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As the 31st State Expands Medicaid: Do We Need to Be Concerned About a...
Recently, Montana became the 31st state, including D.C., to expand Medicaid. Discussion regarding Medicaid expansion is ongoing in one state: Utah. Nineteen (19) states have rejected Medicaid...
View Article“A Modest Proposal for the ACA Employer Mandate”
We all know about the ACA employer mandate. It placed a tremendous burden on employers, many of whom will only feel this burden weighing them down as we ring in the new year because, starting in 2016,...
View ArticleCMS Clarifying Medicare Overpayment Rules: The Bar Is Raised (Yet Again) for...
Have you ever watched athletes compete in the high jump? Each time an athlete is successful in pole vaulting over the bar, the bar gets raised…again…and again…until the athlete can no longer vault over...
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RAC Audits: If It Walks Like a Duck and Quacks Like a Duck, It IS a RAC Audit
Recently, hundreds of dentists across North Carolina received Tentative Notices of Overpayment (TNOs) from Public Consulting Group (PCG) demanding recoupment for reimbursements made to dentists who...
View ArticleThe Effects of Medicaid Expansion under the ACA: Findings from a Literature...
Research on the effects of Medicaid expansions under the Affordable Care Act (ACA) can help increase understanding of how the ACA has impacted coverage; access to care, utilization, and health...
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Medicare/Caid Audits: Urine Testing Under Fire!!
I have blogged about peeing in a cup before…but we will not be talking about dentists in this blog. Instead we will be discussing pain management physicians and peeing in a cup. Pain management...
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All Medicare/Caid Health Care Professionals: Start Contracting with Qualified...
Being a health care professional who accepts Medicare and/ or Medicaid can sometimes feel like you are Sisyphus pushing the massive boulder up a hill, only to watch it roll down, over and over, with...
View ArticleKey Medicaid Questions Post-Election
Disclosure: This is the opinion/facts from the Kaiser Family Foundation, not me. But I found this interesting. My opinion will be forthcoming. Kaiser Family Foundation article: Medicaid covers about 73...
View ArticleFifth Circuit Rules Individual Mandate Unconstitutional but Leaves ACA’s Fate...
Extra, extra, read all about it: Breaking News! In a 2-1 decision issued December 18, a Fifth Circuit panel held that the individual mandate under the Affordable Care Act (ACA) is unconstitutional...
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Texas Judge Poo Poos the ACA Preventable Services Mandate!
In March, the U.S District Court in the Northern District of Texas vacated the requirement that ACA-compliant health plans cover certain U.S. Preventive Services Task Force (USPSTF) recommended...
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