Tag: Insurance
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OIG Issues Favorable Advisory Opinion Allowing Free Pharmaceutical Product To Patients
By Jim Hoover, Burr & Forman LLP On January 15, 2025, the Office of Inspector General (OIG) posted a favorable Advisory Opinion regarding a program to provide free access to a pharmaceutical product to patients who meet financial and other eligibility criteria and who do not have adequate coverage for the product. The Advisory Opinion…
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Here’s How Alabamians Can Fight Insurance Red Tape That Delays Medical Care
Alabama doctors and patients frustrated with delays in care caused by insurance companies’ prior authorization process now have a new way to share their stories and promote change. A new online platform — www.ALFixPriorAuth.com — invites Alabamians to share their experiences with prior authorization problems. The website and the initiative behind it to encourage faster…
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PIPA Open Enrollment During October
The Physicians Insurance Plan of Alabama through Blue Cross Blue Shield is available for qualified* members of the Medical Association providing you, your family and staff with strong benefits at affordable premiums as compared to other options. The PIPA health coverage rates for 2019 will have a decrease of 4.5 percent and dental coverage has…
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Don’t Get Caught in a Copay Conundrum
In the current environment of increasing patient deductibles and copays, the billing and collection of the patient portion of the services you provide is top of mind. In the Department of Health and Human Service’s report dated May 23, 2017, Alabama’s average monthly health insurance premium amounts increased 223 percent from 2013 to 2017, versus…
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Four Dangerous Words Physicians Regularly Say
One trend evident in all medical practices is the shift in payment responsibility from insurance payers to the insured patients. As employers modify coverage to contain their premium costs, health care providers are treating patients who have $2,500, $5,000 and even $10,000 deductibles. Physicians who have practiced for many years have instructed their collections staff…
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As CHIP Funding Lags, Doctors And Parents Scramble To Cover Kids’ Needs
Dr. Mahendra Patel, a pediatric cancer doctor, has begun giving away medications to some of his patients, determined not to disrupt their treatments for serious illnesses like leukemia, should Congress fail to come up with renewed funding for a key children’s health program now hostage to partisan politics. In his 35 years of practice, Patel,…
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Children’s Insurance, Other Health Programs Funded — For Now — In Bill
The bill passed by Congress in late December to keep most of the federal government funded for another month also provided a temporary reprieve to a number of health programs in danger of running out of money, most notably the Children’s Health Insurance Program, or CHIP. Funding for CHIP technically expired Oct. 1. States have…
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Legislative Update: What Happened This Week in Washington…
From President Trump’s new tax plan to renewed funding for the Children’s Health Insurance Program to former President Obama’s Independent Payment Advisory Board, health care has been at the center of a lot of discussions this week on Capitol Hill. Vote Expected Today for CHIP — The House is expected to vote today to pass…
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Metro Areas Increasingly Dominated by Single Insurance Companies
In an analysis of competition in health insurance markets across the U.S., a study conducted by the American Medical Association found that in 169 of 389 metropolitan areas (43 percent), a single health insurer had at least a 50 percent share of the market. This represents an eight percent increase in such markets over just…
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Pres. Trump’s Executive Order Creates Confusion
Earlier this week, President Trump signed an executive order that could be a first step in dismantling the Affordable Care Act. About 20 health organizations have so far spoken out against the executive order arguing the action could weaken patient protections and destabilize the individual market. President Trump’s executive order signed on Thursday, Oct. 12,…