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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

Elderly patients in the hospital need to keep moving

August 16th, 2016 | Posted in Clinical Trends, Consumer Focus, Long-Term Care, Quality Care

By Anna Gorman / Kaiser Health News BIRMINGHAM, Ala. — Thelma Atkins ended up in the University of Alabama at Birmingham (UAB) Hospital-Highlands after a neighbor in her senior living center ran over her feet with a motorized scooter. Terri Middlebrooks, a nurse at the hospital, tried to figure out how active the 92-year-old Atkins was before theRead More

Educate patients about CMS’ pre-claim review demo before they receive letters denying care

July 19th, 2016 | Posted in Consumer Focus, Insurance Coverage

Beware that patients who have been discharged into home health care in five states may begin to receive letters from CMS stating that their home care services are not covered. CMS is conducting a pre-claim review demonstration in Illinois, Florida, Texas, Michigan and Massachusetts that will generate letters if documentation to justify the home careRead More

Obama administration issues sweeping protections for LGBTQ patients

July 19th, 2016 | Posted in Consumer Focus

Discrimination against patients based on their sexual orientation, gender identity or whether they conform to “sex stereotypes” are all banned under a final rule HHS that is effective as of now. The rule, commonly known as section 1557 of the Affordable Care Act (ACA), applies to health care providers and health plans alike. The ruleRead More