Policy and Legislation
While the Affordable Care Act's individual mandate was naturally expected to drive the previously uninsured to non-group plans, it has become increasingly clear that the individual market is also bracing for a potentially significant influx of currently insured enrollees who are driven there both by choice and necessity.
The Office of Inspector General issued a "special fraud alert" cautioning that physician-owned distributorships (PODs) are "inherently suspect" under the anti-kickback statute and listing suspicious characteristics of these entities that may increase the risk of fraud and abuse.
The Department of Health and Human Services' Office for Civil Rights (OCR) says it will survey the 115 HIPAA-covered entities that were audited last year to gain insight about their audit experiences.
As the investigation into a fatal outbreak of fungal meningitis continues, the commissioner of the Food and Drug Administration proposed Friday that the agency gain new authority to regulate pharmacy compounding, including charging fees to fund an expanded safety framework.
Medicaid pays for more than 62 percent of all long-term care (LTC) costs in this country so programs to encourage more people to carry long-term care insurance may be needed to lessen the burden to the federal insurance program to the poor.
So far California has received $910 million in federal grants to launch its new health insurance exchange under the Affordable Care Act ("Obamacare").
The payment of higher Medicare rates to physicians and hospitals in regions that have good health outcomes and lower costs, while reducing payment rates where there is lesser quality and higher costs will not drive individual providers to deliver care more efficiently reports the Institute of Medicine (IOM).
Healthcare is part of the service industry and increased competition amongst providers should lead to cost stabilization and advancements in healthcare services. Unfortunately, multiple barriers limit the healthcare industry from behaving like other service industries.
New research from the Urban Institute and the Robert Wood Johnson Foundation shows that hospitals can expect to pull in an additional $293.9 billion dollars between 2013 and 2022 if all states opt to expand Medicaid as outlined in the Affordable Care Act.
Celebrating its third anniversary this weekend, the Affordable Care Act has shown demonstrable benefits, but those are no guarantee of overall success.