Understanding Health Reform Part III: Insurance Costs

Part III of the HMS Healthcare Management Solutions breakdown of the federal health reform ruling focuses on ways to hold insurance companies accountable and keep costs down.  The following changes provisioned by the Patient Protection & Affordable Care Act (PPACA) can help you get the most out of health insurance.

  • Limits On Premium Dollar:  The health care law limits how much of your premium dollar your insurer can spend on things other than providing and improving the quality of your health care.
  • Lifetime & Annual Limits:  Lifetime limits on most benefits are banned for all new health insurance plans. Annual limits on your health benefits are now restricted and will be phased out by 2014.
  • Flexible Spending Accounts: If you have a flexible spending account, health savings account, or health reimbursement account, here are some important changes you should know about.
  • Rate Review:  Rate Review helps protect families and small businesses from unreasonable rate increases. Insurance companies must now justify any rate increase of 10% or more.

Stolen Computer Contains Patient Information

The Associated Press reports a laptop computer with the personal information of approximately 10,000 patients of Hartford Hospital and VNA HealthCare has been stolen.

Hospital officials say they learned of the theft on June 26, after it was reported missing buy a vendor that was performing some data analysis related to hospital readmissions.

Data on the stolen laptop includes:

  • Names
  • Social Security Numbers
  • Medicaid & Medicare Numbers
  • Diagnosis & Treatment Records
  • Other Patient Information

Although the data was not encrypted, there is no indication that any of the information has been misused.

Click here to read more.

HMS Now Offers Long Term Care Billing

HMS Healthcare Management Solutions is excited to announce we are adding long term care billing and operational development to our extensive line of customized services.   We are ready and available to assist your long term care facility with billing and revenue cycle management in addition to the products and services we already provide to home care and hospice agencies.

Let the HMS team of knowledgeable industry experts assist your skilled nursing facility, continuing care community or rehabilitation center with the nuances of long term care medical billing to ensure proper payment.  We’ll apply our reimbursement, clinical, operational, billing, regulatory and compliance knowledge to help your facility succeed in an ever-changing environment.  Contact us today to see how we can help you!


Tiptastic Tuesday: Diabetes Fraud Alert

HMS healthcare Management SolutionsHMS Healthcare Management Solutions has learned criminals who plot to defraud the government and steal money from the American people have a new target: people with diabetes.  Although the precise method may vary, the scheme generally involves someone pretending to be from the government, a diabetes association, or even Medicare calling you.

Click here to read more including tips on what to do if you suspect you are the victim of fraud.

Understanding Health Reform Part II: Insurance Choices

Part II of the HMS Healthcare Management Solutions breakdown of the federal health reform ruling focuses on a variety of alternatives to the individual private insurance market. If you need health insurance, the following programs of the Patient Protection & Affordable Care Act (PPACA) may be available to you.

  • Pre-Existing Condition Insurance Plan:  If you have been rejected for insurance due to a health condition or disability, you may be eligible for coverage through the Pre-Existing Condition Insurance Plan.
  • Young Adult Coverage: If you are under 26, you may be eligible for health insurance coverage under your parent’s plan.
  • Affordable Insurance Exchanges: Starting in 2014, you will be able to shop for insurance and compare health plans in new state-based Affordable Insurance Exchanges.
  • CO-OP Insurance Plans: Starting in 2014, you or your small business may be able to buy insurance from a new type of non-profit, consumer-run health insurer, called a Consumer Operated and Oriented Plan (CO-OP).

CMS Increases SNF Payment Rates

HMS Healthcare Management SolutionsThe Centers for Medicare & Medicaid Services (CMS) will increase its skilled-nursing facility payment rates by 1.8% on October 1, 2012. The rate increase is expected to boost payments by $670 million for than 15,000 Medicare-certified skilled-nursing facilities paid under the SNF prospective payment system.

The annual increase was based on a marketbasket index that reflects changes in the prices of goods and services used by nursing homes, plus a multifactor productivity adjustment required by the Patient Protection and Affordable Care Act (PPACA). The new rate is based on a 2.5% marketbasket-adjusted 0.7% productivity cut.Click here to read more.

Meaningful Use Monday: EHR Benefits

Electronic health records (EHR) make it possible for healthcare providers to better manage your care through secure use and the sharing of health information.  With electronic health records, healthcare providers have:

  • More accurate and complete information to provide the best possible care
  • The ability to better coordinate care, as health information can be shared electronically and in a fast and convenient way
  • Information to help diagnose health problems, reduce medical errors and provide safer care at lower costs

EHRs also allow more convenient care. In fact, the use of electronic health records can:

  • Expand your access to affordable care
  • Make our healthcare system more efficient
  • Build a healthier future for our nation

HMS Healthcare Management Solutions can help your practice achieve meaningful use requirements with our fully integrated, affordable, cloud-based EHR solutions. Contact us to see how our consulting and revenue cycle management assists healthcare providers each and every day!