Category: Health Insurance

Implications of the repeal of the individual mandate on uncompensated care audits — and what to do

With the mandate repealed, and DSH dollars unchanged, competition for that money is going to be fierce, experts predict.

Open enrollment initial numbers show first three days yielded more than 371,600 plan selections

Since enrollment weeks are measured Sunday through Saturday, these first figures account for only three days, from Thursday to Saturday.

Hospitals illegally claimed $4 million in education funds, says OIG

The agency placed the bulk of the blame on the Centers for Medicare and Medicaid Services, and the agency has signaled intent to tighten oversight.

Midterm Results Show Health Is Important To Voters But No Magic Bullet

Even though they are taking control of the House, Democrats will be unlikely to advance many initiatives on health that don’t meet Republican approval since the GOP controls the Senate and the White House. But they can block any efforts to weaken the Affordable Care Act or change Medicaid or Medicare.

California Dreamin’? With Newsom’s Win, Single-Payer Unlikely To Follow Anytime Soon

Even though Democrat Gavin Newsom campaigned for single-payer, it’s unlikely that he and other lawmakers will completely overhaul the state’s health care system right away. Instead, they will likely propose incremental steps to provide more Californians with health insurance.

Medicaid expansion in five states rests on hotly contested gubernatorial elections

In Maine, which represents a sixth closely-watched race for governor, the question of expansion heads to court.

Hospital communication-and-resolution programs do not expand liability risk

Some medical centers are wary that willingly admitting errors could result in increased liability costs, which has been a barrier to adoption.

Tenet sees operating revenue drop but significant year-over-year progress in shrinking net losses

Tenet adjusts its outlook for 2018, now forecasting expected net income of $84 million to $144 million, the system says.

CVS expects deal with Aetna to close by Thanksgiving

CVS profits in Q3 decreased 5.8 percent to $2.4 billion, driven by a $64 million increase in acquisition-related transaction and integration costs.

Change, TIBCO use blockchain to build smart contract system for payers.

Using embedded codes in blockchain technology, claims process themselves.