Compliance 101: Your Plan Should Increase Office Efficiency and Transparency. Does It?

Although patient confidentiality is an important piece of compliance practice standards, a compliance plan addresses much more. An effective compliance plan helps an office run more smoothly from check-in to check-out and for patient care. And it also helps open lines of communication to encourage whistle-blowing that protects your practice. Full Story

Report: In Age Of Reform, Insurance Companies Bet On Public Plans Instead Of Commercial

In the age of healthcare reform and hospital consolidation, insurers have begun to hone in on taxpayer-funded plans to shore up revenue. Modern Healthcare takes a look at the SEC filings for some of the nation’s largest payers, finding that “the industry is creatively maneuvering into new lines of business.” Full Story

CMS Approves California Medicaid Waiver. How Does It Differ From Texas’ Expiring 1115?

California is the latest state to receive federal approval for the renewal of a waiver meant to pay for reforming the Medicaid program by instituting new care delivery strategies and platforms. Modern Healthcare reports that California’s waiver is worth $6.2 billion and will help offset the cost of uncompensated care accrued at its safety net hospitals. Texas has a similar request pending with the Centers for Medicare and Medicaid Services. Known as the 1115 waiver, the state had to request renewal by last September. Texas’ waiver is worth nearly five times as much as California’s ($29 billion over four years) and… Full Story

Meet The Healthcare Lawyer Who D CEO Honored As Outstanding In-House Counsel

When Parkland decided to spin off a healthcare data analytics department, it was entering uncharted territory. Steve Roth, senior vice president and senior deputy general counsel at Parkland, led the effort to create what is now the nonprofit Parkland Center for Clinical Innovation. Roth serves as its chief counsel. Full Story

Alternative Payment Models Look To Help Offset Cost Of Repealing SGR

Earlier this year, Congress repealed the much maligned Sustainable Growth Rate cost-control scheme used by the Centers for Medicare & Medicaid Services (CMS). If you are like I am, you are celebrating this legislative victory—the SGR Repeal and the Medicare Provider Payment Modernization Act—which took too many years to achieve. The estimated cost of repealing SGR is $150 billion over 10 years because, in the simplest terms, the SGR law attempted to control growth in Medicare costs by reducing the reimbursement rate for each “unit of service” provided by physicians. But, as Joel White, president of the Council for Affordable… Full Story