Category: Healthcare News

Transparent e-Visit Billing: Essential Tips for Primary Care Physicians

Transparent e-Visit Billing: Essential Tips for Primary Care Physicians

In an era where digital progress is transforming every facet of the economy, healthcare is no different. Breakthroughs, particularly in telehealth and e-visits, offer the potential to make healthcare more accessible than ever. While these advancements bring significant promise, they also bring about fresh challenges, particularly in the realm of billing. A growing number of […]
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Decline in Top Star Ratings: A Closer Look at MA, Part D Plans in 2024

Decline in Top Star Ratings: A Closer Look at MA, Part D Plans in 2024

In 2024, approximately 42% of Medicare Advantage plans offering prescription drug coverage are projected to achieve four or more stars, a decrease from the 51% recorded this year and the 68% in 2022, according to data released by the CMS on Friday. The five-star rating system, established by the Affordable Care Act, serves to assist […]
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Advancing Prior Authorization: The Evolution in CMS Regulation

Advancing Prior Authorization: The Evolution in CMS Regulation

The Centers for Medicare & Medicaid Services (CMS) have embarked on a decisive move by enforcing a standard for Advancing prior authorization. In a conversation with the Senior Director of Utilization Management, we discussed the potential implementation and impact of this proposed mandate, slated for enactment in January 2026 The Predicament of Prior Authorization The […]
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Top ACA Compliance Mistakes to Avoid in 2024

Top ACA Compliance Mistakes to Avoid in 2024

 As the 2024 calendar year’s open enrollment period swiftly approaches, it is imperative for organizations to focus on ensuring compliance with the Affordable Care Act (ACA) in order to guarantee that their procedures for managing health plans are well-executed. Despite nearly a decade of ACA reporting, organizations still tend to make errors in Affordable Care […]
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3.36% Cut in The Proposed 2024 Medicare Physician Pay Schedule

3.36% Cut in The Proposed 2024 Medicare Physician Pay Schedule

What’s the news: The AMA is emphatically stating that the proposed 3.36% reduction in the 2024 Medicare physician payment schedule is ill-advised, posing a threat to the accessibility of high-quality physician care for the 50 million plus elderly individuals enrolled in Medicare. The AMA President emphasized that with escalating costs associated with medical practice; another […]
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Medicare Advantage Plans: A Positive Experience for Beneficiaries

Medicare Advantage Plans: A Positive Experience for Beneficiaries

Higher satisfaction with problem resolution was observed among beneficiaries who were more inclined to renew their Medicare Advantage plan. Medicare Advantage plans have garnered favorable satisfaction scores, with beneficiaries showing high approval ratings for trustworthiness, operational ease, and coverage adequacy, as outlined in a recent market research study. The 2023 US Medicare Advantage Study encompasses […]
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Employer Healthcare Costs to Increase 8.5% in 2024

Employer Healthcare Costs to Increase 8.5% in 2024

A recent study conducted by a leading professional services firm revealed that the anticipated expenses borne by U.S. employers for their workforce’s healthcare will see a notable uptick of 8.5%, surpassing $15,000 per employee. This surge, assuming companies do not introduce augmented employee contribution methods or alternate cost-reducing strategies, stands almost twice as high as […]
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CMS Proposes Changes to Remote Patient Monitoring in PFS Proposed Rule

CMS Proposes Changes to Remote Patient Monitoring in PFS Proposed Rule

The 2024 physician fee schedule (PFS) proposed rule has been released by the Centers for Medicare & Medicaid Services (CMS). Within this rule, remote physiologic monitoring (RPM), also known as remote patient monitoring, has garnered significant attention. While customary for a proposed rule, CMS has introduced several suggested modifications to RPM. However, what sets this […]
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