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- Pam Lassila on Best Practices and Common Conditions of Audit Preparation
- Capitol Hill Healthcare Update | Gorman Health Group Blog on What Trump Could Actually Do to ObamaCare, Day One, Without Congress
In sports, a good coach will tell you, “Practice like you play, because you will play like you practice.” Well, the same can be said for case sampling. My colleague, Anita McCreavy and I advise plans, “You can use an audit practice run of your Model of Care’s Special Needs Plan Enrollees (MOC-SNPE) universe to tell you if your operations are ready for a Centers for Medicare & Medicaid Services (CMS) audit.” Additionally, there is opportunity to add to the universe fields to assist management in further prioritizing potential gaps.
While headlines rage in DC about Trump’s leaks to Russian spies visiting the White House last week, the Senate’s sausage factory grinds away on TrumpCare. You’ll recall following House passage of the American Health Care Act (AHCA), the Senate essentially declared it DOA in the upper chamber and started over. Health plans are in the middle of bid development for the ObamaCare Marketplace and for Medicare Advantage and Part D, so timing and details matter.
I sure hope Republicans enjoyed their victory lap for getting the American Health Care Act (AHCA) through the House by the thinnest margin, because there are two huge icebergs dead ahead: the backlash, and the Senate.
The Gorman Health Group 2017 Forum concluded last week in New Orleans with over 200 of our closest clients and partners. As we enter our 21st year, we returned to where it all began for us, with a little startup called Peoples Health, our first and closest client who now dominates southern Louisiana. The Forum ended the day JazzFest 2017 began, so many of us stayed to enjoy the festival and the best of New Orleans heritage and culture.