Reimbursement
Despite improvements, Medicare has once again been placed on the Government Accountability Office's high-risk list -- a designation the program has held since 1990.
When Senator Marco Rubio (R) of Florida said in the Republican response to President Obama's State of the Union address that "the biggest obstacles to balancing the budget are programs where spending is already locked in," the first example he then turned toward is Medicare.
For many physician practices -- especially those working with health maintenance organizations (HMOs) -- obtaining pre-authorization to perform certain treatments or procedures is a necessary evil: Physicians must request pre-authorizations accurately and in a timely fashion or they won't get paid.
The Internal Revenue Service (IRS) declared employer-sponsored health insurance tax exempt in 1943, and ever since health benefits have been an integral part of the American workplace and the greater economy. Today, it is at a crossroads, amid health reform, economic and demographic trends.
States that continue to resist the Affordable Care Act (ACA) are finding themselves in a tougher and tougher spot. It's hard to retain ideological purity while dealing with the nuts and bolts of implementation. Exhibit A is the health insurance exchanges. States can run their own exchanges, but those that decide not to act will find the federal government running their exchanges for them. So you will have the weird phenomenon of blue states running their own exchanges and red states ceding authority to the feds.
When Sen. Marco Rubio (R-Fla.) said in the Republican response to President Barack Obama's State of the Union address that "the biggest obstacles to balancing the budget are programs where spending is already locked in," he pulled no punches and pointed directly at Medicare.
WellPoint's board of directors have selected a health system executive, Joseph Swedish, to head the company after last August's investor-stoked departure of Angela Braly.
Rural hospitals are girding for harsh impacts from a 2 percent decrease in Medicare reimbursements under federal spending sequestration, set to take effect in March, by taking advantage of how they already operate, a new report suggests.
As the IRS finalizes regulations for the Affordable Care Act's individual and employer mandates, the complex eligibility and exemption framework being proposed has some legal analysts worried that working families in certain income brackets won't be eligible for premium support.
Out of the 258 accountable care organizations (ACOs) recognized by the Centers for Medicare and Medicaid Services, 60 of them, across more than 15 states, have banded together to form the National Association of ACOs.