In Italy, the reimbursement provided to healthcare organisations for medical and surgical procedures is based on the diagnosis related group weight (DRGW), which is an increasing function of the complexity of the procedures. This makes the reimbursement an upper unlimited function. This model does not include the relation of the volume with the complexity. The paper proposes a mathematical model for the optimisation of the reimbursement by determining the optimal mix of volume/procedure, considering the relation volume/complexity and DRGW/complexity. The decreasing, linear, and increasing returns to scale have been defined, and the optimal solution found. The comparison of the model with the traditional approach shows that the proposed model helps the healthcare system to discern the quantity of the reimbursement to provide to health organisations, while the traditional approach, neglecting the relation between the volume and the complexity, can result in an overestimation of the reimbursement.

This informative guide from Red Wing for Business compares the many advantages of a managed safety footwear program with those of a typical reimbursement program – for both you and your employees.

Get our guide that compares the many advantages of a managed safety footwear program with those of a typical reimbursement program. Get the guide and see how working with a reputable safety footwear provider can tailor a program for your business needs, as well as for the safety and productivity of your workers.

Health Care Provider Boot Camp Day 8: Billing and Reimbursement Training for Designated Doctor and Other Certifying Doctor Exams

Texas Workers’ Compensation 2025 Professional and Workers’ Compensation Specific Exams Reimbursement Rates

A New York appellate court ruled that an injury compensation fund was entitled to reimbursement from an insurance carrier of a motorist who caused an accident. Case: In the Matter of State Farm Mutual Automobile Insurance…

The Supreme Court of New Hampshire ruled that an employer or insurance carrier that has been denied reimbursement from the Special Fund for Second Injuries is entitled to a hearing before…

The Oregon Workers’ Compensation Division on Thursday announced that most lodging and meal reimbursement rates for injured workers who travel to medical appointments will increase Oct. 1. The standard lodging rate…

The Massachusetts Appeals Court ruled that an insurance company that was not contributing any assessments to the Workers’ Compensation Trust Fund was still eligible for reimbursement for benefits paid to…

Learn what constitutes proper billing, how to find and use fee schedules, documentation requirements and dispute resolution. Attendees will achieve a better understanding of the requirements for getting paid under…

The Alabama Court of Civil Appeals revived an insurance provider's claim for reimbursement from a widow's wrongful death settlement. Timothy Tumlin worked for L&C General Contractors Inc. He died as a…

The Wyoming Supreme Court ruled that the state's Workers’ Compensation Division has the authority to order reimbursement of an employee’s reasonably incurred medical expert witness fees. Case: Leal v. State ex…

Sponsors in the Child and Adult Care Food Program (CACFP) can receive reimbursement for meals served in compliance with program regulations at qualifying child care centers, adult day care centers, emergency shelters, family day care homes and afterschool programs. Sponsors may be reimbursed for up to two meals and one snack per participant each day. Participant eligibility is tied to income eligibility guidelines that are adjusted annually by the USDA.

Informa Connect's Copay, Reimbursement and Access Congress
November 18-20, 2024 | Hilton Penn’s Landing in Philadelphia, PA
Drug Channels readers save 10% with code USAVE24*

The access and affordability landscape is undergoing a seismic shift. Evolving legislation, disruptive market forces and the ever-growing complexities of cost sharing programs threaten patient adherence and commercialization strategies. Are you ready?

A program driven by marketplace insights and led by industry trailblazers, Copay, Reimbursement and Access Congress is back November 18-20 and will deliver up-to-date insights necessary to enhance patient affordability, ensure program sustainability and navigate the regulatory landscape. In a time where remaining compliant has never been more complex and program innovation has never been more important, be sure to join your industry counterparts to drive adherence, access and commercialization forward.

Why attend the Copay, Reimbursement and Access Congress?

Keeping up with shifting market dynamics in the midst of maximizing access, while also meeting business objectives is a challenging task and brings about many questions for access professionals.

• Is your program sustainable and innovative to better support patients?
• Accumulators, maximizers, AFPs – What are your next steps to ensure effective reimbursement strategies?
• In an election year, what is the future of health policy?

Experts will tackle these questions and more as the industry comes together to benchmark best practices to accelerate access and commercialization. Do not miss your chance to join seasoned leaders, your peers and leading solution providers as they navigate marketplace trends and dive into the impact coupons, benefit design, accumulators, maximizers, alternative funding programs and drug pricing legislation have on patient affordability and out-of-pocket costs. This is your chance to gain critical insights on industry standards, forward-thinking strategies to optimize your copay and cost sharing programs and so much more.

Content highlights:

• Over 20 hours of content, including 7+ dedicated sessions to help decipher copay legislation
• Crucial perspectives from Pfizer, Sanofi, Janssen, Teva, Ascendis Pharma, Melinta Therapeutics, GSK, HIV + Hepatitis Policy Institute and more
• Insights direct from enforcement agents on the top trends and actions within the copay and patient services space
• Illuminating case study, Navigating the Patient Journey in a Shifting Copay Landscape from Spark Therapeutics
• 465 minutes of valuable in-person networking with colleagues and counterparts to expand your network and establish powerful partnerships
• Additional content access through Streamly, a platform that gives you 12-month access to all of the available conference content** to review at your leisure
• And more!

Download the agenda and register today—Be sure to use your exclusive promo USAVE24 to save 10% off* of your registration

See you there!

*Cannot be combined with other offers, promotions or applied to an existing registration. Other restrictions may apply.
**Pending speaker permissions

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The content of Sponsored Posts does not necessarily reflect the views of HMP Omnimedia, LLC, Drug Channels Institute, its parent company, or any of its employees. To find out how you can promote an event on Drug Channels, please contact Paula Fein (paula@DrugChannels.net).

Today’s guest post comes from Kimberley Chiang, Vice President of Biopharma Commercial Solutions at CoverMyMeds

Kimberley highlghts the crucial roles of field reimbursement managers in removing access and reimbursement barriers. She then identifies the keys to successful implementation of field reimbursement services.

To learn more, register for CoverMyMeds' November 13, 2024, webinar: Specialty Therapies & Field Reimbursement Services: Driving Better Outcomes for Brands and Patients.

Read on for Kimberley’s insights.
Read more »

�I think it is an opportunity for nurses to learn a skillset you don�t learn in nursing school.� � Jeffin Bush

In United States among different cities, medical reimbursement for the same medlinkmental health/medlink treatment was found to vary dramatically.

The Government of Andhra Pradesh has launched another welfare scheme for students. It has announced a new flagship program named "Jagananna Vidya Deevana," which will provide full fee reimbursement to the students. Chief Minister YS Jagan Mohan Reddy has introduced the

Making products meet international standards requires ISO Certifications, but getting it is an expensive affair. To get around this, the government provides reimbursement to SMEs seeking ISO 9000/ISO 14001Certification.

An Indiana University student is suing the school, looking for a partial reimbursement on tuition and fees paid for the spring semester.

An Indiana University student is suing the school, looking for a partial reimbursement on tuition and fees paid for the spring semester.

The Delaware Department of Insurance today released a list of consumer-friendly automobile insurer actions that are being implemented due to reduced vehicle use throughout the COVID-19 pandemic. As filed with the department, these actions represent millions of dollars being returned to or saved by policyholders throughout the state. The following list may not be inclusive […]

Robert Wood Johnson University Hospital Hamilton, a New Jersey-based hospital, has agreed to pay $6.35 million to settle allegations that the hospital defrauded Medicare.

Schwarz Pharma Inc. will pay $22 million to resolve False Claims Act allegations that the company failed to advise the Centers for Medicare and Medicaid Services (CMS) that two unapproved products did not qualify for coverage under federal health care programs.

The Justice Department announced today that a federal court has permanently barred Cash Management Systems, a Virginia corporation, from promoting two tax schemes that allegedly involve disguising wages as tool-reimbursement or tool-rental payments.

Caremark LLC, a pharmacy benefit management company (PBM), will pay the government and five states a total of $4.25 million to settle allegations that it knowingly failed to reimburse Medicaid for prescription drug costs paid on behalf of Medicaid beneficiaries, who also were eligible for drug benefits under Caremark-administered private health plans.

“I think it is an opportunity for nurses to learn a skillset you don’t learn in nursing school.” – Jeffin Bush

“I think it is an opportunity for nurses to learn a skillset you don’t learn in nursing school.” – Jeffin Bush

The CM said Students' fares were being paid directly by his government to the railways, while migrant workers will be reimbursed the entire expenses they incurred on the journey once they have completed their 21-day quarantine after reaching Bihar.

The Government of Andhra Pradesh has launched another welfare scheme for students. It has announced a new flagship program named "Jagananna Vidya Deevana," which will provide full fee reimbursement to the students. Chief Minister YS Jagan Mohan Reddy has introduced the

Herbert, Kyle