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Showing 65 posts from 2014.

Part I: Understanding All-Payer Claims Databases

Over the last decade, many states have established all-payer claims database (“APCD”) systems that collect medical, pharmaceutical, and dental eligibility and claims information. Payers, including insurance providers, third-party administrators, prescription drug plans, Medicaid, and Medicare, are responsible for depositing eligibility and claims data into a collective system. The data can then be used to generate important information about cost and quality of care. By gathering detailed information in one place, a statewide picture emerges – information on service providers, patient demographics, and other important healthcare data. More >

Major Money Marked for Addiction Treatment in Kentucky

The Commonwealth of Kentucky has long suffered from a prescription drug abuse and methamphetamine problem, and heroin use has also been on the rise recently. As a result, more than $32 million is being set aside to help address the growing substance abuse problem in Kentucky. The much-needed funds are a result of settlements with two pharmaceutical companies, according to Attorney General Jack Conway. More >

Part II: Are U.S. Providers Ready to Catch Up in Medical Coding?

If you are a provider and are unsure about the differences in ICD-9 and ICD-10 codes or why there is a need for implementation, I highly suggest you read Tuesday’s post. More >

Are U.S. Providers Ready to Catch Up in Medical Coding?

After the bungled introduction of HealthCare.gov, providers are unquestionably leery of other technical health care-related requirements on the horizon. If there is a lesson to be learned in the wake of the Health Exchange debacle, it is this: it is never too early to prepare for change. More >

The Sun is Not Setting on the EHR Safe Harbor

The Centers for Medicare & Medicaid Services (“CMS”) and the U.S. Department of Health & Human Services Office of the Inspector General (“OIG”) recently announced that the regulation allowing certain health care entities to donate electronic health records (with the entity subsiding up to 85% of the donor’s costs) to physicians has been extended to December 31, 2021. The regulation, which provided a safe harbor from the Stark Law and Anti-kickback statute, was set to expire on December 31, 2013. More >

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