments, more than entrusting in hospital systems and larger physician organizations. Private equity firms are investing in  physician practices specializing in certain profitable specialties, such as  orthopedics, urology and gastroenterology. As certain compliance requirements have increased while reimbursement has decreased, physicians practices [...]

By | 2019-04-29T09:27:47+00:00 April 29th, 2019|Articles, Physician Issues & Best Practices|0 Comments

Democrats Condemn Trump’s ACA Abolishment

The Trump Administration had ordered the Justice Department to abolish the Affordable Care Act (ACA), which had been enacted nine years ago under the Obama Administration. The House of Representatives voted on Wednesday to stop the Justice Department from carrying out the ACA termination, with the final tally set at 240 to 186, counting eight [...]

By | 2019-04-04T15:11:54+00:00 April 4th, 2019|Articles, Government Mandates and Compliance|0 Comments

Federal Judge Overrules AHP Final Rule

On Thursday, a U.S. District Judge ruled against the Trump administration's efforts to expand on association health plan rules. The Trump administration had developed a final rule that allows for association health plans to be developed by associations and employers, which the judge has ruled that it is beyond the Trump administration's authority under the [...]

By | 2019-03-29T09:36:29+00:00 March 29th, 2019|Articles, Government Mandates and Compliance|0 Comments

Fewer Providers Participating in the Bundled Payments for Care Improvement Advanced Model

On Thursday, the Centers for Medicare and Medicaid Services (CMS) made the announcement that the number of providers who participate in the Bundled Payments for Care Improvement (BCPI) Advanced model has decreased by 16%, scaling down to 1,086 providers from 1,299 providers. The BCPI Advanced model was initially started in October 2018 as the first [...]

By | 2019-03-22T13:01:14+00:00 March 22nd, 2019|Articles, Government Mandates and Compliance|0 Comments

More Physician-Led ACO’s are Leaving After ACO Reform

The Centers for Medicare and Medicaid Services (CMS) has been working to continually evolve and reform the Accountable Care Organizations (ACOs) program. A recent reform to the ACO program was the Pathways to Success Rule, which was enacted in late 2018, which focused on reforming the Medicare Shared Savings Program (MSSP). The Pathways to Success [...]

By | 2019-03-15T12:28:19+00:00 March 15th, 2019|Articles, Industry Updates|0 Comments

CMS Administrator Announces Stark Law Overhaul

After having received over 300 comments on recommended modifications to the Stark law, the Centers for Medicare and Medicaid Services (CMS) decided to make major changes to the federal law. CMS Administrator Seema Verma announced part of the big improvement to the Stark law on Monday, stating that the CMS will a major part will [...]

CMS Star Rating Model to be Reconsidered

The Centers for Medicare and Medicaid Services (CMS) is considering eliminating their current star rating model for a model that takes the average of scores, rather than their current model based on a latent variable model (LVM). The decision would not be quick, but would be enacted in 2020. The CMS' new stance on their [...]

By | 2019-03-04T09:49:31+00:00 March 4th, 2019|Articles, Industry Updates|0 Comments