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Mergers & Trends to Watch in 2016

Aetna & Humana and Anthem & Cigna: Keep watch and see if the Department of Justice allows the mergers to proceed. A final decision will most likely not occur until after the second quarter. Also expected to have a say in the decision are the companies’ shareholders, consumer groups, and of course, the politicians. 2016… Read More

Changing Your Mindest: Making 2016 the Best Year Yet!

One of the most important things you can do for your agency, and for your book of business is to get healthy. Not matter how compliance savvy you are or how much you know about Medicare, if your life is full of stress and unhealthy habits, your business will suffer. Since your mindset always trumps… Read More

What’s New in Medicare for 2016?

2016 marks a unique year for the 50-year-old Medicare program with some of the biggest changes ever: Clinicians will now be paid to offer patients counseling for end of life care options. This type of personalized counseling had been previously removed from Obamacare in its early days. Prior to this year, if a patient chose… Read More

Accountable Health Communities Model & Upcoming January 2016 Webinars

On January 5th, the Department of Health and Human Services announced the introduction of a new five-year program designed to determine if certain types of screening and their referrals to community based services will result in improvements to the quality and affordability of Medicaid and Medicare. The program, called the Accountable Health Communities Model or… Read More

CMS Medicare Marketing Dos and Don’ts

CMS Marketing Guidelines become more and more strict with each passing year.  Agents are required to pass training at the time of contracting with a new carrier, and annually thereafter.  With the abundance of information given during the training, it is always a good idea to have a quick reference guide for marketing Medicare Plans. … Read More

ACA – Important Reporting Extension for Employers

Last week, the Internal Revenue Services (IRS) and the U.S. Treasury announced an extension of some of the Obamacare reporting requirements so that employers have more time to meet their obligations. Employers have been given an extension from February 1, 2016 to March 31, 2016 to allow them to get health information statements to their… Read More

Medicare Insurance Fraud Scandals on the Rise in 2015

This summer, the largest Medicare fraud bust involved the arrest of 243 people, including 43 doctors and nurses over $712 million worth of illegal billing and bogus patient care. In Miami, a mental health facility billed over $64 million dollars for psychotherapy treatment sessions that never happened; in fact, patients were simply moved to different… Read More

HIPAA and the Business Associate: What to Expect for 2016

Over the course of the following year, federal regulators must increase their efforts to apply HIPAA compliance to business associates because so few have mature security controls. Mac McMillan, the security expert and CEO of the consulting firm CynergisTek, argues this point. In 2013, business associates became directly responsible for HIPAA compliance under the HIPAA… Read More