iHealthBeat: Health Plans

CMS Maintains Funding Bump for State Medicaid System Upgrades

Fri, 04 Dec 2015 18:17:00 Z

CMS has finalized a rule to make permanent an increased funding match, which was scheduled to expire this month, to help states upgrade their Medicaid eligibility and enrollment systems. The agency estimates that making the funding bump permanent will cost about $3 billion between fiscal years 2016 and 2025. Modern Healthcare.

The Rising Star in the Value-Based Community: Pharmacists

Mon, 30 Nov 2015 11:00:00 Z

Given the frequency of their interactions with patients and their medical knowledge, pharmacists are uniquely positioned to work with health plans and providers to achieve value-based care standards. When integrating pharmacists with the VBC team, we should tap into technology to improve workflow, promote patient engagement and better leverage patient data.

Report: Health Care IT Payer Outsourcing Market To Increase by 40%

Tue, 24 Nov 2015 17:51:00 Z

A new report projects that the market for health care IT payer outsourcing will increase by 40% in the next two years. The increase will stem from software tools that have accelerated expenses faster than expected and revenue growth, researchers say. FierceHealthPayer, Black Book release.

Feds Seek To Expand Data Employer Wellness Programs Collect

Fri, 30 Oct 2015 17:53:00 Z

The Equal Employment Opportunity Commission is seeking feedback on how employers can safeguard personal data that are collected through employer wellness programs and stored electronically. The request for public comment is part of a newly proposed rule that would expand the type of data collected through employer wellness programs. Kaiser Health News.

Employers Use Online Tools, Financial Incentives To Cut Health Costs

Mon, 19 Oct 2015 16:50:00 Z

Amid rising health care costs, some employers are leveraging online tools that offer financial incentives to workers for being savvy health care shoppers. One such tool, SmartShopper, helped the New Hampshire Health Trust save an estimated $826,000 in health care costs after making the program available to about 47,000 enrollees. AP/Sacramento Bee.

SCOTUS' Docket Includes Vermont Health Data Collection Law Case

Mon, 05 Oct 2015 14:25:00 Z

The U.S. Supreme Court's new term begins today. One of the cases justices will hear centers on the legality of a requirement under Vermont law for self-funded insurers to submit certain information upon request to the state's database. Oral arguments are expected to begin in December or January 2016. Modern Healthcare.

Health IT Projects Included in HHS' Grants To Improve Patient Care

Tue, 29 Sep 2015 18:24:00 Z

HHS has announced nearly $700 million in grants for 39 organizations to help improve patient care, in part through health IT. The funding will be used to support various ambulatory programs, including continuing education and training providers on how to use patient data to improve care. Wall Street Journal et al.

Medical Industry Lags Behind in Switch to Electronic Billing Systems

Thu, 11 Jun 2015 17:57:00 Z

While most other industries in the U.S. have migrated to electronic billing systems, the medical industry has not yet transitioned away from paper billing. Federal data show that paper billing practices have contributed to the high cost of administrating private coverage. Bloomberg Business.

CMS' Medicaid Managed Care Proposal Encourages EHR Use

Thu, 28 May 2015 16:33:00 Z

CMS has released a proposed rule for Medicaid managed care plans that aims to create more standardized practices across states and align managed care standards with those of the private market. The proposed rule also would encourage states to bolster health IT use among providers who are ineligible for federal incentive programs. Modern Healthcare, The Hill.

Study: EHRs Could Help Patients Maintain Health Insurance 'Stability'

Thu, 23 Apr 2015 17:52:00 Z

A new study published in the Journal of the American Medical Informatics Association finds that electronic health records could be used to validate patients' health insurance information and help patients retain their coverage through enrollment and retention support. FierceEMR, JAMIA.

HIMSS15: A Health System Ripe for Change

Wed, 15 Apr 2015 13:17:00 Z

Humana President and CEO Bruce Broussard made a plea for conference attendees to "change the conversation" in health care. Meanwhile, National Coordinator for Health IT Karen DeSalvo discussed how legislation to permanently replace the Medicare sustainable growth rate formula could affect federal health IT efforts.

Report Finds Most Health Insurers Have Released Few Mobile Apps

Thu, 19 Mar 2015 17:45:00 Z

A report by Research2Guidance finds that 77% of health insurers have released two or fewer mobile applications. An analyst notes that insurer-built apps often fail to gain traction because they do not use certain best practices. MobiHealthNews, Research2Guidance graph.

HealthCare.gov Continues To Experience Technical Issues

Wed, 18 Feb 2015 18:08:00 Z

HealthCare.gov, which launched in 2013, still has issues communicating with insurers in ways that makes it difficult to ensure enrollees have signed up for the correct plan and to update their personal information. In addition, a recent glitch has caused the White House to extend the latest open enrollment period for some consumers. Politico, New York Times' "The Upshot."

Cyberattack Affects up to 80M Anthem Customers, Employees

Thu, 05 Feb 2015 18:33:00 Z

Health insurer Anthem says a database containing the personal information of about 80 million of its customers, former customers and employees was accessed by hackers between Dec. 10, 2014, and Jan. 27. The cyberattack likely is the largest ever reported by a health care organization. San Jose Mercury News et al.

Consumer Watchdog Urges Californians To Boycott Health Database

Mon, 22 Dec 2014 18:23:00 Z

Consumer Watchdog argues that California residents should opt out of a new health database being created by Anthem Blue Cross and Blue Shield of California because they do not yet have enough information on privacy and data use. Cal INDEX officials recently have released a notice detailing its privacy and security policies. Los Angeles Times et al.

SCOTUS Might Consider Legality of State Health Data Collection Laws

Fri, 19 Dec 2014 17:24:00 Z

The Supreme Court is weighing whether to hear Gobeille v. Liberty Mutual Insurance Co., a case that examines the legality of state laws requiring self-funded insurers to provide certain health information to state databases. States say the data are needed to provide a full picture of population health, while insurers say federal law exempts them from providing such data. Modern Healthcare.

Health Plan Identifiers Hold Little Value for Stakeholders, Poll Finds

Wed, 24 Sep 2014 17:52:00 Z

A survey conducted by the Workgroup for Electronic Data Interchange finds that health plans and other stakeholders see "little to no value" in using unique health plan identifiers for electronic transactions. A 2012 HHS rule requires all health plans to adopt HPIDs by 2016, but WEDI says they are no longer necessary. Health Data Management, FierceHealthIT.

Pilot Taps Registry, Portal To Ease Insurance Benefit Coordination

Mon, 08 Sep 2014 17:39:00 Z

The Council for Affordable Quality Healthcare in partnership with 11 national and large regional insurers has expanded a pilot project that aims to help insurers coordinate benefits. The project, which uses an online registry and payer portal, is now available in all 50 states and the District of Columbia. Health Data Management, CAQH release.

MGMA Urges CMS To Issue Additional Guidance on EFT Transfers

Mon, 23 Jun 2014 17:59:00 Z

The Medical Group Management Association in a letter calls on CMS to issue specific guidance on what constitutes an "excessive fee" for electronic funds transfer transactions required by HIPAA. In addition, MGMA wants CMS to ban health plans and financial institutions from using "virtual" credit cards to pay provider reimbursements. Health Data Management, MGMA letter.

At HIMSS Conference, Patients Emerge as Driving Force for 'Triple Aim' of Health Care

Fri, 28 Feb 2014 13:00:00 Z

Patient engagement emerged as a major theme during the Healthcare Information and Management Systems Society's 2014 conference in Orlando. Empowering patients could prove to be a key ingredient in achieving the "Triple Aim" of improving patient experience, advancing population health and reducing health care costs.

Consumers Turning to Twitter With Insurance Questions, Complaints

Thu, 30 Jan 2014 18:37:00 Z

With changing deadlines, overwhelmed call centers and continued confusion about health insurance options and policies under the Affordable Care Act, consumers are turning to Twitter and other social media platforms to seek answers or raise concerns. ProPublica.

CMS Seeks To Create Matching Agreements for ACA Data Hub

Thu, 15 Aug 2013 15:50:00 Z

CMS has announced plans to create computer matching agreements with the Internal Revenue Service and the Veterans Health Administration to regulate information shared through a data hub under the Affordable Care Act. CMS will accept public comments on the matching program for 30 days. Becker's Hospital Review et al.

Study: Better Designed Exchange Websites Could Save $9B

Wed, 14 Aug 2013 16:57:00 Z

A study finds the federal government and consumers could save more than $9 billion annually by improving the design of the websites used for state health insurance exchanges under the Affordable Care Act to help enroll consumers in health plans. Modern Healthcare's "Vital Signs," University of Pennsylvania Law School study.

19 Health Care Groups Join Surescripts' Data-Sharing Network

Tue, 13 Aug 2013 17:36:00 Z

Nineteen health care groups -- including Cerner and Quest Diagnostics -- have joined Surescripts' data-sharing network. Surescripts President and CEO Harry Totonis attributed the network's growth to the meaningful use program and growing support for electronic health information exchange. Washington Business Journal's "BizBeat," Surescripts release.

CMS Steps In To Help Enforce Electronic Patient Data Rules

Fri, 09 Aug 2013 16:31:00 Z

In response to recent compliance violations, CMS is working with an anonymous health care provider and a health IT consultant to develop a strategy that would help some insurers adopt new standards to meet federal requirements for sharing electronic data with physicians. Modern Healthcare.

Health Insurers Tap Social Media To Boost Customer Service

Thu, 08 Aug 2013 17:45:00 Z

Health insurers are turning to social media outlets, such as Twitter, to resolve customer complaints, boost brand awareness and educate consumers. One expert said the public nature of social media holds health plans accountable. Kaiser Health News.

Bill Introduced To Delay Implementation of ACA Data Hub

Mon, 29 Jul 2013 16:10:00 Z

Rep. Pat Meehan has introduced a bill to delay the implementation of a nationwide data hub designed to connect federal agencies with state health insurance exchanges under the Affordable Care Act. He says he is concerned the hub will collect too much personal information, even though federal officials have said the system will not store such information. The Hill's "Healthwatch."

Leapfrog Group Unveils Online Tool To Calculate Hospital Error Costs

Fri, 26 Jul 2013 16:25:00 Z

The Leapfrog Group has launched an online tool to help employers and purchasers calculate the costs of hospital errors, accidents and infections. The American Hospital Association criticized the tool, arguing that it uses a flawed methodology. Modern Healthcare, HealthLeaders Media.

Tavenner Says Data Hub for Insurance Exchanges Is Complete

Wed, 17 Jul 2013 15:57:00 Z

During a congressional hearing today, CMS Administrator Marilyn Tavenner said that construction of a federal data hub established under the Affordable Care Act is finished and that final testing will be completed one month before exchange enrollment begins. Tavenner also rebuked GOP criticisms of possible privacy issues related to the hub. Bloomberg.

Republicans Concerned About Data Hub for Insurance Exchanges

Mon, 01 Jul 2013 17:08:00 Z

House Republicans have sent a letter to HHS asking for more information about a data hub designed to connect state health insurance exchanges with federal agencies. The GOP lawmakers are questioning whether the hub will function properly and protect personal health data. The Hill's "Healthwatch," Reuters.

HHS Updates Website To Help Facilitate Insurance Exchange Enrollment

Tue, 25 Jun 2013 07:00:00 Z

Yesterday, the Obama administration announced it has updated Healthcare.gov to help U.S. residents prepare for open enrollment in the Affordable Care Act's health insurance exchanges in October. The website offers educational information on the exchanges. New York Times et al.

Healtheway Names eHealth Exchange Founding Members

Wed, 19 Jun 2013 07:00:00 Z

Healtheway -- the public-private partnership overseeing a nationwide health information exchange -- has announced its nine founding members. The organizations include health IT vendors and health care provider groups, among others. Healthcare IT News, Healtheway release.

Mobile Part of Exchange Outreach Plans, but Full Use Lagging

Thu, 13 Jun 2013 07:00:00 Z

Some community groups are leveraging mobile devices and social media as part of their outreach efforts for the Affordable Care Act's health insurance exchanges. Meanwhile, states still are in the early stages of formulating their mobile strategies so consumers can access the exchanges on the go.

CIOs Have Various Roles Under Affordable Care Act, New Study Finds

Wed, 12 Jun 2013 07:00:00 Z

A survey by National Association of State Chief Information Officers and Healthcare Information and Management Systems Society finds state CIOs are taking on various health IT-related roles, such as overseeing health information and insurance exchanges. InformationWeek.

Experts Predict Initial 'Glitches' in Health Exchange Websites

Mon, 10 Jun 2013 07:00:00 Z

There likely will be some initial "glitches" when the health insurance exchange websites open for enrollment on Oct. 1, according to experts. Building the online marketplaces under the Affordable Care Act has proven to be a complex task as they need to communicate and interface with government databases, state Medicaid systems and insurers, officials say. Wall Street Journal.

States Cite Federal Data Hub as Main Concern for Exchanges, GAO Finds

Tue, 04 Jun 2013 07:00:00 Z

A report finds that states seeking to launch their own health insurance exchanges believe that a data hub meant to pass information to federal agencies is hindering implementation. Federal officials say they have given states enough guidance to connect with the hub. Governing.

OIG: Two Medicare Provider Databases Inaccurate, Incomplete

Fri, 31 May 2013 07:00:00 Z

An HHS Office of the Inspector General report finds that two Medicare databases store health care provider information that is inaccurate or incomplete. The report also finds that the information shared between the databases was inconsistent for 97% of records. OIG provided CMS with several recommendations to address the issues raised in the report. FierceHealthIT et al.

WEDI Announces New ICD-10 Collaborative To Share Best Practices

Thu, 23 May 2013 07:00:00 Z

The Workgroup for Electronic Data Interchange has launched a new initiative that aims to help health information organizations share best practices and conduct end-to-end testing related to ICD-10 codes. Groups in four states are participating. Modern Healthcare, WEDI release.

Report: Data Analytics Crucial for Population Health, ACOs

Fri, 17 May 2013 07:00:00 Z

An Institute of Health Technology Transformation report finds that data analytics is critical to the success of population health management and accountable care organizations. The report lists several steps that are key to the effective use of health data analytics, such as building partnerships with health plans to obtain claims data. HIT Consultant, Clinical Innovation & Technology.

Federal Officials Say Insurance Exchange Websites on Schedule

Fri, 10 May 2013 07:00:00 Z

White House and HHS officials say they have taken several steps to ensure that health insurance exchanges will be operational by Oct. 1. However, to hit that deadline, officials will need to ensure that a host of technological systems are functioning effectively. USA Today.

Report: More Employers Adopting Health Care Engagement Technology

Wed, 01 May 2013 07:00:00 Z

A report from Buck Consultants and WorldatWork finds that 52% of surveyed employers are weighing the use of mobile or online games to boost their employees' health care engagement over the next three years. Crain's Business Insurance/Modern Healthcare, Becker's Hospital Review.

When it Comes to ICD-10 Physician Documentation: Collaborate and Educate

Thu, 11 Apr 2013 07:00:00 Z

Physician education is one of the most difficult challenges in preparing for the transition to ICD-10. Hospitals should provide such education to their medical staff through a phased approach utilizing learning management systems and expert content delivered via a peer-to-peer, physician-to-physician format.

Report Cites CMS for Poor Oversight of Health Plan Comparison Portal

Wed, 03 Apr 2013 07:00:00 Z

A report from HHS' Office of Inspector General finds that CMS does not adequately oversee the "Plan Finder" website that it established to help consumers find coverage prior to the launch of the Affordable Care Act's health insurance exchanges. Modern Healthcare, CQ HealthBeat.

Lawmakers Question VA Over Large Backlog of Veteran Medical Claims

Thu, 21 Mar 2013 07:00:00 Z

During a House Committee hearing yesterday, a Department of Veterans Affairs official maintained that the agency will be able to eliminate its backlog of nearly 900,000 claims by 2015. However, lawmakers said they are skeptical. Military Times/USA Today, NextGov.

Audit: Computer Flaws Led NY To Issue $26M in Medicaid Overpayments

Mon, 04 Mar 2013 08:00:00 Z

An audit by the New York State Comptroller finds that flaws in a state computer system caused about $26 million in Medicaid overpayments and other questionable payments. The audit analyzed claims for individuals dually eligible for Medicaid and Medicare. WNYT, WKBW.

Opinion Piece Calls for Decentralized Approach on Claims Database

Thu, 28 Feb 2013 08:00:00 Z

In an opinion piece, Deven McGraw of the Center for Democracy & Technology writes that the Obama administration's proposal to create a centralized database of individuals' health insurance claims would create "needless privacy and security risks." The Hill's "Congress Blog."

Private Firms Secure IT Contracts for Federal, State Health Exchanges

Thu, 21 Feb 2013 08:00:00 Z

Several large private firms have been awarded multimillion-dollar contracts to develop IT infrastructure for federal and state health insurance exchanges. Some of the contracts also require the companies to update states' Medicaid IT systems. Kaiser Health News' "Capsules."

What Percentage of Health Insurance Claims Were Filed by Paper or Electronic Processes?

Wed, 20 Feb 2013 08:00:00 Z

The percentage of health insurance claims filed electronically has increased from 44% in 2002 to 94% in 2011, while the percentage of claims filed via paper processes has decreased from 56% in 2002 to 6% in 2011, according to a recent report by America's Health Insurance Plans.

New Tool Lets Providers Seek Electronic Payment From Multiple Insurers

Wed, 13 Feb 2013 08:00:00 Z

CAQH, formerly known as the Council for Affordable Quality Healthcare, has launched a new online tool that allows health care providers to use a single electronic funds transfer system to obtain claims reimbursements from multiple health insurers. Modern Healthcare et al.

IBM Offering Two New Decision Support Tools Based on Watson

Mon, 11 Feb 2013 08:00:00 Z

IBM has released two new applications that use its Watson supercomputer to help health care providers and insurers make decisions about patient care and insurance coverage. One of the new decision support tools offers recommendations for treating patients with lung cancer and the other tool recommends treatments that should be covered by insurers. AP/Atlanta Journal-Constitution et al.

AHIP Report Finds Rise in Electronic Processing, Filing of Medical Claims

Wed, 06 Feb 2013 08:00:00 Z

A report by America's Health Insurance Plans finds that the percentage of medical claims filed and processed electronically has nearly doubled since 2002. AHIP says that electronic claims filing and processing can boost efficiency and curb costs. The Hill's "Healthwatch" et al.

Most States Updating, Digitizing Medicaid Enrollment Systems

Thu, 24 Jan 2013 08:00:00 Z

A new survey from the Kaiser Family Foundation finds that 47 states have received or applied for federal funds to upgrade their Medicaid enrollment systems. Under the Affordable Care Act, all state Medicaid programs must shift to online enrollment systems by January 2014. The federal government is covering 90% of the cost of Medicaid IT upgrades through 2015. The Hill's "Healthwatch" et al.

UnitedHealth, Mayo Partner on Data Mining Project To Improve Care

Tue, 15 Jan 2013 08:00:00 Z

UnitedHealth Group and the Mayo Clinic have launched a new research initiative to identify best practices for high-quality, low-cost care. The project will involve analyzing millions of de-identified health insurance claims and clinical records. Minneapolis/St. Paul Business Journal et al.

Insurers Say New Rate Filing Rules Would Require IT Upgrades

Tue, 08 Jan 2013 08:00:00 Z

A survey from America's Health Insurance Plans finds that the costs involved in meeting new rate filing and data submission requirements could be 70% higher than HHS estimates. Insurers say meeting the requirements could require IT upgrades. Government Health IT, FierceHealthIT.

IT Companies Expected To Gain Business From Affordable Care Act

Thu, 03 Jan 2013 08:00:00 Z

The implementation of the federal health reform law is expected to generate business for IT firms. New data systems likely will be needed to handle the law's Medicaid expansion and operate state health insurance exchanges. The Hill's "Healthwatch," Kaiser Health News.

More Health Plans, Employers Begin To Pay for Telehealth Services

Fri, 21 Dec 2012 08:00:00 Z

The use of telehealth technology is increasing as more insurers and employers begin to cover virtual physician consultation services. Proponents say such services could help ease the primary care physician shortage and are less costly than other in-person visits. Wall Street Journal.

Fraud Detection System Helped Medicare Save $115M, CMS Says

Mon, 17 Dec 2012 08:00:00 Z

A new report from CMS finds that Medicare has saved about $115 million since it implemented new fraud prevention technology in the summer of 2011. The system uses predictive analytics to identify suspicious billing patterns and prevent payments. According to officials, much of the estimated savings are a result of removing fraudulent providers from the program. AP/Boston Globe, Forbes.

Health IT Vendor Files Lawsuit Against Aetna for Patent Infringement

Fri, 14 Dec 2012 08:00:00 Z

HealthTrio, a health IT vendor, has filed a lawsuit claiming that Aetna and two of its technology subsidiaries infringed on 10 of HealthTrio's software patents. Aetna said it is reviewing the suit and will "defend the case vigorously." Modern Healthcare, Health Data Management.

Lawmakers Question IT Contract for Federal Health Plan Exchange

Tue, 11 Dec 2012 08:00:00 Z

Sen. Chuck Grassley and Rep. Fred Upton are raising concerns about a potential conflict of interest involving a UnitedHealth Group subsidiary contracted to build a database hub for a federal health insurance exchange. The lawmakers said the contractor is in a position to tailor the system to favor the interests of UnitedHealth Group. The Hill's "Healthwatch," St. Paul Pioneer Press.

CMS Facing Delays in Rollout of Anti-Fraud System, GAO Finds

Fri, 16 Nov 2012 08:00:00 Z

A Government Accountability Office report finds that CMS is behind schedule on implementing a $90 million predictive-modeling system to combat Medicare and Medicaid fraud. The system would use data analytics to find suspicious claims and immediately stop payments. According to GAO, many details of CMS' transition to the new system remain unclear. Modern Healthcare, Politico's "Pulse."

IT Issues Could Delay Creation of Health Insurance Exchanges

Thu, 15 Nov 2012 08:00:00 Z

Most insurers participating in state health insurance exchanges will use an electronic system to submit their policies for review. Observers say the system has yet to be updated because officials are waiting on regulations from the Obama administration. Kaiser Health News.

HHS Extends Deadline for State Insurance Exchange Blueprints

Mon, 12 Nov 2012 08:00:00 Z

HHS has announced that states now have until Dec. 14 to submit detailed plans for establishing online health insurance exchanges under the Affordable Care Act. The extended deadline aims to help states obtain the technical support necessary to pursue their own exchanges. The deadline extension will not affect the anticipated January 2014 launch of the exchanges. Washington Post's "Wonkblog" et al.

Questions Raised About IT Contractor Building Health Plan Exchange

Mon, 05 Nov 2012 08:00:00 Z

UnitedHealth Group recently bought Quality Software Services, which has received a contract to complete IT work for a federally run health insurance exchange. The deal has raised concerns that UnitedHealthcare might benefit from the acquisition. The Hill's "Healthwatch."

Policy Brief: States To Benefit From Upgrades to Medicaid IT Systems

Fri, 02 Nov 2012 07:00:00 Z

A new policy brief from the Robert Wood Johnson Foundation's Maximizing Enrollment project suggests that many states could better measure outreach and track enrollment trends if they upgraded their IT systems for Medicaid enrollment and eligibility. Government Health IT.

AHIP Launches iPad App To Provide Health Care Spending Information

Wed, 31 Oct 2012 07:00:00 Z

A new iPad application from America's Health Insurance Plans uses federal data to provide charts about health spending. Users can view historical and projected spending data on a national level or by state. Healthcare IT News, National Journal's "Influence Alley."

Conn. Using Databases To Identify Improper Health Plan Enrollment

Tue, 16 Oct 2012 07:00:00 Z

Connecticut officials are comparing two databases to determine whether state workers and retirees improperly kept former spouses on their health insurance plans. Officials say it is too early to tell whether the computer-assisted audit will be successful. Hartford Courant.

GAO Praises Upgrades to Medicare Eligibility Transaction System

Tue, 09 Oct 2012 07:00:00 Z

A new report by the Government Accountability Office finds that CMS has improved the operations of its HIPAA Eligibility Transaction System in part by implementing a series of upgrades to the hardware, software and operating system for HETS. Health Data Management, FierceHealthIT.

Stakeholders React to Warning on Use of EHRs for 'Upcoding'

Wed, 26 Sep 2012 07:00:00 Z

Several health care organizations have responded to the Obama administration's warning that it will not tolerate hospitals' use of electronic health record systems to inflate medical bills. Many stakeholders said that they agree that such "upcoding" is unacceptable but added that federal officials should provide more guidance on using EHR systems in medical billing. Politico et al.

ACOs To Spend Up to $4M for Technology, Data Requirements

Wed, 26 Sep 2012 07:00:00 Z

Black Book Rankings predicts that 302 developing and planned U.S. accountable care organizations will spend a total of $500 million on health IT in their first year. The report notes that ACOs could face between $1 million and $4 million in initial technology costs. FierceHealthIT et al.

Launch of Utah's Health Care Claims Database Beset by Challenges

Tue, 25 Sep 2012 07:00:00 Z

Utah's Department of Health is working to launch a database on medical and prescription drug claims to help consumers make informed health care decisions. However, the project has faced numerous problems related to staffing, contractors and funding. Salt Lake Tribune.

Report Aims To Guide States on Using IT in Insurance Exchanges

Wed, 19 Sep 2012 07:00:00 Z

A new report from the University of Massachusetts Medical School and the National Academy of Social Insurance offers recommendations to help states use technology to support the infrastructure of their health insurance exchanges. Health Data Management, NASI release.

Hackers Corrupt Online Portal for Utah's Health Insurance Exchange

Thu, 13 Sep 2012 07:00:00 Z

Hackers recently corrupted the website for Utah's health insurance exchange, creating garbled words, blurred headlines and an inability to access certain pages. State officials said the incident did not compromise any personal data. Salt Lake Tribune, Government Technology.

Stakeholders Comment on HHS' Final Rule To Delay ICD-10 Deadline

Tue, 04 Sep 2012 07:00:00 Z

Several groups have issued statements commenting on HHS' final rule to delay the ICD-10 compliance deadline and establish unique Health Plan Identifiers. MGMA-ACMPE says it is concerned that the ICD-10 shift will lead to cash-flow disruptions. Healthcare IT News et al.

GAO Finds States Lack Medicaid Long-Term Care E-Verification

Tue, 04 Sep 2012 07:00:00 Z

A recent Government Accountability Office report finds that as of late 2011, no state had fully implemented an electronic system to verify that individuals applying for Medicaid long-term care are eligible for the coverage. McKnight's Long-Term Care News & Assisted Living et al.

Final Rule Delays ICD-10 Deadline, Establishes Health Plan Identifiers

Fri, 24 Aug 2012 07:00:00 Z

Today, HHS released a final rule that officially delays until Oct. 1, 2014, the compliance date for using ICD-10 transaction codes. The final rule also implements unique Health Plan Identifiers for all health insurers to simplify billing processes. Modern Healthcare, HHS release.

Report: More Insurers Adopting Consumer Engagement Tools

Tue, 21 Aug 2012 07:00:00 Z

A new report from Chilmark Research finds that health insurers increasingly are using games, social media, mobile health applications and other technologies to boost consumer engagement. However, the report notes that the health insurance industry still is in the "early-innovator, adoption stage" for using such tools. Healthcare IT News, Health Data Management.

FAIR Health Launches Claims Database for Academic Researchers

Thu, 09 Aug 2012 07:00:00 Z

Academic researchers now can apply to access a new health insurance claims database. The project was launched by FAIR Health, an organization launched as a result of a 2009 settlement between New York state, UnitedHealth Group and other insurers. American Medical News.

New HHS Rule Aims To Facilitate Electronic Health Care Payments

Wed, 08 Aug 2012 07:00:00 Z

Yesterday, HHS issued an interim final rule to make it easier for health care providers to accept electronic payments. Under the rule, health plans would need to provide standardized, online enrollment for electronic transactions. The rule, along with standards adopted earlier this year, could generate as much as $9 billion in savings over a decade. The Hill's "Healthwatch" et al.

Kaiser Permanente Study Finds PHR Users More Likely To Stay Members

Tue, 31 Jul 2012 07:00:00 Z

A new report by Kaiser Permanente finds that members were nearly 2.6 times more likely to stay with the health system if they used a no-cost personal health record. The report finds that email and viewing lab results are the two most popular PHR features. Modern Healthcare.

CMS: States Can Keep Federal Funds for Health Reform Law's IT Projects

Mon, 16 Jul 2012 07:00:00 Z

States that opt out of the federal health reform law's Medicaid expansion or choose not to run their own insurance exchanges will be able to keep the federal funds they have received to build the IT infrastructure for those projects, according to CMS. Modern Healthcare et al.

CMS Seeks To Improve Usability of Medicare Plan Finder Website

Fri, 06 Jul 2012 07:00:00 Z

According to a Federal Register notice, CMS plans to evaluate design changes that would add quick links and enhanced data display to the agency's Medicare Plan Finder website. CMS said the changes could make the website easier for seniors to use. Government Health IT.

UnitedHealthcare Launches Tool To Let Members Download PHRs

Thu, 05 Jul 2012 07:00:00 Z

Today, UnitedHealthcare announced that it is launching a "Blue Button" tool to let policyholders access, download and print their personal health records from the insurer's website. UnitedHealthcare said that 12 million policyholders will be able to use the tool by the end of this year and about 26 million policyholders will be able to use it by mid-2013. MedCity News, Healthcare IT News.

HHS Announces New Funding Opportunities for Insurance Exchanges

Mon, 02 Jul 2012 07:00:00 Z

HHS has announced new opportunities for states to receive federal funding to support their health insurance exchanges. Such exchanges will rely on a solid IT foundation to connect with advanced eligibility systems for Medicaid and other programs. The Hill's "Healthwatch" et al.

Group Releases Online Platform for Health Insurance Exchanges

Fri, 08 Jun 2012 07:00:00 Z

A coalition of 17 states, called Enroll UX2014, has released an online tool to help state governments create a user interface for navigating health insurance exchanges. Backers of the tool say they hope it will help states overcome financial and political challenges to building health insurance exchanges so they can meet deadlines under the federal health reform law. Washington Post.

Calif. To Award Major IT Contract for Health Insurance Exchange

Fri, 01 Jun 2012 07:00:00 Z

The California Health Benefit Exchange plans to award a $359 million contract to Accenture to build an eligibility and enrollment website for the state's health insurance exchange. Most of the funding will be provided by the federal government. Sacramento Business Journal et al.

IT Challenges Hindering State Health Insurance Exchanges

Wed, 30 May 2012 07:00:00 Z

States implementing health insurance exchanges under the federal health reform law face logistical challenges in launching health IT systems that can handle enrollment procedures, according to health policy experts. Some states might have to seek assistance from the federal government under a "partnership model" to launch a successful IT system for their exchange. Politico.

CMS, NASA Announce Contest for Software To Screen Health Providers

Tue, 29 May 2012 07:00:00 Z

CMS and NASA's Federal Center of Excellence for Collaborative Innovation could award up to $600,000 for the creation of open-source software that improves the health care provider screening process for Medicaid and the Children's Health Insurance Program. Modern Healthcare.

HHS Releases Guidance on Establishing Health Insurance Exchanges

Thu, 17 May 2012 07:00:00 Z

HHS has released guidance to help states establish health insurance exchanges under the federal health reform law or work with the federal government to create a "federally facilitated exchange." HHS also awarded $181 million in exchange grants to six states. Reuters et al.

CMS Seeking Input on Verification Tools for Health Plan Exchanges

Wed, 09 May 2012 07:00:00 Z

CMS has posted a notice on the Federal Business Opportunities website seeking information about data systems that could help health insurance exchanges verify whether an individual has access to employer-sponsored coverage. Responses are due by May 21. Government Health IT.

California To Overhaul 30-Year-Old Medicaid Computer System

Mon, 23 Apr 2012 07:00:00 Z

California Auditor Elaine Howle recently announced that the state is developing a new computer system to handle Medi-Cal billing. The new system -- called Health Enterprise -- will replace the Medicaid Management Information System that currently processes billing. Capitol Weekly.

HHS Proposes Delaying ICD-10 Compliance Until October 2014

Mon, 09 Apr 2012 07:00:00 Z

Today, HHS released a proposed rule that calls for delaying the ICD-10 compliance deadline by one year, to Oct. 1, 2014. The proposed rule also includes a provision to assign a unique health plan identifier number to all health insurers. The proposal aims to make it easier for health care organizations to use computer systems for administrative functions. Modern Healthcare et al.

High Court's Ruling Could Affect Health IT Aspects of Reform Law

Mon, 26 Mar 2012 07:00:00 Z

Today, the Supreme Court started hearing oral arguments in the lawsuit against the federal health reform law. The Healthcare Information and Management Systems Society has released a fact sheet on the case, and a HIMSS official has posted a blog entry noting that the court's decision could affect certain health IT-related provisions of the overhaul. Government Health IT et al.

HHS Issues Final Rule on State Health Insurance Exchanges

Mon, 12 Mar 2012 07:00:00 Z

Today, HHS released its final rule on state-based health insurance exchanges under the health reform law. Most of the exchanges will rely on an IT foundation to link up with eligibility systems for Medicaid and other programs. HHS said the final rule aims to provide states with guidance while giving them the flexibility to design their own exchanges. The Hill's "Healthwatch" et al.

Computer Error Creates Payment Issues for Maine Medicaid Program

Fri, 09 Mar 2012 08:00:00 Z

Maine likely will need to refund the federal government after a computer error caused MaineCare, the state's Medicaid program, to continue paying out benefits to about 19,000 residents who had become ineligible for the program. Portland Press Herald, Bangor Daily News.

Study Links Online App to Enrollment Jump for Calif. Health Program

Thu, 08 Mar 2012 08:00:00 Z

A new study credits Health-e-App, an online application tool, with boosting enrollment in California's Healthy Families program. Use of the online tool was associated with a 14% increase in total Healthy Families applications from 2010 to 2011. Sacramento Business Journal.

Private-Sector Insurers Tap Health IT To Support Accountable Care

Thu, 08 Mar 2012 08:00:00 Z

Health plans have embraced the concept of value-based payment models. As part of that push, insurers such as Aetna and UnitedHealth Group have made substantial investments in health IT to support these new payment designs.

UnitedHealth Launches Cloud Platform for Data Exchange, Health Apps

Tue, 14 Feb 2012 08:00:00 Z

UnitedHealth Group's Optum health-services unit soon will launch a cloud-computing platform that will allow health data exchange and offer health-related applications. Initially, the apps will be aimed at health providers and insurers but eventually could be expanded to focus on consumers. Wall Street Journal.

Opinion: Health IT Can Help Streamline Health Plan Prior Authorization

Mon, 13 Feb 2012 08:00:00 Z

Gene Ransom -- CEO of MedChi, the Maryland State Medical Society -- argues that advances in health IT can be used to streamline the insurance prior authorization process, which would "make health care in Maryland more efficient, more effective and more affordable." Baltimore Sun.

Judge OKs $200M in Doctor Payments Under UnitedHealth Settlement

Fri, 10 Feb 2012 08:00:00 Z

A federal judge has approved the distribution of $200 million to physicians under a settlement in a lawsuit against UnitedHealth Group. The lawsuit was filed over an allegedly flawed database that underpaid out-of-network doctors. Modern Physician, Health Data Management.

MGMA Executive Urges HHS To Address HIPAA 5010 Challenges

Thu, 02 Feb 2012 08:00:00 Z

Medical Group Management Association President and CEO Susan Turney has sent a letter calling for HHS Secretary Kathleen Sebelius to address several challenges health care providers are facing as they work to adopt HIPAA 5010 transaction standards. The letter reiterated MGMA's request for CMS to delay enforcement of HIPAA 5010 standards until June. Modern Healthcare et al.