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NHCAA Comments on Medicare Data Use Proposed Rule

Published on 3/28/2016 by “NHCAA”

CMS recently issued a proposed rule to implement changes to the Qualified Entity Program, established by the ACA and expanded by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The rule would allow qualified entities (which are certified by CMS to access Medicare, Medicaid and CHIP claims data to conduct combined analyses with other claims data) to provide or sell data and analyses to “authorized users.” Health insurers would be considered authorized users under the health i...

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2015 NHCAA Annual Report

Published on 2/4/2015 by “NHCAA”

Because of the support of our members, NHCAA experienced another exciting year of accomplishments and advancements as demonstrated in our 2015 Annual Report. We strive to continuously improve our service to our members and to champion the integrity of our nation's health care system.

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NHCAA comments on NAIC Subgroup work on Medical Loss Ratio

Published on 1/20/2016 by “NHCAA”

In recent months, the Medical Loss Ratio Quality Improvement Activities (B) Subgroup of the National Association of Insurance Commissioners (NAIC) has been examining the issue of medical loss ratio and reviewing new quality improvement (QI) initiatives, which are reported annually on the Supplemental Health Care Exhibit Allocation Report. The Subgroup invited regulators and interested parties to submit comments for consideration. Read the January 15th letter that NHCAA submitted.

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Press Release: Nicholas J. Messuri, Esq., elected NHCAA Board Chair

Published on 11/18/2015 by “NHCAA”

The National Health Care Anti-Fraud Association (NHCAA) today announced that Nicholas J. Messuri, Esq., Vice President and Deputy General Counsel for Fraud Prevention & Recovery at DentaQuest and Delta Dental of Massachusetts has been elected as the new Chair of its Board of Directors. Messuri succeeds Katherine M. Leff, Director of the Special Investigations Unit (SIU) at CareSource.

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NHCAA Comments on Proposed Medicaid Managed Care Rule

Published on 7/29/2015 by “NHCAA”

NHCAA has submitted a letter of comment in response to CMS publishing on June 1, a long-awaited proposed rule that aims to overhaul regulatory oversight of Medicaid managed care. Our comments focus on medical loss ratio and compliance program requirements.

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