The Medicare Secondary Payer law rendering a potential $1,000 per day penalty for noncompliance against primary payers has finally been demystified to some extent. The proposed regulation issuing guidance about Medicare Secondary Payer Civil Monetary Penalties relative to Section 111 reporting was unoffi...
As General Counsel & Vice President of Claims Solutions, Shawn Deane leads J29’s Medicare Secondary Payer (MSP) services team. Shawn is a practicing attorney and has over 16 years of experience in Medicare compliance, workers’ compensation, and insurance claims. He was previou...
I don’t disagree, but I think that’s a secondary concern. The real problem is that government spending will become an ever-larger economic burden. And that will hinder growth whether it’s financed by borrowing or taxes. Speaking of taxes, here’s the chart from the study that deserves...
Payer considerations in 2024 as Medicare Advantage changes Sweeping changes to Medicare Advantage: How payers could respond As the MA market shifts, brokers face beneficiary churn, payers’ vertical integration, and compensation uncertainty. To survive, they’ll need to expand services and professionalize...
Meta-analysis: secondary prevention programs for patients with coronary artery disease. Ann Intern Med. 2005;143(9):659-67216263889PubMedGoogle ScholarCrossref 34. McAlister FA, Stewart S, Ferrua S, McMurray JV. Multidisciplinary strategies for the management of heart failure patients at high risk...
CHART 1 Full Part B Coverage Beneficiaries who file individual tax returns with modified adjusted gross income: Beneficiaries who file joint tax returns with modified adjusted gross income: Income-Related Monthly Adjustment Amount Total Monthly Premium Amount Less than or equal to $97,000 Less than ...
Excellent, excellent point. Kind of digging a little bit deeper on the diagnosis codes and how things are the focus and the concerns by the government. If you have diagnoses that are listed, right, primary, secondary, et cetera, but there’s no treatment for those diagnoses or if you have...
D-SNPs, however, remain the largest of the SNPs. Recent years have seen substantial growth in their population, with payer entry and investment to match. This isn’t lost on state governments. While not a nationwide phenomenon, more states continue to move into highly integrated and fully inte...