Category: Insurance
Could Patient Surveys Help Fix Medicare’s Payment Problems? New Research Shows Promise
The Medicare Payment Puzzle: Why It Matters to You Medicare, the federal health insurance program serving over 60 million Americans, has a complex challenge: how to fairly pay healthcare providers and insurance plans for taking care of patients with different health needs. Think of it like this – it should cost more to care…
NY Consumer Directed Personal Assistance Program (CDPAP) Transition in 2025
What is CDPAP? The NY Consumer Directed Personal Assistance Program (CDPAP) empowers Medicaid recipients with chronic illnesses or disabilities to manage their home care services. Unlike traditional home care, CDPAP allows consumers to recruit, hire, train, supervise, and if necessary, terminate their personal assistants (PAs). CDPAP provides flexibility by allowing family members (except…
Demystifying Health Insurance Waivers: Your Complete Guide
What is a Health Insurance Waiver? A health insurance waiver is a formal document that allows individuals to decline or “waive” employer-sponsored health insurance coverage after demonstrating they have alternative qualifying coverage. This legal document protects both employers and employees by documenting the intentional decision to opt out of available health benefits. Understanding…
CMS Announces End of Medicare Advantage VBID Model
Breaking News: VBID Model Termination The Centers for Medicare & Medicaid Services (CMS) has made a pivotal announcement regarding the Medicare Advantage Value-Based Insurance Design (VBID) model’s termination after 2025. This decision stems from the discovery of substantial and unprecedented costs to Medicare Trust Funds, amounting to $4.5 billion over just two years –…
Generic vs Brand Name Drugs: Differences and Factors to be Considered
According to the FDA, generic drugs cost 80-85% less than brand name medications, representing a significant opportunity for healthcare cost savings. This comprehensive guide examines the key differences between generic and brand name pharmaceuticals, analyzing cost variations, quality standards, and factors affecting medication pricing. Understanding these distinctions enables informed decision-making about prescription medications while optimizing…
Understanding Healthcare Price Transparency Laws
Healthcare price transparency laws represent a fundamental transformation in how healthcare organizations manage and disclose pricing information. The implementation of federal requirements beginning January 2021 established new standards for price disclosure and accessibility. This comprehensive analysis examines the current regulatory landscape, compliance requirements, and strategic implications of healthcare price transparency laws, providing essential insights for…