Aetna Faces Uphill Battle

by | Feb 16, 2018 | Business, Payers

If you haven’t heard the name Dr. Jay Ken Iinuma before, you’re about to get acquainted. Iinuma is the former Medical Director of health insurance giant Aetna, and he might just be the reason yet another Aetna deal flatlines. During a recent deposition in a lawsuit...

Is HHS About to Lose Funding?

by | Feb 13, 2018 | Community, Payers

Yesterday, President Donald Trump presented his $4.4 trillion FY19 budget proposal – and it looks like the Department of Health and Human Services (HHS) is going to have to tighten its fiscal belt. Trump’s proposed budget demonstrates a 21% decrease from HHS’...

The Road to Compliance

by | Dec 29, 2017 | Compliance, Healthcare, Payers

The road to compliance is long and bumpy, but a trip we must all take in 2018. In January 2017, compliance professionals from the Department of Health and Human Services (HHS), Office of Inspector General (OIG) held an assembly in which they discussed how to measure...

Is This The End of CHIP?

by | Dec 21, 2017 | Healthcare, Payers

The Children’s Health Insurance Program (CHIP) is a program that has managed to gain (mostly) bipartisan support, as it provides low-cost healthcare to children in families that earn too much money to qualify for Medicaid; but its days may be numbered.  The funding...

Mammography Coding

by | Oct 18, 2017 | Coding, Medical Record Auditing, Payers

In honor of Breast Cancer Awareness Month, we’ve decided to release a brief reminder to not only schedule a routine mammogram, but to recall the 2017 Mammogram Coding Changes. Mammography Coding The Centers for Medicare and Medicaid Services (CMS) announced in...