April 2015

Our e-newsletter for Enterprise Risk Management, Claim Settlement and Healthcare Solutions.

Enterprise Risk Management (ERM) - Risk Profile Development – Evaluating and Treating the Risks

This installment in our series describes the process of risk evaluation and treatment for risk profile development. We will briefly describe the next steps to organize and execute strategies to eliminate or mitigate the risks. Read more >>

Claim Settlement, Medicare, and Medicare Set Asides

CMS Releases an Updated MMSEA Section 111 Non Group Health Plan (NGHP) User Guide

On April 6, 2015, The Centers for Medicare & Medicaid Services (CMS) released an Updated MMSEA Section 111 Non Group Health Plan (NGHP) User Guide – Version 4.6.  Read more >>

CMS Updates Their Chronic Care Fact Sheet

Centers for Medicare and Medicaid Services (CMS) updates their chronic care management services and is available in an 11-page fact sheet.   Read more >>

Healthcare

CMS Announces Hospital Comparison Ratings

On April 16, 2015, the Centers for Medicare & Medicaid Services (CMS) for the first time introduced star ratings on Hospital Compare, the agency’s public information website, to make it easier for consumers to choose a hospital and understand the quality of care they deliver.   Read more >>

CMS Proposes Mental Health Parity Rule for Medicaid and CHIP

On April 6, 2015, The Centers for Medicare & Medicaid Services (CMS) announced a proposed rule to align mental health and substance use disorder benefits for low-income Americans with benefits required of private health plans and insurance.   Read more >>