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One Medical Acquisition: The Path Forward

Bill of Health

billion acquisition of One Medical (NASDAQ: ONEM) by Amazon triggered significant hyperventilating about the transformative and immediate impact of this transaction on the health care industry. Important Disclosure: Flare Capital was a significant investor in Iora Health and had a board seat. By Michael Greeley. Last week’s $3.9

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From Evolution to Innovation, from Health Care to Health: How Health Plans With Collaborators Are Re-Defining the Industry

Jane Sarashon

As a constant observer and advisor across the health/care ecosystem, for me the concept of a “health plan” in the U.S. Furthermore, health plan members now see themselves as medical bill payers, seeking value and consumer-level services for their health insurance premium investment. is getting fuzzier by the day.

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Judge Sets Deadline For HHS To Clean Up Medicare Appeals Backlog Pileup

The Health Law Firm

Board Certified by The Florida Bar in Health Law On November 2, 2018, a federal judge in Washington, D.C. said the US Department of Health and Human Services (HHS) has until the end of 2022 to completely clear out its backlog of thousands of Medicare billing appeals. Indest III, J.D.,

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Fifth Circuit Upholds ACA Risk Adjustment Program

Healthcare Law Blog

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger insurers. See Vista Health Plan, Inc. United States Dep’t of Health & Hum. 2018 Final Rule, 83 Fed.

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What you should know about Part B drug payments to comply with IRA 2022

Innovaare Compliance

The Inflation Reduction Act of 2022 has wide-ranging impact on payments for drugs used by Medicare beneficiaries, whether they are administered in the provider’s office (Part B) or used in the ambulatory setting (Part D). Part B drugs have had the fastest spending growth for drugs for Medicare. percent annually.

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Texas OIG Inspectors Discover Errors in Reported Nursing Home Staff Hours

Med-Net Compliance

On November 3, 2022, the OIG released the results of a recent inspection of a nursing home by the Texas Health and Human Services (HHS) Office of Inspector General Audit and Inspections Division (OIG Inspections).

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CMS Advances Rulemaking for Section 111 Civil Money Penalties and Future Medicals

Medval Compliance Blog

by Frank Fairchok, Vice President of Medicare Reporting Services. Last week, the Centers for Medicare & Medicaid Services (CMS) advanced the rulemaking process in two long-awaited areas. 0938-AT85 – Medicare Secondary Payer and Future Medicals (CMS-6047).