CT Attorney General Wants Hospitals to Disclose ‘Facility Fee’

Many patients have been surprised to see a “facility fee” on top of charges for in-office services and procedures provided to them by practices. Connecticut Attorney General George Jepsen has asked the state’s hospitals for a list of their affiliated providers by December 6 after receiving numerous complaints from consumers who were not informed about the fees. A “facility fee” is what hospitals say they have to charge patients of practices they have acquired because acquiring an independent practice increases their overall costs. Jepsen wants a list for patients so that they have the option of going somewhere else if they don’t want to be charged a fee which is a separate and sometimes expensive fee.

Emerging trends in Connecticut and throughout the country point towards heavy healthcare industry consolidation where hospitals are merging with other hospitals and acquiring medical practices. Jepsen notes that it’s especially important for consumers to understand this shift and the associated costs.

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6 Tips for Picking the Right Health Insurance

If you’re still confused about picking the right health insurance, don’t worry! Here are some quick and easy tips to consider when picking an insurer:

  1. Look at options both on and off the exchange.
  2. Get the summary of benefits and coverage form (SBC) which lists information about the different health insurers.
  3. Look at the price, not just the price of the premium but also other out-of-pocket expenses like co-pays.
  4. Look at provider networks to see if your doctor is covered, especially if you need out of network benefits (from providers like psychologists and chiropractors, for example).
  5. Check to see if your medications will be covered and if they will, what the cost will be.
  6. If you are still confused about choosing the right provider, consult with an insurance broker.

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CMS Proposes Smaller Cuts for Home Health Providers

CMS issued a final rule last week announcing that it would reduce payments to home health providers by 1.05 percent in 2014 which is a smaller cut than the 1.5 percent cut previously proposed.  This payment “includes a 2.3 market basket increase, minus 2.73 percent for rebasing adjustments, and another 0.62 percent reduction tied to refinements in the home healthcare prospective payment system.”  In total, the cuts will cost $200 million for the coming year.

Earlier this year, CMS announced a plan to reduce home health reimbursements by 3.5 percent annually between 2014 and 2017 but has since backtracked fearing it would cost home health agencies too much.

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Tiptastic Tuesday: Have a Stress Free Thanksgiving

Thanksgiving is only a couple days away and often times, the cooking combined with family can translate into an extremely stressful day.  If you’re hosting this year, don’t worry, we have put together a few tips to help make turkey day stress-free:

  • Prepare ahead of time.  Preparing dishes (as much as you can) before will allow you to spend more time with your family.
  • Don’t take too much on your own. If you need help, don’t hesitate to ask a family member to help you cook or assist in doing chores.
  • Be creative. Feel free to add personal touches to your table setting. Tip: drape the table in a bright runner instead of a white tablecloth, it’ll be cheaper and easier to clean up!
  • Honor your guests. Separate those family members who don’t mix well and steer clear of certain subjects such as sex, money, politics, and religion that make people uncomfortable.
  • Use Thanksgiving day as a learning opportunity.There is no doubt that you will learn certain tricks and tips after cooking all that delicious food.  Embrace it!

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OIG Announces Four Year Plan to Maximize Fraud Recoveries

The Office of Inspector General (OIG) announced that it’s committing the next four years, from 2014 to 2018, to increasing fraud recoveries and the protection of patient data. They have released a strategic plan comprising of a number of goals including “fighting fraud, waste and abuse; promoting quality, safety and value; securing the future; and advancing excellence and innovation.” The plan also highlights the switch from quantity based care to value based care. Some long term care providers are not too enthusiastic about the news believing that they already have too many post-payment audits on government reimbursements.

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Monday Morning Recap

The HMS Healthcare Management Solutions Monday Morning Recap reviews some of the top stories and healthcare highlights you may have missed last week.