October 2014

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

Enterprise Risk Management (ERM)

Over the past several years, the healthcare community has been gearing up for conversion of the International Classification of Diseases, Ninth Revision called “ICD-9”, to the Tenth Revision called “ICD-10”. The Centers for Medicare and Medicaid Services (CMS) announced recently that they will be implementing the ICD-10 standards on 10/1/15. So what are organizations doing now? Click here for the most recent information from our integrated practices >>

Claim Settlement, Medicare, and Medicare Set Asides

The Centers for Medicare and Medicaid Services (CMS) have recently released an Updated MMSEA Section 111 User Guide. CMS’s Version 4.3 of the User Guide encompasses the most changes to date as compared to all prior versions since the inception. Medicare provides several downloadable files to keep up with all of the recent changes. For a summary and links to the new User Guide, click here >>

Healthcare

In August, the U. S. Drug Enforcement Administration (DEA) published the Final Rule moving hydrocodone combination products (HCPs) from Schedule III to the more-restrictive Schedule II status. For many years, the healthcare and insurance communities have debated the most cost effective ways for treating patient pain from chronic medical conditions. The more restrictive ruling by the DEA will bring a greater focus by physicians and insurers to find alternatives to HCP prescriptions. Find out how the healthcare and insurance communities may respond to this ruling >>