healthcare payers

Healthcare Consumers Demand Convenience

Healthcare Consumers Demand Convenience

Consumers are showing an increased demand for patient-centric portals with simplified transparency. More specifically, healthcare payers are seeking a convenient way to receive and review electronic health records (EHR) within the current market. With these recent developments, 68% of physicians believe they are prepared to provide quality in the midst of a changing industry, as stated by Healthcare Finance. This innovative revolution has consumers interested in technologies that will aid in managing their health.

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CMS eliminates barrier to ACA Individual Mandate Exemption

CMS eliminates barrier to ACA Individual Mandate Exemption

Consumers who abandoned the Obamacare exchanges this year are entitled to a “hardship” exemption to the individual mandate penalty, CMS publicized Wednesday. This will directly affect people who chose to go uninsured or who enrolled in coverage that doesn’t comply with Obamacare protocols. This follows the agency’s April guidance that expanded the exemption to people who live in rural counties or have claims going back to 2016, but applicants still had to give a written explanation for why they required the exemption.

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Texas ACA lawsuit to begin: What you need to know

Texas ACA lawsuit to begin: What you need to know

Today, a Texas lawsuit will be heard determining pivotal laws and regulations concerning the Affordable Care Act. Republican attorney generals, led by Texas’ Attorney General Ken Paxton, will go against the Democratic party, led by California’s Attorney General Xavier Becerra, to debate the fate of the ACA. U.S District Judge Reed O’Connor will hear both sides and determine whether the health law should be put on hold while the case is being contested. GOP Plaintiffs are looking for a “preliminary injunction” on the law.

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NPAG 2018 Recap

NPAG 2018 Recap

Excellus Blue Cross Blue Shield was pleased to host the 2018 National Plan Automation Group (NPAG) Conference in picturesque Lake Placid, NY. The event showcased 4 days of interactive sessions exploring opportunities in EDI, electronic payments, health records, “HEDIS,” and the past, present, and future of authorization transactions. While NPAG sponsored a progressive networking retreat, attendees took advantage of Lake Placid Golf Club, Ausable Chasm, and an adventurous BobSled Experience.

In case you were not able to attend, here’s our recap of what was discussed:

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New York SHOP program removes online enrollment & premium billing

New York SHOP program removes online enrollment & premium billing

Starting this month, NY State of Health (NYSOH) made several changes to the state’s SHOP program in an effort to give the federal tax credit to as many small businesses as possible.   

In New York, 98% of businesses have fewer than 100 employees and over 40% of the workforce is employed in these small businesses. The recent changes impacting these businesses were allowed through the November 2017 rule that allows small employers to enroll directly through issuers and brokers and still receive the small business tax credits.  

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Alex Azar on track to become next HHS Secretary

Alex Azar on track to become next HHS Secretary

Following yesterday’s Senate Finance Committee hearing, it appears Alex Azar, the former head of Pharmaceutical company Eli Lilly’s U.S. operation, is on track to be confirmed as the Head of the Department of Health and Human Services (HHS). If confirmed, Azar will replace Thomas Price M.D., a former congressman who served as the HHS secretary for seven months before resigning. 

Despite a probe by Democrats, including that from Sen. Ron Wyden (D-Oregon), on his drug industry ties, Republicans have focused on the fact that Azar would come to the job with greater working knowledge of the sprawling agency, with its budget of more than $1.1 trillion and far-flung staff of nearly 80,000, than many of his predecessors, according to the Washington Post.  

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CMS signals support for Medicaid work requirements

CMS signals support for Medicaid work requirements

Earlier this month, the head of the Centers for Medicare and Medicaid Services (CMS), Seema Verma, made an announcement conveying that CMS would approve waiver applications from states that would require Medicaid enrollees to participate in “community engagement” activities, otherwise known as work requirements. This follows a letter co-authored by Verma that encouraged state Medicaid directors to use these waivers to modify their Medicaid programs to empower consumers. To advocates, work requirements are a way to empower Medicaid enrollees by encouraging them to be independent, self-sufficient consumers of healthcare.

Here’s what you should know about the proposed work requirements for Medicaid:

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Repealing individual mandate: not as bad as once feared?

Repealing individual mandate: not as bad as once feared?

Background

On Wednesday, December 13th, leaders from both the House and Senate will meet in Washington to finalize the Tax Cuts and Jobs Bill. If they decide to include removing the individual mandate, this will undoubtedly have an impact on healthcare in America – but it may be not as extreme as originally thought.

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