Description: CPT, NCCI, ICD, CCI, DRG, APC, PTP – understanding healthcare claims involve a dizzying array of code sets and payment methodologies, and yet the claim form is the intersection of health plan affordability, provider payment, and data analysis. This webcast will cover: • The code sets used in medical coding • Types of correct coding policies implemented by CMS and commercial payers • Payment integrity strategies to drive health plan affordability • Data analytics approaches leveraging medical coding knowledge

Description: 1993 SOA Spring Meeting, Boston. This session discussion is about cash-flow testing as a management tool. Topics covered included: 1. Was the year-end process useful or a necessary evil? 2. How realistic were the assumptions used? 3. How much was pure guesswork? 4. What were the lessons learned from the exercise?

Description: The panel offers a summary of the Medicare Modernization Act signed into law in 2003, which implemented sweeping changes to the Medicare program. Topics include Medicare Advantage, the impact on Medicare Supplement, Part D, and the impact on retiree health plans. From Record of Society of Actuaries, Vol. 30, No. 3, Session 127

Description: 1988 Valuation Actuary Symposium. This session discussed the current thinking of the Special Advisory Committee on the Valuation Law which was formed by the NAIC to significantly expand the scope and usefulness of the proposed actuarial opinion.

Description: 1988 Valuation Actuary Symposium. The speakers in this session addressed the relative volatility of participating whole life versus universal life and the annual-premium versus single- premium basis.

Description: This paper attempts to quantify the benefits to the purchaser of a non-qualified variable annuity as compared to an investment in a mutual fund. From Actuarial Research Clearing House 1991, VOL. 3.

Description: HIV is still a big public health concern, but there are therapies available to prevent infection before and immediately after exposure. As legislatures and the USPSTF considers adding these therapies to the list of preventive care covered without cost share, actuaries will need to estimate the impact on their care cost. The presenters will share an actuarial tool kit to estimate the impact of covering PrEP and PEP for different populations. Examples are provided and discussion is welcome.

Description: MHPAEA prohibits health plans from imposing financial requirements or treatment limitations on behavioral health benefits that are more restrictive than those applied to medical and surgical benefits. MHPAEA's regulations define treatment limitations to include nonquantitative treatment limitations (NQTLs), which are benefit design features that are not numerical, but otherwise limit the scope or duration of benefits.

Description: This paper presents an analysis of the basic actuarial theory for life insurance policies which have fixed premiums, the entire reserve held in a separate account, the assets of which would be invested primarily in common stocks, etc. From Transactions of Society of Actuaries 1969, Vol. 21 Pt. 1, No. 61

Description: This article discusses the Carter Report. It is a review of the Canadian federal system of taxation that would have far-reaching implications if enacted.