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No Surprises Act

The No Surprises Act 2021 is set to take effect for health plan years beginning on or after January 1, 2022.  This legislation expands restrictions on charging health care plan holders out-of-network rates for certain services and includes many medical plan changes and requirements, some of which are listed below. No Surprise Medical Billing- amending […]
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One Step Closer to the End of Surprise Medical Bills – Maybe

After ongoing negotiations for over two years, Congress has released Discussion Draft legislative text of the proposed No Surprises Act that seeks to protect patients from receiving surprise medical bills (unexpected medical bills for out-of-network and emergency care). Highlights of the Proposed Act Patients cannot be balance billed: by out-of-network providers at in-network facilities (with […]
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National Kidney Month

By: Rebecca Modene PhD, RN – Manager of Clinical Underwriting March is National Kidney Month and March 12th is World Kidney day. Astoundingly 10% of the world’s population is affected by chronic kidney disease (Kidney.org, 2019). In the United States, an estimated 37 million American adults have chronic kidney disease (Kidney.org, 2019). According to the […]

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Be Proactive Not Reactive to Cancer Risks

By:  Rebecca c. Modene Phd, RN – Manager of Clinical Underwriting February is National Cancer Prevention Month, which coincides with World Cancer Day on February 4th. World Cancer Day started on Feb 4, 2000 by the Union for International Cancer control and its intent is to bring awareness to cancer from prevention to treatment worldwide […]

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Surprise Medical Billing – Federal Law Developments

Employers and employees alike experience the headache and often significant financial burden surprise medical bills (balance billing from an in-network facility where the patient unknowingly receives care from out-of-network providers) present.  While some states ban the practice, employers who sponsor or participate in self-funded medical coverage are generally not covered by these laws.   Surprise […]
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Employer Clinic Compliance Issues

An employer clinic (sometimes referred to as onsite or worksite clinics) historically provided care to employees for on-the-job accidents and first aid.  Now, many employers see onsite clinics as a way to reduce healthcare spending, increase productivity, and provide a desirable benefit to employees.  Establishing an onsite clinic may have several positive effects, but the […]
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