Reimbursement

When the new insurance tax hits Medicaid managed care plans this year, it will basically leave the government taxing itself and perhaps spur more states to start contracting with not-for-profits.

For state exchanges still struggling to function, and governors facing the consequences, the Centers for Medicare & Medicaid Services is offering an exception to the rule of tax credits only being available through public marketplaces.

The Obama Administration recovered a record $4.3 billion last year from fraudsters trying to dupe federal health programs, or those who sought payments to which they were not entitled.

Since 2008 when CMS first implemented the Hospital Consumer Assessment of Healthcare Providers and Systems survey for U.S. hospitals, the scores from these surveys have become increasingly more important to hospital executives as a measure of quality. They are now used to determine 30 percent of the total incentive under the Hospital Value Based Purchasing program.

As health systems around the nation buy up office-based physician practices and redub them outpatient facilities, Pennsylvania's largest insurer may be starting a competing trend with a new payment policy for one of the most profitable specialities.

The price of an initial inpatient stay explains almost all of the wide spending variation from hospital to hospital on episodes of care, such as for knee or hip replacements, the National Institute for Health Care Reform has found.

The price of an initial inpatient stay explains almost all of the wide spending variation among hospitals on episodes of care, such as for knee or hip replacements, the National Institute for Health Care Reform has found. That finding is important for the move toward bundled payments.

Last month, Paul R. Bengston, CEO of Northeastern Vermont Regional Hospital, a small, critical access hospital located in St. Johnsbury, Vt., was chosen to lead the American Hospital Association's Section for Small or Rural Hospitals in 2014. The 21-person governing council represents small or rural hospitals in the AHA's policy process and member services initiatives.

Tax preparers may play a key role in getting many uninsured individuals covered during the final weeks before the health insurance exchange enrollment deadline as most of the uninsured who file tax returns use in-person professional preparers, including two-thirds of those who claim the earned income tax credit (EITC).

After the Health and Human Services Department gave a tentative go-ahead for some hospitals to help pay for health plan costs and an uproar ensued over funding for HIV/AIDS patients, Blue Cross and Blue Shield of Louisiana is planning to stop accepting premium payments from most third parties.