Are You Ready to Apply for ObamaCare?
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Are You Ready to Apply for ObamaCare?

Applying for the New Health Insurance

Starting January 1, 2014, ObamaCare mandates that you obtain health insurance coverage. This is not a suggestion. The law says virtually all Americans must carry health insurance, although most will just keep the coverage they now have through their jobs, Medicare or Medicaid. To obtain insurance you have two ways to apply–paper form and online. Read more

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What Would the Newly Insured Look Like?

New insured coming to the insurance market in 2021

In 2014, more than 12 million Americans are expected to enter the insurance market to buy health insurance from state or federally operated health benefit exchanges. By 2021, the exchange market is expected to have doubled, which will mark the single largest expansion of health care benefits since the introduction of Medicare in the 1960s. Read more

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8 New Preventive Services Covered for Women

Healthy Living

Health and Human Services (HHS) has added eight new prevention-related health care services that all health plans must cover with no out of pocket expense to the patients. The new health care rules require that the coverage of these services take effect at  the patient’s next renewal date–on or after August 1, 2012—for most health Read more

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What is Next for Doctors and Health Plans After the U.S. Supreme Court’s Ruling?

Doctor

Our current healthcare system is fragmented. We even have a name for this system–the “Third Party” system. The first party is the patient, the second party is the provider and the third party is the insurance company. In our post, we talked about the effects of the Supreme Court’s ruling on patients. In this article we touch Read more

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89 New ACOs Added, the Total Now is 154

Accountable Care Organizations (ACOs)

On July 9, 2012, the Centers for Medicare & Medicaid services (CMS) announced the addition of 89 new Accountable Care Organizations (ACO) to the Medicare Shared Saving Program (MSSP). With the new ACOs, the total number of providers participating in Medicare Shared Savings initiatives is now totals 154. Since the inception of Medicare ACO program in January Read more

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Medical Loss Ratio (MLR) rebates, do you qualify?

Cost of Healthcare in the United States (2010)

One piece of the Affordable Care Act (ACA) is the subject of Medical Loss Ratios (MLR). So, what is a MLR? It is the total amount of the premium dollar spent on paying medical claims and making quality improvements minus taxes and regulatory fees. And, why is it called a “loss”? Because, it is a Read more

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10% Bonus for Primary Care Providers: Are You Receiving Yours?

Doctor

One of the many parts of the Affordable Care Act is the quarterly incentive payment program by Medicare for primary care services. This program is for primary care practitioners. The program began on January 1, 2011 and will sunset on December 31, 2015. The Primary Care Incentive Payment (PCIP) equals to 10% of the Medicare Read more

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“Healthcare for All, All for Healthcare”, or is it?

Healthcare Reform - US

The passage of the Patient Protection and Affordable Care Act (PPACA) in March 2010 was regarded as a turning point in U.S. history. However, the law was challenged in the nation’s highest court. Consequently, on June 28, 2012, the U.S. Supreme Court voted to uphold the PPACA by a vote of 5-4. Why is healthcare Read more

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Avoid the e-Prescribing Penalty for 2013

Medicare E-Prescription Payment Adjustment 2013-2014

The deadline for Medicare e-Prescription (eRx) is June 30th, 2012. As a Medicare provider, you may be subject to 1.5% Medicare penalty if you do not send 10 electronic prescriptions and report 10 corresponding G-codes. Physicians who are subject to a penalty are also required to adjust co-insurance or co-pay amounts. Medicare e-Rx Incentive Program is Read more

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Medicare E-Prescription Program – A Brief Summary

Medicare ePrescription Program 2009-2014

To promote the adoption and use of e-prescribing by eligible professionals, including physicians, the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) established a 5-year Medicare incentive program beginning in 2009.  The law also included a penalty phase beginning in 2012 that runs through 2014 for physicians who are eligible for the Medicare Read more

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