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Curbing Waste, Fraud, and Abuse in Medicaid

Research

Health Care

March 9, 2016

Tara O'Neill Hayes

result of efforts to guard against improper denial of benefits. Other opportunities exist because of the overwhelming effort required to verify every piece of information and ensure compliance with all laws and regulations. Patient Waste, Fraud, and Abuse Patients can commit fraud in a number of ways. An individual may falsify information pertaining to

PRIMER: MACRA and the Merit-based Incentive Payment System (MIPS)

Insight

Health Care

January 31, 2017

Tara O'Neill Hayes

participate in the EHR Incentive Program, and therefore may be unfamiliar with the technology and/or some of the required functionalities. As such, some of the required thresholds are lower than the requirements imposed in “Modified Stage 2” and Stage 3. The objectives of the measures evaluated in this category will focus on the advancement

What Congress Needs to Consider When Reforming Medicare Part D

Insight

Health Care

June 28, 2019

Tara O'Neill Hayes

may weaken the incentive not to increase prices, relative to AAF’s original proposal, depending on the discount rates required. It may also provide financial savings to more beneficiaries. Implementing this proposal in combination with the administration’s proposed “rebate rule” could lead to even higher premium increases. Further, a lower OOP cap would be required

International Disability Programs: Recent Reform

Research

Debt, Health Care

June 20, 2014

Gordon Gray

raised to at least 35 percent from the previous 15 percent ·     A 2 year waiting period is required before applying to long-term disability, during which time individuals may claim employer-provided sickness absence benefits ·     Inflow into the disability program decreased 63 percent. Unsurprisingly, outflow and recovery rates of beneficiaries also dropped following the

Ignoring the Lessons of History

The Daily Dish

Debt, Economy, Financial Services, Trade

August 3, 2016

Douglas Holtz-Eakin, Patrick Hefflinger

included in the Dodd-Frank Act. Regulators stated banks with less than $10 billion in assets will not be required to comply with the same rules and standards regarding swaps that larger banks will be required to meet. The rule announced this week finalizes an interim final rule approved last November. Eakinomics: Ignoring the Lessons of

March 15th Edition

The Daily Dish

Housing

March 15, 2016

Douglas Holtz-Eakin

we have a return to pushing the affordable housing goal. It is all the more mystifying because the FHFA is required to suspend allocations to the various “affordable housing” funds (Hope Reserve Fund, National Housing Trust Fund, Capital Magnet Fund, among others) if they would contribute to the financial instability of the GSEs. As it turns

Subsidy Verification in the ACA: Complexity Creating Taxpayer Risk

Testimony

Health Care, Regulation

June 10, 2014

Douglas Holtz-Eakin

system is too difficult for consumers to navigate. The complexity of the subsidy eligibility system, and the information required of the consumers and employers will result in erroneous subsidy allotments. The tax system is already too complicated and in need of reform. The additions to the tax code stemming from the ACA will continue

Competing Proposals to Reform Medicare Part D

Insight

Health Care

September 23, 2019

Tara O'Neill Hayes

aforementioned problems by making several changes, shown below: It increases insurer liability in the catastrophic phase, moves the required manufacturer rebates to the catastrophic phase, and places a cap on beneficiaries’ OOP liability. The accounting firm Milliman modeled this plan and current law to find the parameters at which the expected manufacturer rebates under

Risky Business

The Daily Dish

Financial Services, Housing

October 1, 2019

Douglas Holtz-Eakin

Mae to retain up to $25B of capital and Freddie Mac up to $20B. Both are above their minimum required core capital levels at 2Q19 of $22.3B and $18.4B, respectively. Based on our earnings forecast, it would take Fannie Mae until 4Q20 or 1Q21 to reach this level from retained earnings and it would take Freddie Mac until 2Q21

The Impact of Shifting Rebates to Catastrophic Coverage in Medicare Part D

Insight

Health Care

June 11, 2019

Tara O'Neill Hayes

Coverage Gap Discount Program (CGDP) to the catastrophic phase of coverage. Under current law, the maximum rebate amount required of manufacturers for a given drug in 2020 is $3,698, regardless of the drug’s cost, and the majority of mandatory rebates are paid for drugs that cost $480-$580. If manufacturers were instead required to pay

The American Action Forum is a 21st century center-right policy institute providing actionable research and analysis to solve America’s most pressing policy challenges.