MACRA Law

MACRA Law is a complex rule. MACRA healthcare affects how a patient receives care and how a doctor is paid by medicare.

Center for Health Policy

Established in 2007, the Center for Health Policy at Brookings is dedicated to providing practical solutions that achieve high-quality, innovative, and affordable health care throughout the United Sta

The CMS Blog | The official blog for the Centers for Medicare & Medicaid Services (CMS) – visit www.cms.gov

The official blog for the Centers for Medicare & Medicaid Services (CMS) - visit www.cms.gov

FTC Hosts Workshop on Competition in Prescription Drug Markets

On Monday, November 13, our colleagues in the Antitrust Section published an alert on the recent FTC workshop, “Understanding Competition in Prescription Drug Markets: Entry and Supply Chain Dynami

Individual Mandate Repeal Added to GOP Tax Bill

Republican senators are going to include a repeal of Obamacare's individual mandate in the revised version of their tax plan.

How Eliminating The Medical Expense Deduction Could Increase Medicaid Spending

The release of the House and Senate GOP tax plan this month has left Washington on edge as it comes to grips with the realities of tax reform. However, the elimination of the medical expense tax deduc

What To Do If You Can’t Afford Health Insurance

The Issue We all need healthcare and health insurance, and the cost of medical care has exploded. We need to find a good way to manage the cost of insurance and care. The difficulty is compounded beca

Trump Nominates Former Drug Company Executive as HHS Secretary

Trump will nominate former drug company executive and lobbyist Alex Azar as secretary of Health and Human Services (HHS). Azar is a critic of ObamaCare.

ML Strategies Weekly Health Care Preview – Week of November 13th

It’s all about tax reform in Congress. This week, the House will look to pass its version of tax reform while the Senate begins marking up its package. Meanwhile, the end of the year is fast approac

Latest OCR Cybersecurity Newsletter Tackles Mobile Devices

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) released its October Cybersecurity Newsletter last week with a focus on mobile devices. Given the amount of work con

Understanding Medicare Cost-Sharing

What is Medicare Cost-Sharing? When you use Medicare, you share the cost of your care by paying premiums, deductibles, copayments, co-insurance, and out-of-pocket maximums. If you receive a paycheck,

HHS Announces New Rules for Medicaid Expansion Waivers

This week HHS announced new rules for Medicaid expansion waivers.The new rules notably allow states expanding Medicaid to implement work requirements.

Maine Expanded Medicaid Under the ACA By Referendum

Voters in Maine voted to expand access to Medicaid under the Affordable Care Act (ObamaCare). Maine was the first in the nation to settle the issue by referendum.

ML Strategies Weekly Health Care Preview – Week of November 6th

The CHIP Reauthorization fight heads to the Senate where it faces an uncertain path forward as neither side can agree on payfors and the Senate Finance Committee focuses in on tax reform. While the Tr

Open Enrollment is Here Despite Hurricanes and Wildfires.

It’s Open Enrollment! Participating in open enrollment is essential even if you have been affected by the hurricanes and wildfires or are dealing with other pressing issues. It is open enrollment f

Don’t Forget to Verify Your Plan or Re-Enroll

Most people who have coverage right now will be automatically re-enrolled in their plan (unless they take action), however, everyone should verify their plan.

CMS Finalizes Medicare Part B Reimbursement Cut for 340B – What Does it Mean?

On November 1, 2017, CMS announced that it is in fact cutting Medicare Part B reimbursement for 340B drugs to the tune of $1.6 billion.  To be accurate, what CMS announced is its intent to finalize p

Building a Health App? Part 7: Commercialization and Strategic Partners

Given the uncertainty in reimbursement from private insurance and government programs such as Medicare and Medicaid, it is important early on to consider how best to land and leverage relationships wi

Six Key Follow-Up Questions Asked by Congress in 340B Hearing

Earlier this month the House Energy and Commerce Committee’s subcommittee on Government Oversight and Investigations held its second hearing on the 340B Drug Discount Program. The hearing followed o

Open Enrollment Starts Nov. 1st, Don’t Wait to Get Covered

Just a quick reminder, open enrollment under the Affordable Care Act (ObamaCare) starts Nov. 1st. Shop at HealthCare.Gov and get covered!

More People Than Ever Can Find a Health Plan for $75

More people than ever will be able to find a health plan for $75 or less per month after cost assistance under the Affordable Care Act (ObamaCare).

Pharma Distributors Trade Association Sued for Conspiracy to Exclude Competition for its Track and Trace Software

On October 23, 2017, a company that developed software to track and trace pharmaceuticals filed a complaint against a pharmaceutical distributors trade association that currently dominates the market

ML Strategies Weekly Health Care Preview – Week of October 30, 2017

As the calendar turns to November, pressure continues to grow in Congress to pass a CHIP extension and address outstanding minibus extenders. Also on the radar is the first open enrollment period unde

MACRA’S QUALITY PAYMENT PROGRAM HAS GONE LIVE – ACTION REQUIRED IN 2017 TO AVOID PART B PAYMENT REDUCTIONS IN 2019 – QPP BASICS TO KNOW IN GETTING STARTED

MACRA’S QUALITY PAYMENT PROGRAM HAS GONE LIVE – ACTION REQUIRED IN 2017 TO AVOID PART B PAYMENT REDUCTIONS IN 2019 – QPP BASICS TO KNOW IN GETTING STARTED A new Congress has convened, a new admi

President-Elect Trump Names Rep. Tom Price, MD (R-GA) as HHS Secretary, Seema Verma, Health Care Consultant, as CMS Administrator

Medicare/Medicaid Reform and ACA Repeal on the Horizon, MACRA Moves Forward for Now The new administration’s agenda for health care may have come into clearer focus with President-Elect Donald Trump

Time Remains to File a request for Informal Review of CY 2017 PQRS Negative Payment Adjustment

QRUR Informal Review Also Available. Physicians and other eligible professionals and practices who failed to meet criteria for satisfactory PQRS reporting in calendar year (CY) 2015 now face a negativ

CMS publishes Final MACRA Rule for MIPS and APM Incentives

On October 14, 2016, the Centers for Medicare & Medicaid Services (CMS) released its final rule implementing the new Quality Payment Program for physicians in lieu of the repealed sustainable grow

HHS’ FINAL NONDISCRIMINATION RULE IMPACTS MOST PHYSICIANS

Physicians subject to the Rule must meet notice and posting obligations by October 16, 2016. The federal Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), has p

MACRA ON THE MOVE!

CMS proposed rule details Medicare’s new physician “Quality Payment Program” Reporting under new measures slated to begin in 2017 The Centers for Medicare & Medicaid Services (CMS), the fede

IOWA LEGISLATURE AMENDS BEHAVIORAL HEALTH DISCLOSURE LAWS

2016 Amendments Permit Disclosure for Care Coordination Only Under State Law One of the more challenging aspects of medical records management are federal and state legalities around release of substa

HIPAA AND FEES FOR MEDICAL RECORDS

HIPAA AND FEES FOR MEDICAL RECORDS – Updated OCR guidance sets limits. Physicians and other HIPAA covered entity providers are familiar with HIPAA’s rule on fees that may be charged when individua

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