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Commercial Investment Real Estate Sep/Oct 2009 Andrew Dick	Deal Diagnosis Healthcare real estate transactions not only are driven by economic factors, but also by compliance with federal and state healthcare laws.
Managed Care July 2001 John Otrompke	Stark Allows Federal Regulators To Review Claims Records Fully HMO executives, as well as the providers and physicians who contract with them, should have by now felt the changes in their daily work lives resulting from the government's increased scrutiny of health plans' operations under the fraud-and-abuse compliance laws...
Commercial Investment Real Estate Sep/Oct 2009 Andrew Dick	Understanding Federal Healthcare Laws Commercial real estate professionals who work with medical office development must be aware of the federal healthcare fraud and abuse laws.
Managed Care October 2001 Michael Levin-Epstein	Medicare+Choice Reform: Hope, but No Quick Action Expected There have been small accomplishments, and wheels have been churning for more forceful action -- that is, they were until Sept. 11...
American Family Physician April 15, 2006 Liz Smith	Newsletter Medicaid Cost Sharing and Premiums May Reduce Physician Revenues... AMA Supports Amendment on Cuts to Medicare Physician Payments... Increase in Candidates Matched into Family Medicine Residencies... etc.
Pharmaceutical Executive August 1, 2013 Jill Wechsler	Costs and Coverage Challenge Medicare Drug Plans Rate cuts and fraud concerns create problems for Part D plans and Part B providers.
Managed Care May 2000 Michael Levin-Epstein	Marketing Medicare+Choice? Mind Your Ps and Qs, Says OIG A lot of Medicare HMOs' marketing materials don't cut it, says a report by the Office of the Inspector General. It adds that the Health Care Financing Administration is partly to blame....
Pharmaceutical Executive February 1, 2012 Jill Wechsler	Costs and Benefits of Health Reform Will expanded markets and accountable care organizations offset higher rebates, added fees, and closer scrutiny of marketing and prices?
Managed Care October 2001 Michael Levin-Epstein	Medicare Demonstration Projects Seek To Coordinate Chronic Care The Centers for Medicare and Medicaid Services is awaiting the results of landmark demonstration programs to determine if improved Medicare services can be furnished to chronically ill patients without increasing costs...
Nursing Management September 2011 Sally Austin	What does EMTALA mean for you? When a patient enters your hospital, do you know what your obligations are under the Emergency Medical Treatment and Active Labor Act?
Financial Planning November 1, 2007 Donald Jay Korn	Medicare Choices What are Medicare private fee-for-service plans and why did their fortunes rise and fall so dramatically? Most important, if these plans survive in their current form, should advisors suggest them for clients enrolled in or approaching Medicare eligibility?
Managed Care July 2000 Michael Levin-Epstein	Congress Asked To Take Action As HMOs Flee Managed Medicare Thanks mainly to the increasing cost of providing a prescription drug benefit, HMOs are exiting Medicare+Choice, the system that was supposed to manage the health of the nation's senior citizens, in droves. Only an act of Congress can save Medicare+Choice, but is seems doubtful that will happen.
Nursing Management April 2009 Sharon H. Pappas	Profits, Payers, and Patients: Responding to Changes Profit is necessary for hospitals to fulfill their missions, invest in expansion and new technologies, and reinvest in existing patient care infrastructures. Profitability is the work of the financial team and the clinical team to produce the hospital's desired financial outcome.
Commercial Investment Real Estate May/Jun 2013 Mauldin & Maddron	Medical Office Momentum The Affordable Care Act takes some risk out of healthcare property investment.
Managed Care December 2001	CMS Medicaid Managed Care Proposal Under Close Scrutiny Bioterrorism. Medicaid managed care plans. No link between them? Guess again. It all has to do with how proposed Medicaid regulations would affect patients' rights and funding for Medicaid programs ranging from nursing home care to emergency rooms...
Managed Care December 2006 MargaretAnn Cross	Confronting The Medicare Cost Shift Plans are increasingly concerned about the degree to which providers overcharge them to make up for losses from government programs.
Managed Care May 2003	Premiums up, benefits down for M+C Premiums continue to rise for Medicare+Choice beneficiaries while the benefit selection gets somewhat narrower, a study funded by the Commonwealth Fund and conducted by Mathematica Policy Research finds. Monthly premiums rose from about $23 in 2001 to about $37 in 2003.
American Family Physician September 15, 2006 Liz Smith	Newsletter CMS Issues Guidance on Part D vs. Part B Coverage Determination... Residents, Students Adopt Resolutions on Drug Samples, Universal Care... CMS Proposes Changes to Outpatient Services Policies and Payment... etc.
Managed Care April 2002 Frank Diamond	Medicare+Choice: Uncertain Future for Unstable Program While policy makers haggle over President Bush's budget request for the system, an ominous question looms: Can money solve all the problems?
BusinessWeek October 1, 2009 Sasseen & Arnst	Why Business Fears the Public Option Executives contend that it will lead health-care providers to charge patients in private plans higher rates.
Managed Care April 2000 Michael Levin-Epstein	Congressional Anti-Kickback Battle Hinges on HCFA's Regulatory Stance In an election year, the political hot buttons -- the Patients Bill of Rights and a Medicare prescription benefit, and maybe the issue of medical errors -- are sure to get a lot more attention than such mundane things as laws that would address potential kickbacks....
Managed Care November 2001	Medicare+Choice Problems Chasing Away 58 Health Plans Medicare+Choice, the program that was supposed to ease the elderly into managed care, is itself suffering from the uneasiness of HMOs dissatisfied with payment rates...
Pharmaceutical Executive June 1, 2005 Jill Wechsler	Washington Report: "D" Is for Data It is critical for Medicare to address important questions on drug safety and utilization, and about how prescribing decisions affect health outcomes and costs.
Pharmaceutical Executive January 1, 2012	Compliance: Getting Those Ducks in a Row Pharma must coordinate the efforts of medical, legal, HR, global partners and many other players in the regulatory compliance space to keep itself afloat in choppy seas.
Financial Planning April 1, 2007 Joan Warner	What's Next for Medicare Is America's retirement healthcare plan really in trouble? Here's some good news -- and some hard decisions for your financial advisory clients.
Managed Care May 2002 Patrick Mullen	Interview: Thomas Scilly In a candid, wide-ranging interview, the Centers for Medicare and Medicaid Services administrator counsels patience in solving the myriad problems of health care. A fix could take 20 years
Registered Rep. November 5, 2012 Mark Miller	Lawsuit Settlement Is a Game-Changer for Long-Term Care Coverage Medicare recipients will find it easier to get coverage.
Knowledge@Wharton	Major Health Care Reform Under President Bush Remains Elusive Three of the chief health-care challenges facing the United States are: finding a way to provide coverage for the millions of uninsured, reforming Medicare, and setting up a prescription-drug plan for the elderly. The White House is likely to make headway on only the third of these in the next two years.
Managed Care January 2001 Mark D. Abruzzo	When Claims Are Audited, Following Compliance Laws Matters Ever since the government intensified its efforts to crack down on medical fraud, and asked the health care community to assist, compliance and compliance planning are the buzzwords. Unfortunately, compliance efforts are often misguided and can put the practice in an awkward position...
Managed Care August 2001 John Carroll	Info on Questionable Physicians Languishes in National Data Bank A clearinghouse was created that stores details about malpractice suits and disciplinary actions. So how come HMOs don't use it?
Managed Care February 2001 Michael Levin-Epstein	Mainstream Media Misinterpret HCFA's Policy on Medical Errors Is the Health Care Financing Administration changing its policy on disclosure of medical errors to Medicare beneficiaries? The issue is causing a tremendous amount of confusion among physicians and health plans. To HCFA, however, the fuss is much ado about nothing...
Pharmaceutical Executive March 1, 2009 Jill Wechsler	Through the Looking Glass Pharma relations with researchers are critical for developing new technology, and reformers will discourage inappropriate relationships by making any links to pharmaceutical marketing known to all.
Managed Care May 2007 Frank Diamond	Medicare Advantage Hits Jackpot with Private Fee-for-Service Plans The secret to the success of Medicare private fee-for-service plans is as old as gold. Will beneficiary satisfaction force Congress to keep the faucet turned on?
Managed Care October 2000	Quick Fix May Be in Store for M+C, But Meaningful Change Likely To Wait Whatever diversion prescription drug proposals have provided, Medicare+Choice is back on Congress's radar screen. While sentiment is again running strong among legislators to address the wounded program, Congress is now racing a clock ticking ever closer to the elections...
Pharmaceutical Executive January 1, 2006 Bill Shearer	Patient Assistant Programs and Medicare Part D About 2.5 million low-income seniors who participate in prescription access programs are eligible for drug coverage under Medicare Part D - but the programs are out of alignment.
Searcher October 2011 Stephanie C. Ardito	The Medical Digital: Navigating the Medicare Maze Since entitlement programs are the chief governmental programs under fire, I decided to revisit the healthcare bills passed back in March (H.R. 3590, the Patient Protection & Affordable Care Act).
Managed Care February 2006 Martin Sipkoff	Don't Bet That Problems With Part D Are Over Medicare Part D enrollment snags could be just the start of political and regulatory headaches facing health plans and pharmacy benefit managers.
Managed Care March 2002 Michael Levin-Epstein	Illinois's Medicare Drug Program Called 1st Stab at National Reform The Illinois demonstration program gives the state permission to use federal and state Medicaid dollars to provide prescription drug coverage for 365,000 low-income, elderly Medicare beneficiaries...
BusinessWeek January 6, 2011 Justin Blum	Why Medicare Can't Catch the Fraudsters One provider's claims were paid despite unusual billing patterns
Managed Care August 2004	Medicaid Fees Rise, But Still Below Medicare A recent study reports that 30 states raised their Medicaid fees at or above the rate of inflation, including 10 that raised physician fees by more than 35%.
Managed Care April 2005	Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation.
Managed Care July 2007	AMA: Patients Will Feel Cuts in Medicare Next year's proposed 10 percent cut in Medicare payments is serving as a rallying point for members of the American Medical Association, which says the cuts will make it difficult for physicians to accept new Medicare patients.
Managed Care May 2002 Frank Diamond	Medicare+EvenMoreChoice: U.S. Encourages PPO Option The government offers financial incentives that include $100,000 in seed money, risk-sharing deals, and higher payment rates
Managed Care January 2001 David Ricks & Joe Suminski	Nowhere To Go but Out? Tracking Medicare+Choice Managed Medicare's trouble may have something to do with underfunding or rich benefits, but for health plans, market share has a lot to do with it, too...
Knowledge@Wharton	Prescription Drug Coverage for Seniors Faces Uncertain Future The discussion about adding a prescription drug benefit to Medicare will be put on hold...
Managed Care August 2006	So Far, Experts Like What They See in Part D Health care opinion leaders so far think Medicare Part D is a success, though changes are needed to the program, according to a survey by the Commonwealth Fund.
Commercial Investment Real Estate May/Jun 2014	Medical Office Fever Sales of medical office buildings topped $6.7 billion in 2013, according to Real Capital Analytics, proof that this niche sector remains attractive to investors.
Managed Care August 2001	GAO: Consultants Point Docs Toward Federal Law Violations The General Accounting Office has found that some health care consultants have been advising physicians to do things that conflict with federal laws and that may be unethical...
Pharmaceutical Executive August 1, 2012 Debbie Warner	Adapting to a New Era of Cancer Care Coverage and treatment decisions will be driven by value and defined differently by each stakeholder.
Pharmaceutical Executive April 10, 2014	Obama Policies Reshape Pharma Marketing Health reform initiatives promote transparency, challenge reimbursement, writes Jill Wechsler.