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Insurers Owe Customers Billions

Low medical loss ratios will compel insurers to return nearly $2.5 billion to their customers for the 2019 reporting year. Under federal law, individual and small group insurers must spend 80 percent of their premium revenue on health care services and large group insures must spend 85 percent. If they fail to do so they must return the difference to their enrollees, whether individuals, employers, or a combination of the two. In all, insurers owe nearly $2.5 billion – the most ever in a single year – to more than 11 million customers. Rebates can be paid as premium credit [...]

iqtsupport2020-11-30T06:00:49-05:00November 30, 2020|Uncategorized|

Number of Uninsured Children Rising

The number of uninsured children in the U.S. is rising. Since 2016, the number of uninsured children has risen by approximately 726,000 as the uninsured rate among children rose from 4.7 percent to 5.7 percent in 2019. An increase of 320,000 children between 2018 and 2019 was the largest such increase in more than a decade. Texas accounts for one-third of the four-year increase, or about 243,000 newly uninsured children, with Florida second with 55,000 newly uninsured children. Learn more about the increase in the number of uninsured children in recent years and why it occurred in the report “Children’s [...]

iqtsupport2020-10-19T06:00:16-04:00October 19, 2020|Uncategorized|

Coronavirus Update for Tuesday, October 6

The Department of Health and Human Services is now providing extensive information about its planned Phase 3 distribution of Provider Relief Funds. Background Last Thursday HHS announced the planned distribution of $20 billion in new funding for providers on the front lines of the COVID-19 pandemic. Under this Phase 3 General Distribution allocation, providers that have already received Provider Relief Fund payments are invited to apply for additional funding that considers financial losses and increased expenses experienced due to COVID-19. Previously ineligible providers, such as those that began practicing in 2020, will also be invited to apply, and an expanded [...]

iqtsupport2020-10-07T06:00:54-04:00October 7, 2020|Uncategorized|

Coronavirus Update for Thursday, June 4

Coronavirus update for Thursday, June 4 as of 2:30 p.m. Centers for Medicare & Medicaid Services CMS has published a compendium of Medicare physician fee schedule changes implemented in recent months in response to the COVID-19 crisis. CMS has posted a table that describes COVID-19 adjustments announced yesterday for CMMI model programs. CMS announced that the Nursing Home Compare web site now provides data on COVID-19 cases and deaths in individual nursing homes. Accompanying this announcement is publication of an FAQ on this nursing home data and a memo to state Medicaid programs about the data. Department of Health [...]

iqtsupport2020-06-05T06:00:43-04:00June 5, 2020|Uncategorized|

Coronavirus Update for May 28, 2020

Coronavirus update for Thursday, May 28 as of 2:30 p.m. Centers for Medicare & Medicaid Services CMS has updated its COVID-19 FAQs on Medicare fee-for-service billing with additional or revised answers to the following sections: Expansion of Virtual Communication Services for FQHCs/RHCs – questions 11-23 Medicare Telehealth (please note that these FAQs do not include flexibilities that might be exercised under the CARES act) – questions 23-33 General Billing Requirements – questions 2 and 3 Diagnosis Coding under International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) – question 1 Chronic Care Management Services – question 1 Outpatient Therapy Services [...]

iqtsupport2020-05-29T06:00:11-04:00May 29, 2020|Coronavirus, COVID-19, Uncategorized|

Coronavirus Update for May 15, 2020

Coronavirus update for Friday, May 15 as of 2:30 p.m. Centers for Medicare & Medicaid Services CMS released a bulletin that gives guidance to states on how to temporarily modify provider payment methodologies and capitation rates under their Medicaid managed care contracts to address the impact of the COVID-19 emergency while preserving systems of care and access to services for Medicaid beneficiaries. See CMS’s announcement of the bulletin here and find the bulletin itself here. CMS updated its COVID-19 FAQ on Medicare fee-for-serving billing with new information about accountable care organizations that terminate their Shared Savings Program agreement (p. 40). [...]

iqtsupport2020-05-18T06:00:51-04:00May 18, 2020|Coronavirus, COVID-19, Uncategorized|

Coronavirus Update for April 27, 2020

Coronavirus update for Monday, April 27 as of 3:30 p.m. Department of Health and Human Services Last Friday HHS deposited its second tranche of CARES Act funding in hospitals’ bank accounts. We have contacted HHS to inquire about the specifics of the funding formula, whether there are additional future attestation requirements, the timing for the next round of payments, and more. In the meantime, providers that received Provider Relief Payments in either round of funding should visit the CARES Act General Distribution Portal, where you will be able to provide data that HHS may use to calculate payment distributions from [...]

iqtsupport2020-04-28T06:00:50-04:00April 28, 2020|Coronavirus, COVID-19, Uncategorized|

U.S. May Pick Up Tab for Coronavirus Care for the Uninsured

Care for the uninsured who contract the coronavirus may be paid for by the federal government under the National Disaster Medical System program. That program, activated during national disasters, pays hospitals, doctors, and other medical facilities approximately 110 percent of Medicare rates for hospital and doctor care, home health services, primary care, and rehabilitation services. The possibility of using the program for this purpose is being discussed within the Trump administration and was raised during a congressional hearing earlier this week by the Department of Health and Human Services’ assistant secretary for preparedness. Learn more about the National Disaster Medical [...]

iqtsupport2020-03-06T06:00:28-05:00March 6, 2020|Uncategorized|

High-Deductible Plans Losing Luster Amid Low Unemployment

The competition for employees is leading more businesses to offer more generous health insurance plans in addition to high-deductible plans. As health insurance premiums rose in recent years, more and more companies were offering their employees more high-deductible insurance options to help keep down the cost of premiums. Now, however, with some workers clamoring for more conventional plans and businesses finding themselves in competition for workers at a time of low unemployment, more businesses are offering those conventional plans to their workers. 2020, in fact, will mark the third consecutive year during which the percentage of companies offering only high-deductible [...]

iqtsupport2019-11-01T06:00:26-04:00November 1, 2019|Uncategorized|

Surprise Medical Billing Problem Growing Worse

Insured patients are getting more surprise medical bills, and more expensive surprise medical bills, even as Congress attempts to tackle this problem. According to a new study, 42.8 percent of emergency department patients now receive surprise medical bills for out-of-network services, up from 32.3 percent in 2010, with those surprise bills rising from a mean of $220 in 2010 to $628 in 2016. Patients experience similar frustrations with inpatient visits, with surprise bills for out-of-network services arriving in the mailboxes of 42 percent of patients in 2016, up from 26.3 percent in 2010. Those surprise bills rose from a mean [...]

iqtsupport2019-08-15T10:06:29-04:00August 15, 2019|Uncategorized|