In 2015, we already have seen a great deal of activity in healthcare transactions that is attracting antitrust scrutiny, with mixed results.
Fee splitting prohibitions are aimed primarily at situations where a healthcare professional, in order to generate patient referrals from other licensed or unlicensed persons, splits part of the professional fee earned from treating the referred patient with the source of the referral.
Retail clinics offer convenient, low-cost basic primary care treatment, screening and diagnostic services in a variety of settings. Increasingly, these clinics are an integral part of a U.S. healthcare system in the throes of massive change as payers and providers migrate toward the Triple Aim ...
Last October the Obama Administration announced it would seek to continue enhanced federal funding for state Medicaid E&E systems, provided states meet updated systems standards and funding conditions.
On April 29, 2015, Montana Governor Steve Bullock signed Senate Bill 405, referred to as the Montana Health and Economic Livelihood Partnership Act (HELP Act), which expands Medicaid to cover an estimated 70,000 new adults.
Arkansas broke new ground with its Marketplace Premium Assistance Medicaid expansion (widely referred to as the “Private Option”) last year, spurring additional states to consider the model.
The Affordable Care Act provides states with a powerful incentive to expand Medicaid to adults with incomes up to 133% of the Federal Poverty Level, paying for 100% of Medicaid coverage through 2016, and eventually phasing to 90% in 2020 and beyond.
Early data emerges on the impact of Medicaid expansion on states’ budgets and enrollees’ healthy behaviors.
A key goal of the ACA is to create an insurance market in which consumers have the ability to compare coverage options across standardized criteria and identify the plans that best meet their families’ healthcare needs.
More than 7 million people in states with federally run marketplaces currently receive health insurance subsidies. If they suddenly had to pay unsubsidized premiums, most would no longer be able to afford their coverage.