ABL Healthcare Member News & Industry Trendletter * July 3, 2018
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>>> Harry Soza is Founder and CEO of CAREMINDr, which enables doctors to effortlessly "check in" on patients being treated for serious chronic conditions, or during post-procedure recovery. The check-ins bridge the time gap between regular office visits, and can be early warnings if a patient's conditions are worsening, or improvement is not going as expected. A successful serial entrepreneur, Harry previously founded MYSN as a communication and promotional channel for health and wellness activities, and large audience events. He also launched OURewards, and SN-Impact Corporation. Earlier, he founded Resolution Health (RHI), where he was CEO for six years; venture capital-financed RHI was subsequently sold to WellPoint. Before RHI, Harry was Founder and President of VC-backed Preferred Solutions, Inc., one of the first online pharmacy benefit management companies, which was acquired by PacifiCare, and operates today as Prescription Solutions. Still earlier, Harry was Founder and President of two other VC-backed technology firms. Harry has joined the Silicon Valley Round Table.

An Open Letter
to Atul Gawande, MD
Compiled by Mimi Grant

Dear Atul,
Even though you've yet to officially begin your new career at the helm of the yet-to-be-named "Amazon-Berkshire Hathaway-JPMorgan Chase health plan" (which we'll call "ABC"), several of ABL's Adaptive (Healthcare) Business Leaders have collaborated on a few suggestions for your consideration as you seek to dramatically improve the quality of care ABC employees receive. Of course, they're also mindful of your plan to target "waste in the current U.S. healthcare system." So here are their recommendations: . . . READ REST OF BLOG >>>

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AgilisIT CEO Judges Competitions for Entrepreneur & Biz Students

Joyce Tang, CEO of AgilisIT, recently participated on the panel of judges for the Entrepreneur Challenge, a University of California at San Diego competition for student entrepreneurs working in high tech, life tech, and cleantech. Joyce also recently served as a judge at San Diego State University's Business Innovation Class final presentations, which encourages students to use novel and creative ways to solve today's social and environmental problems. (Joyce Tang, Orange County)

Alvaka Suggests Safeguards re: HIPAA & Physical Workstations

In HIPAA Security: Don't Neglect Physical Workstation Security Safeguards, Alvaka Networks' Oli Thordarson notes that for those who must comply with the HIPAA Security Rule, they are required to: "Implement physical safeguards for all workstations that access electronic protected health information [EPHI], to restrict access to authorized users," where a workstation is defined as "an electronic computing device, for example, a laptop or desktop computer, or any other device that performs similar functions, and electronic media stored in its immediate environment. Physical controls can often be low-cost measures that a company can put into action, which can greatly increase protections, such as: policies that require workstations and/or office doors to be locked while employees are away from their desk; arranging workstations so they are not visible to everyone; and using computer privacy filters or USB port locks that will restrict access to sensitive data and prevent the transferring of informationh (Oli Thordarson, Orange County)

AT&T Launches FirstNet Public Safety Communications Platform

The doors to 5,300+ AT&T retail stores across the U.S. are now open to verified first responders interested in signing themselves up for FirstNet service, which is the country's first nationwide public safety communications platform dedicated to first responders. AT&T is building FirstNet in a public-private partnership with the First Responder Network Authority. (Judi Manis)

Care3: Tackles Mitochondrial Disease & CEO Interviewed

Care3, a team collaboration platform for healthcare delivered in the home and community, and MitoAction, a patient advocacy organization within the mitochondrial disease community, have formed a global innovation partnership focused on advancing the knowledge of, and care delivery for, mitochondrial disease. Meanwhile, Care3 CEO David Williams was recently featured on The Credentialed podcast, in which he talks about why serving the underserved matters in today's healthcare system, how Care3 is built to uniquely deliver better outcomes at lower cost, and how David's background has led to a mission of achieving global healthcare equality. (David Williams, Los Angeles)

Cigna Confronts Opioid Addiction & Overdose with New Goal

Cigna announced it will collaborate with employers, customers, prescribing clinicians, pharmacists, and community-based organizations to reduce the number of opioid overdoses by 25% among its commercial customers in targeted U.S. communities by December 2021. Cigna will also partner locally to develop immediate and long-term approaches that make it easier for people to access treatment for substance use disorders. In March 2018, Cigna announced a 25% reduction in prescription opioid use among its commercial customers achieved in collaboration with over 1.1 million prescribing clinicians. However, claims data shows that despite a reduction in the number of prescriptions, opioid overdoses continue to rise. (Chris De Rosa, Orange County)

Covered California Unveils Balanced Budget & Wins Award

Covered California's Board of Directors have adopted a $350 million budget for fiscal year 2018-19 that highlights the agency's ongoing strength and stability. The balanced budget, which relies solely on funds collected from qualified health plans, calls for continuing significant investments in marketing and outreach, and does not include any state or federal funding. Covered California expects to begin FY 2018-19 with approximately $310 million in reserves, which is the equivalent of about 11 months of operating expenses. Meanwhile, for the second year in a row, the Radio Mercury Awards honored Covered California for its creative marketing, specifically for a Spanish-language radio spot that was developed to air prior to the 2018 FIFA World Cup. (Kathy Keeshen, Sacramento)

ElderConsult to Address Early Signs of Dementia

On the evening of July 12, in Burlingame, Elizabeth Landsverk MD, of ElderConsult Geriatric Medicine, will speak about the Early Signs of Dementia and Living Well. The event will run from 5 to 7 p.m., at Atria Burlingame. (Elizabeth Landsverk MD, Bay Area)

GeBBS Plants 5,000 Trees to Celebrate 5,000-Employee Milestone

GeBBS Healthcare Solutions announced that the company is planting 5,000 trees in the U.S., Philippines, and India to celebrate surpassing 5,000 worldwide employees. CEO Nitin Thakor said the achievement reinforces that the company is delivering real solutions to long-standing problems in the healthcare industry, and that GeBBS will continue to push the needle to lower costs and drive efficiencies within the revenue cycle. (Nitin Thakor, Los Angeles)

Global One Partners with DISC Sports & Spine Center

DISC Sports & Spine Center, of Newport Beach, recently partnered with Global One Ventures and Blue Shield to form an in-network bundled payment model. The collaboration will give bundled rates to the payer's in-network subscribers for minimally invasive spine surgery, orthopedic surgery, sports medicine, and pain management services at DISC's surgery centers. Meanwhile, Scott Leggett, Co-Principal of Global One, published an article in Physician News Network Healthcare Consumer, Meet Bundled Payments. (Scott Leggett, Orange County)

Good Samaritan Hospital Receives Stroke Care Award

Good Samaritan Hospital has received the American Heart Association/ American Stroke Association's Get With The Guidelines-Stroke Silver Plus Quality Achievement Award, which recognizes the hospital's commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. Good Samaritan also received the association's Target: Stroke Elite Plus Honor Roll, meaning it has met quality measures developed to reduce the time between the patient's arrival at the hospital and treatment with the clot-buster tissue plasminogen activator (tPA), the only drug approved by the FDA to treat ischemic stroke. (Andy Leeka, Los Angeles)

Gorman's Dave Sayen is Optimistic About Atul Gawande's New Role

Dave Sayen, of Gorman Health Group (GHG), has written a blog post about the naming of Atul Gawande, MD, as CEO of the Amazon, Berkshire Hathaway, and JP Morgan health venture, in which he concludes that Dr. Gawande "has something very special and rare: he can get people's attention, make them listen, and make them understand a paradigm shift. Over my long tenure at CMS, the agency went from paying the bills for healthcare to moving a broader agenda to improve healthcare, making it cheaper and safer. I believe the appointment of Dr. Atul Gawande to lead the joint healthcare venture represents a tipping point with business and government finally getting on the same page about healthcare." Meanwhile, GHG has published a Summary & Analysis of the 2019 Rate Announcement & Final Call Letter. (Dave Sayen, Bay Area)

Health Coach Institute Examines Career Paths for Health Coaches

In its recent blog post - The Many Career Paths for Health Coaches - Health Coach Institute (HCI) shares that health coaching is expanding into mainstream medicine, the corporate world, schools, and other institutions, and health coaches are being seen as essential collaborators who can provide clients and patients with the critical support, accountability, and guidance they need to transform their health in a sustainable way. HCI notes that health coaches are finding roles in traditional medicine, corporate wellness firms, specialty healthcare companies, care coordination, functional medical practices, the fitness industry and weight loss centers, digital medicine companies, health insurance companies, community clinics, spas and health food stores, workplace health programs, schools and universities, and more. (Eric Neuner, Bay Area)

HumanGood Previews New Approach to Community Dining

HumanGood's White Sands La Jolla facility recently debuted a dining pilot program by inviting residents to a special dinner, featuring a menu with local, sustainably-sourced, farm-to-table ingredients. The meal was served family style, with menu items that were simple, fresh, elegantly prepared, and meant to be enjoyed in the company of others. It's a preview of HumanGood's new approach to dining in its communities, showcasing how HumanGood values translate into an improved experience in its communities. (Tara McGuinness, Bay Area)

IIC Inks Partnership with Blue Shield Care1st

IIC, a leading advanced radiology center, and Blue Shield Care1st, which services 525,000+ Medicare and Medi-Cal recipients in California, have reached a reciprocal agreement allowing BSC1st's non-contracted IPAs to contract with IIC at the BSC1st negotiated rate, with the goal to improve access and clinical sharing, lower disparity, and improve survival for patients in Southern California. IIC CEO Brad Schmidt says that breast cancer affords an interesting case study on the importance of "shopping" as treatment costs for insurance now average $23,078 per patient, yet there exists a tremendous disparity on survival where death rates for some populations can be 56% higher in L.A. County than the national average. BSC1st partnered with IIC to allow IPAs more flexibility to shop for access and technology, while supporting the underserved. (from IIC: Brad Schmidt; from Blue Shield Care1st: Greg Buchert; both Los Angeles)

Kaiser Permanente Again Tops Annual Consumer Loyalty Study

Kaiser Permanente (KP) for the eighth year in a row is ranked highest for customer loyalty in the health plan category, according to the NICE Satmetrix 2018 U.S. Consumer NPS Benchmarks. KP received a Net Promoter Score of 40, a 43% increase over last year's score (28) and triple the industry average (13). KP joins satisfaction leaders in other industries, including Amazon.com, Costco, Apple, JetBlue, Ritz Carlton, Vanguard, and USAA. The scores are based on survey responses from 62,000+ U.S. consumers nationwide who rated their experience with the primary brands they use. Meanwhile, KP has opened a new state-of-the-art medical office building in downtown Sacramento, becoming the only provider to offer major healthcare services in the city's center. (Walt Meyers, Bay Area)

King & Spalding Honored & Announces Medical Device Webinar

Corporate Board Member magazine has named King & Spalding (K&S) one of America's Best Corporate Law Firms in its 18th annual study, reflecting the opinions of 250 corporate directors and general counsel at publicly traded companies from across the U.S., who were asked to select the firms they would most like to represent them in a variety of corporate legal matters. Also, a recent Sacramento Business Journal article - Local notables share the worst advice they ever got – includes K&S Partner Marcia Augsburger, who says the three worst bits of advice she ever got were: (1) "Just breathe." (2) "Don't worry about it." (3) "Don't work so much." Meanwhile, K&S will hold a webinar on July 17, at 10 a.m. Pacific, entitled Is Your Software a Medical Device? Understanding FDA's Evolving Digital Health Policy. (Marcia Augsburger, Sacramento, & Travis Jackson, Los Angeles)

Maxim Healthcare Deploys Next-Gen Health Tools

Maxim Healthcare Services and Leidos have partnered to develop a suite of healthcare products that will put actionable information in the hands of caregivers before entering a patient's home. The products, which will be deployed through Maxim's workforce of 65,000+ frontline caregivers, will operate on the Leidos platform and combine structured and unstructured data from a variety of sources to provide a holistic patient view while identifying potential risks or gaps in care. This information will enable Maxim team members to stratify populations, make more informed clinical decisions, and better allocate resources. In addition, the companies plan to implement these services for health plans, large health systems, employers and government payers seeking to better manage post-acute and long-term community-based care services for chronic care and medically fragile populations. The products will also support population health initiatives for Maxim's large existing business serving self-insured employers. (Jarrod DePriest, Sacramento)

MYnd Analytics/Arcadian Launch School Telepsychiatry Program

MYnd Analytics and its recently acquired subsidiary Arcadian Telepsychiatry Services have launched a school-based telepsychiatry program, which will be offered nationwide through the Arcadian provider organization network located in more than 42 states. The new school telepsychiatry program includes telepsychiatry sessions, consultations, and prescribing for students with a medically treatable condition. (George Carpenter, Orange County)

NCPIC Services Now Available in Roseville

Northern California PET Imaging Center (NCPIC) recently began providing mobile PET/CT services in Roseville, CA, in addition to Midtown Sacramento, Woodland/Davis, Grass Valley, Vallejo, and Auburn. (Ruth Tesar, Sacramento)

Nelson Hardiman: Announces Webinar with CDC & Receives Honor

In this video, Harry Nelson, a Partner in Nelson Hardiman (NH), talks about his recent presentations at the American Health Lawyers Association annual meeting in Chicago, in which he discussed health system adaptation to address the opioid crisis. He also shares that he is collaborating with the Centers for Disease Control on an upcoming webinar; more details to come. Meanwhile, Law360 has ranked NH in the top 10 nationally for Best Law Firms for Minority Attorneys (20-149 lawyers). (Harry Nelson, Los Angeles)

Oscar Health Expands to Six New Markets

Oscar Health has filed to offer its consumer-focused, technology-driven health insurance in nine states and 14 markets in 2019, nearly doubling its current footprint. Six new markets will be spread across three new states - Florida, Arizona, and Michigan - and three additional large metro areas in Ohio, Tennessee, and Texas, subject to regulatory approval. Oscar's expansion also follows the insurer's first-ever quarterly profit, according to Fierce Healthcare. Oscar received over $300 million in premium revenue in the first quarter of 2018, three times higher than the same time last year, as well as a net profit of $7.4 million. Meanwhile, CNBC published a feature article on the company: Oscar Health has a vision of fairer pay for doctors and clearer pricing for patients. (John Puente, Sacramento)

Pathways Health to Present Golf Tournament in July

Pathways Health will hold its 6th annual Links to the Heart Golf Tournament, on July 16, at the newly renovated Stanford University Golf Course. Located in the foothills above the university campus, this course is consistently rated one of the finest in the world. The event supports Pathways and will include contests, prizes, lunch, dinner, awards, and more. Also, Pathways was included in Gentry Magazine's recent Philanthropy Issue. (Barbara Burgess, Silicon Valley)

SAVI Group Addresses Healthcare + Technology Issues

Sumit Mahendru, of SAVI Group, has recently published several blog posts, all of which can be found here. Topics include: *How Technology is Helping Doctors Improve Their Practices; *Is it Possible to Get Your Denial Rates Under 5%?; *Five Questions to Ask Before Digitizing Patient Records; *5 Things To Watch During EHR Migration; *Make Your EHR Adoption Successful with these Tips; *How EMRs Can Change Patient Care for the Better; *ICD-10 Codes: Are You Underusing Them?; and *Coding Changes Are Coming! An EMR System Can Help. (Sumit Mahendru, Orange County)

The Health Trust Awarded Programs in Santa Clara & San Jose

The Santa Clara County Board of Supervisors recently unanimously approved $700,000 - over three years - to The Health Trust to provide evidence-based programs designed to reduce Asian health disparities as identified in the 2017 Santa Clara County Asian/Pacific Islander Health Assessment. And, the San Jose City Council recently approved a one-time allocation of $225,000 from its Essential Services Reserve funding to support The Health Trust Food for Everyone efforts that increase healthy food access for older adults. In addition, the City Council also directed the City Manager to co-convene, in partnership with The Health Trust, a stakeholder group tasked with developing a longer-term plan to improve food access for older adults. (Todd Hansen, Silicon Valley)

Welcome New Tech Member! Jeff Broudy of PCIHIPAA

Jeff Broudy is CEO of PCIHIPAA, a leader in HIPAA compliance and patient data protection, delivering Payment Card Industry (PCI) and HIPAA compliance solutions. PCIHIPAA specializes in helping medical and dental practices mitigate risks related to HIPAA requirements and data protection, quickly, easily, and affordably. The company's team of experts is comprised of certified risk advisors, customer success specialists, and HIPAA lawyers. Since 2012, PCIHIPAA's OfficeSafe compliance solution has protected thousands of medical and dental practices nationwide. Clients enjoy compliance without burdening their own team; data breach protection in case of patient data breach or regulatory fine; encryption solutions to protect patient information; and savings related to redundant PCI fees and excess credit card processing fees. Prior to becoming CEO of PCIHIPAA in June 2015, Jeff was Intuit's VP of Sales and Marketing for Total Merchant Services, and Director of Sales and Marketing. Jeff has joined the West Los Angeles Technology Round Table.

Catasys Gets $10M & Launches OnTrak-AN in California

Catasys, Inc. has entered into a $10 million financing comprised of a receivable facility agreement of $2.5 million with Heritage Bank of Commerce and a four-year term loan of up to $7.5 million with Horizon Technology Finance Corporation. Catasys intends to use the proceeds to scale new contracts and expansions, invest in new technology platforms, and provide excess capital. Meanwhile, Catasys has launched its OnTrak program with the second largest health plan in the U.S. meaning it's now contracted with 7 of the top 8 insurers nationwide. Catasys' OnTrak program has initially launched with this plan in California, which brings the number of states in which OnTrak is available to 20. Eligible commercial members in California are now able to take advantage of OnTrak-AN, an integrated 52-week program that identifies, engages, and treats members with untreated or undertreated behavioral health conditions that impact co-morbid medical conditions, such as diabetes, hypertension, coronary artery disease, COPD, and congestive heart failure, resulting in high medical costs. (Rick Anderson, West Los Angeles Technology)

PCIHIPAA Launches OfficeSafe Pay & More

PCIHIPAA, whose OfficeSafe compliance platform helps medical and dental practices comply with stringent regulations, recently expanded its suite of services to include OfficeSafe Pay, to help healthcare professionals maintain payment card industry compliance and save money on excessive credit card processing fees, and Privacy Automation Tool to enable healthcare professionals to easily execute documents required under HIPAA's Privacy Rule. And, the Kentucky Dental Association welcomed PCIHIPAA as a Silver Patron, whereby PCIHIPAA will help protect KDA members from the onslaught of ransomware attacks, HIPAA violations, and data breaches impacting dental practices in Kentucky. (Jeff Broudy, West Los Angeles Technology)

Amazon to Buy Online Pharmacy PillPack for $1 Billion

Amazon.com Inc. is buying online pharmacy PillPack Inc. for roughly $1 billion, giving the e-commerce giant the ability to ship prescriptions around the country, and overnight, making it a direct threat to the $400+ billion pharmacy business. The online retailer beat out Walmart Inc., which also was in talks for the five-year-old startup, according to people familiar with the matter. The acquisition means Amazon doesn't have to build capabilities in-house that current players have spent years assembling. (Read Article: Wall Street Journal, 6/28/18)

Hospitals Address Widespread Doctor Burnout

To address what experts view as a national epidemic of physician discontent, hospitals are expanding their c-suites with the new position of chief wellness officer. In recent years hospitals have tried a variety of wellness programs, but there is a sense this approach didn't treat the causes of physician angst and alienation. In a discussion paper published last summer, the National Academy of Medicine noted that more than half of U.S. physicians exhibited signs of burnout, a syndrome marked by "a high degree of emotional exhaustion...and a low sense of personal accomplishment." (Read Article: Wall Street Journal, 6/9/18)

Exercise Battles Depression, Particularly in Middle Age: Study

Just as suicide rates are spiking and a national conversation has begun on to how to fight depression - a disease that impacts 16 million adults in the U.S., a new study shows that exercise may be a key weapon in the battle. Published in JAMA Psychiatry, this new study shows that exercise combats depression, particularly in middle-age. (Read Article: The Mercury News , 6/28/19)

Google AI Can Predict When You'll Die "with 95% Accuracy"

Google has developed an artificial intelligence algorithm that could predict when you'll die with up to 95% accuracy, according to the tech giant's researchers. Google applied AI to a vast amount of data from 216,000+ adult patients hospitalized for at least 24 hours each in two medical centers. The proof-of-concept study found that the algorithm could accurately predict risk of mortality, hospital readmission, prolonged hospital stay, and discharge diagnosis. In all cases, the method proved more accurate than previously published models. (Read Article: Fox News, 6/19/18)

CMS Acting to Modernize Medicare Home Health

CMS Administrator Seema Verma has announced a "redesign of the home health payment system [that] encourages value over volume and removes incentives to provide unnecessary care." CMS's proposed changes promote innovation by allowing the cost of remote patient monitoring to be reported by home health agencies as allowable costs on the Medicare cost report form, which is expected to help foster the adoption of emerging technologies by home health agencies and result in more effective care planning, as data is shared among patients, their caregivers, and their providers. Supporting patients in sharing this data will advance the Administration's MyHealthEData initiative. It's planned that this proposed rule would also implement a new Patient-Driven Groupings Model (PDGM) for home health payments. The current system pays for 60-day episodes of care and relies on the number of therapy visits a patient receives to determine payment. The PDGM would eliminate the use of "therapy thresholds" in determining payment and changes the unit of payment to 30-day periods of care. In the proposed rule, the PDGM would be implemented in a budget-neutral manner on January 1, 2020, as part of a broader effort to "put patients over paperwork by improving access to and value of care, and reducing the administrative burden on physicians so that more effective care to patients may be provided." (Read Article: CMS release, 7/2/18)

Fed Judge Strikes Down Kentucky's Medicaid Work Requirements

A federal judge struck down Kentucky's Medicaid waiver that included work requirements for approximately 350,000 beneficiaries, dealing a blow to the Trump administration's new approach to Medicaid. U.S. District Judge James E. Boasberg for the U.S. District Court of the District of Columbia ruled that HHS "never adequately considered whether Kentucky HEALTH would in fact help the state furnish medical assistance to its citizens, a central objective of Medicaid." Boesberg vacated the waiver approval, calling it "arbitrary and capricious," and remanding it back to HHS for further review. (Read Article: Fierce Healthcare, 6/29/18)

Supreme Court Ruling on Union Fees Could Shift Healthcare Politics

American political dynamics around healthcare and other issues could be changed by a U.S. Supreme Court decision that significantly weakens public-sector labor unions. In a ruling with major ramifications for healthcare organizations, a bitterly split high court ruled that public-sector unions cannot collect mandatory service fees from members for representing them in contract negotiations. (Read Article: Modern Healthcare, 6/27/18)

New Rule Expands Access to Health Plans Without ACA Protections

Millions of small businesses and self-employed people will be able to buy health insurance plans exempt from many Affordable Care Act consumer protections under a much-debated rule released recently by the Trump administration. It makes it far easier for small businesses and self-employed individuals to band together and obtain "association health plans" for themselves and their employees. (Read Article: Wall Street Journal, 6/19/18)

Government Doesn't Have to Pay Billions to Health Insurers: Court

The federal government doesn't have to pay insurers billions of dollars under an Affordable Care Act program aimed at enticing them into the markets by helping cover their financial risks, a divided federal appeals court has ruled. The ruling, from a three-judge panel at the U.S. Court of Appeals for the Federal Circuit, had been eagerly awaited by insurers who say they are owed $8+ billion under the ACA's "risk corridors" mechanism. Under the program, the administration collected money from insurers and redistributed it, giving more to companies that fared poorly on the ACA marketplaces. Insurers say the federal government promised to cover certain losses even if it didn't collect enough from participating insurers. But Republicans have said the program can only pay out as much as it collected, creating a shortfall for insurers that totaled about $12.3 billion. (Read Article: Wall Street Journal, 6/14/18)

House Passes Bipartisan Opioid Bill

The House passed a bipartisan healthcare bill on June 22 that had support from almost all members of both parties. H.R. 6, Support for Patients and Communities Act, is a comprehensive opioid bill that combines more than 58 individual bills intended to address the national opioid epidemic. (Read Article: Gorman Health Group, 6/28/18)

CMS OKs State Proposal to Advance Specific Medicaid Value-Based Arrangements with Drug Makers

CMS issued the first-ever approval of a state plan amendment proposal to allow the state of Oklahoma to negotiate supplemental rebate agreements involving value-based purchasing (VBP) arrangements with drug manufacturers that could produce extra rebates for the state if clinical outcomes are not achieved. Oklahoma's state plan amendment proposal will be the first of its kind permitting a state to pursue CMS-authorized supplemental rebate agreements involving VBP arrangements with manufacturers. (Read Article: CMS release, 6/27/18)

CMS Seeks Input on Reducing Regulatory Burdens of Stark Law

CMS has issued a Request for Information seeking recommendations and input from the public on how to address any undue impact and burden of the physician self-referral law (AKA the Stark Law), focusing in part on how the law may impede care coordination, a key aspect of systems that deliver value. (Read Article: CMS release, 6/20/18)

CMS Announces Initiatives to Strengthen Medicaid Program Integrity

CMS recently announced new and enhanced initiatives designed to improve Medicaid program integrity through greater transparency and accountability, strengthened data, and innovative and robust analytic tools. The initiatives include stronger audit functions, enhanced oversight of state contracts with private insurance companies, increased beneficiary eligibility oversight, and stricter enforcement of state compliance with federal rules. (Read Article: CMS release, 6/26/18)

Herzlinger & Klein Opine on a More Sustainable Way to Provide Employees' Healthcare

In their "Opinion" piece, Harvard B School professor, Regina Herzlinger, and Joel Klein, Oscar Health chief policy and strategy officer, recommend that, "The IRS should give all workers the chance to purchase health insurance with pretax dollars - just as employers do - using Health Reimbursement Arrangements. Companies would give employees a fixed amount of money in these HRAs to go out and buy the best plans for their families on the ObamaCare exchanges. The plans there would be subject to the Affordable Care Act's requirements on essential health benefits and cost-sharing limits. Employees could use this tax-free money only for the purchase of health insurance, but would pocket any leftover savings as taxable income." (Read Article: Wall Street Journal, 7/1/18)

Entry-Level Marketing Professional Available

An ABL Member recommends Rachel Harris, a recent university graduate with proficiency in all segments of Google Analytics, Keyword Planner, Ahrefs, Moz Local Listing; also social media savvy: See Resume

207 East Memory Lane
Santa Ana, CA 92705

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