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New patients’ rights requirements, rule changes may help clients in need of services

January 17th, 2017 | Posted in Consumer Focus, Long-Term Care, Quality Care, Uncategorized

Recent announcements from the Department of Health and Human Services (HHS) could help make getting care for your clients a little easier, including the possibility that providers can offer transportation to and from appointments, benefits to financially needy patients and new requirements for clear instructions to patients who require home health services. Providers can nowRead More

Large employer health plans could also see some impacts from Obamacare overhaul

January 17th, 2017 | Posted in Consumer Focus, Insurance Coverage, Uncategorized

By Michelle Andrews | Kaiser Health News While many consumers may think that an overhaul of the Affordable Care Act is unlikely to impact them because their health insurance is through their job at a big company, that’s not exactly true. Several of the law’s provisions apply to plans offered by large employers too (with some exceptions forRead More

Tighter prescribing rules: An anti-abuse strategy that could hurt patients in pain

December 13th, 2016 | Posted in Consumer Focus, Prescription Drug Coverage

By Shefali Luthra | Kaiser Health News As rates of prescription painkiller abuse remain stubbornly high, a number of states are attempting to cut off the supply at its source by making it harder for doctors to prescribe the addictive pills to Medicaid patients. Recommendations on how to make these restrictions and requirements were detailed in aRead More

ACA changes almost certain, but timetable could take a year or more

December 13th, 2016 | Posted in Consumer Focus, Insurance Coverage, Prescription Drug Coverage

The direction of major health care programs, from insurance exchanges to Medicaid expansion, may be a step closer to course reversal after President-elect Donald Trump tabbed new leaders for two key federal health care posts. Trump named Rep. Tom Price, R-Ga., a six-term congressman, former orthopedic surgeon and long-time Obamacare opponent, as his pick toRead More

Take wait-and-see approach when fielding patient questions on post-election changes

November 15th, 2016 | Posted in Uncategorized

As questions come in from patients who may be wondering how the change in presidential administration may impact their health care, stay informed but refrain from offering opinions because the health care industry is in flux right now, recommend patient advocacy experts. President-elect Donald Trump campaigned on a promise to repeal the controversial Affordable CareRead More

Repealing the Affordable Care Act could be more complicated than it looks

November 15th, 2016 | Posted in Uncategorized

By Julie Rovner / Kaiser Health News After six controversial years, the Affordable Care Act, aka Obamacare, may be on the way out, thanks to the GOP sweep of the presidency and both houses of Congress Nov. 8. “There’s no question Obamacare is dead,” said insurance industry consultant Robert Laszewski. “The only question is whether it willRead More

Care managers can play a role in fighting the national opioid epidemic

October 18th, 2016 | Posted in Clinical Trends, Consumer Focus, Quality Care

This guest column is written by Mary Ellen Gervais Ph.D., RN, CCM, president of Hyacinth Health Consulting in Baltimore. It originally was published in Inside the Joint Commission. Care managers who understand the holistic nature of health can play a significant role in relation to the current opioid- and heroin-addiction epidemic. Legal opiates are allRead More

Complaints filed about drug prices in marketplace plans may spur help for patients with chronic diseases

October 18th, 2016 | Posted in Consumer Focus, Insurance Coverage, Prescription Drug Coverage

By Michelle Andrews / Kaiser Health News The health law prohibits insurers from discriminating against people with serious illnesses, but some marketplace plans sidestep that taboo by making the drugs that people with HIV need unavailable or unaffordable, complaints filed recently with the Department of Health and Human Services’ Office for Civil Rights allege. The effect may be to discourageRead More

CMS must provide better education in the wake of maintenance therapy settlement

September 20th, 2016 | Posted in Consumer Focus, Insurance Coverage, Long-Term Care

If you are having problems getting home health agencies or other providers to approve maintenance therapy for patients for fear CMS will deny coverage, help could be on the way. A judge has ordered CMS to do a better job educating home health agencies and other providers about maintenance therapy coverage for patients. A U.S.Read More

After Orlando: Keeping family and friends informed without violating HIPAA

September 20th, 2016 | Posted in Consumer Focus, Professional Skills

The aftermath of the shooting rampage in a gay nightclub in Orlando, Fla., in June revealed confusion among providers about what information sharing is permitted with a patient’s friends, family members and caregivers, and what’s prohibited under HIPAA’s privacy rule. Staff at Orlando Regional Medical Center, the hospital where many of the shooting victims wereRead More