Kip Piper's Health Care Blog
Medicare, Medicaid, Health Reform

As part of the Health Reform Toolkit Series, the Blue Cross Blue Shield of Massachusetts Foundation, the Robert Wood Johnson Foundation, and the Commonwealth Health Insurance Connector Authority have published Effective Education, Outreach, and Enrollment Approaches for Populations Newly Eligible for Health Coverage. The series offers resources for health...
A new report examines individual eligibility for federal premium subsidies in Health Insurance Exchanges when employer-sponsored or public coverage is not available to them.  Both federal premium subsidies and state or federally-run Health Insurance Exchanges are features starting in 2014 under the Affordable Care Act (ACA). While most individuals will be required to...
Comprehensive compliance programs are essential for all hospitals, health systems, physician practices, Medicare Advantage plans, Medicaid health plans, Medicare prescription drug plans, drug manufacturers, medical device makers, long-term care providers, and others doing business with Medicare, Medicaid, or other government health programs. To help prevent fraud, waste, and abuse in Medicare and...
With an array of payment reforms, quality and safety requirements, massive expansion of Medicaid, and creation of the new State Health Benefit Exchange marketplace, the Affordable Care Act (ACA) presents extraordinary new challenges for compliance, especially for health plans, physicians, hospitals and health systems, and drug and device manufacturers. In...
Under the Affordable Care Act (ACA), most health plans are now required to provide preventive services to their enrollees without any co-payments or other cost sharing.  Over time, this is expected to significantly improve prevention and wellness, reducing costs and reducing incidence of preventable condtions.  However, the preventive services...
As part of health reform implementation, states will create a large and complex new marketplace for the buying and selling of health insurance coverage. Through State Exchanges, individuals and small businesses may buy federally defined benefit packages from state licensed and certified Qualified Health Plans. For health plans, this is...

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