HIPAA Journal

JUNE 8, 2023

The Iowa Department of Health and Human Services has announced there have been three separate breaches of the protected health information of Iowa Medicaid recipients in the past two months – two hacking incidents and an impermissible disclosure, all three of which involved third-party contractors.

Medicaid 80

Medicaid Medicaid Ransomware Health Insurance 80

HIT Consultant

NOVEMBER 9, 2023

Director of Healthcare Strategy, LexisNexis Risk Solutions During the peak of the Covid-19 pandemic, over 10 million Americans enrolled in Medicaid – nearly a 14% increase from the beginning of 2020. A month before the public health emergency ended on May 11, 2023, 87 million individuals were enrolled in Medicaid.

Medicaid 64

Medicaid Medicaid Health Insurance Health Outcomes 64

Healthcare Law Blog

AUGUST 25, 2023

On August 21, 2023, the New York State Office of the Medicaid Inspector General (OMIG) announced updates to the Medicaid overpayment self-disclosure program, which now includes an abbreviated process for reporting and explaining overpayments that are considered routine or transactional in nature and have been already voided and adjusted.

Overpayments 52

Overpayments Overpayment Medicaid Medicaid 52

Fierce Healthcare

NOVEMBER 20, 2023

billion in improper payments in fiscal year 2023, according to new data from the federal government. | The Centers for Medicare & Medicaid Services released its annual look at improper payments and found that the overall rate in Medicare was 7.38%, which sits below the 10% level mandated in statute.

Medicare 131

Medicare Medicare Medicaid Medicaid 131

Total Medical ComplianceHIPAA

NOVEMBER 13, 2023

They are: Health IT developers of certified health IT Entities offering certified health IT Health information exchanges Health information networks These penalties began on September 1, 2023, and OIG will not be imposing penalties for any blocking conduct that happened prior to that date.

HIPAA 52

HIPAA Medicaid Medicaid Medicare 52

Healthcare Law Blog

FEBRUARY 3, 2023

Part 521 governing the implementation and operation of effective compliance programs for certain “required providers,” including, now for the first time, Medicaid managed care organizations (MMCOs). [1] New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R.

Medicaid 52

Medicaid Medicaid Compliance Overpayments 52

Bill of Health

MAY 22, 2023

The selections feature topics ranging from an analysis of government and industry investments for recently approved drugs, to a discussion of court decisions on mifepristone, and an examination of the added therapeutic benefit associated with the top-selling brand-name drugs in Medicare. 2023 Apr 7;4(4):e230511. 2023 Apr 26.

Pharmaceutical Industry 157

Pharmaceutical Industry Medicare Medicare Medicaid 157

Healthcare Law Blog

OCTOBER 2, 2023

The government buys billions of dollars in healthcare-related goods and services every year, and no government procurement is perfect. If the answer is “yes”—or even “maybe”—healthcare companies may file a bid protest at the Government Accountability Office (“GAO”) or the U.S. B-421325, 2023 CPD ¶ 74 (Mar.

Governance 52

Governance Department of Veterans Affairs Medicaid Medicaid 52

Innovaare Compliance

JUNE 8, 2023

The Centers for Medicare & Medicaid Services (CMS) has released new audit protocol changes for Medicare and Medicaid plans. These changes, which went into effect on January 1, 2023, are designed to ensure health plans are accurately reporting their costs and that they are not overcharging the government.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIT Consultant

DECEMBER 9, 2022

Here are 5 behavioral health trends that we see taking shape in 2023: 1. The idea, however, has failed to take off in behavioral health, in a large part because implementing interventions has been a challenge, but much of that will change in 2023. Bottom line: In 2023, behavioral health will continue to be in the spotlight.

Medicaid 98

Medicaid Medicaid COVID-19 Governance 98

Provider Trust

AUGUST 9, 2023

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has released its latest 2023 Spring Semiannual Report to Congress, providing a comprehensive overview of its activities from October 2022 to March 2023. Led by acting Inspector General Christi A.

Nursing Homes 52

Nursing Homes COVID-19 Fraud Medicaid 52

Bill of Health

JULY 28, 2023

The selections feature topics ranging from a review of modifications to blood glucose monitoring systems and related patent protections, an examination of insulin price changes from 2012-2019, and a discussion of why a proposed federal bill that would ban government health care programs from using the quality-adjusted life-year is misguided.

Medicaid 130

Medicaid Medicaid Governance 130

HIT Consultant

APRIL 4, 2023

What You Should Know: 2023 started off with the hallmarks of a rebound year. Q1 Funding Soars, But 2023 May Struggle to Catch Up to 2019 Q1 2023 U.S. If funding for the next three quarters matches the average funding across the prior three quarters, 2023 is on pace for the lowest level of annual funding since 2019.

FDA 52

FDA Medicaid Medicaid COVID-19 52

Hall Render

DECEMBER 20, 2023

For NFs, the data would be reported via means prescribed by the applicable state Medicaid agency. The post Buyer Beware: CMS Finalizes Ownership Disclosure Requirements for Medicare Skilled Nursing Facilities and Medicaid Nursing Facilities appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

Nurses 40

Nurses Medicaid Medicaid Medicare 40

Medisys Compliance

JANUARY 30, 2023

The medical billing industry is a complex and ever-changing field, and it is crucial for healthcare providers and billing companies to stay compliant with government regulations. Violations of the False Claims Act can result in significant financial penalties, including fines and exclusion from government healthcare programs.

Compliance 52

Compliance Medical Billing Medical Billing Outsourcing HIPAA 52

Healthcare Blog

APRIL 13, 2023

As hospitals have become increasingly complex organizations, effective governance, risk, and compliance (GRC) strategies have become essential for ensuring patient safety and regulatory compliance. What are the Key Components of a Successful Governance, Risk, and Compliance (GRC) Strategy? What is patient safety culture? News Medical.

Governance 40

Governance Compliance Hospitals Regulatory Compliance 40

Bill of Health

JANUARY 23, 2024

Medicaid pays for more than 40% of births in the U.S., Examining efforts at the federal and state level, I highlight three options, leveraging Medicaid as a policy lever. In the past, when individuals were Medicaid-eligible due to pregnancy, federal law required states to provide coverage for at least 60 days postpartum.

Medicaid 111

Medicaid Medicaid Patient Satisfaction Health Insurance 111

Bill of Health

DECEMBER 6, 2023

To tackle this issue, federal and state governments should strengthen the regulation of insurance networks and insurers should address underlying causes of inadequate networks. The Consolidated Appropriations Act of 2023 requires Medicaid plans to publish and update accurate and searchable provider directories.

Governance 144

Governance Medicaid Medicaid Medicare 144

HIT Consultant

JANUARY 23, 2023

– Avalere’s ‘2023 Healthcare Industry Outlook’ examines how community-wide healthcare will be affected by a recent court ruling, and consider data’s role in addressing health disparities. Key Trends in Healthcare in 2023 The main insights from the report are highlighted as follows: 1.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare IT Today

JANUARY 6, 2023

As we head into 2023, we wanted to kick off the new year with a series of 2023 Health IT predictions. We have seen unprecedented growth in the digital healthcare space and this momentum will only continue in 2023 – bringing more innovation, smarter technology, and impactful legislation and business initiatives.

US Department of Health and Human Services 100

US Department of Health and Human Services Doctors Telemedicine Public Health 100

HIPAA Journal

APRIL 29, 2024

Berry, Dunn, McNeil & Parker, LLC (BerryDunn) provides health data analytics services to healthcare providers, health insurers, and government regulatory and healthcare policy agencies and its clients provide BerryDunn with personal and health data to allow the firm to perform its contracted services.

Health Insurance 91

Health Insurance Health Analytics HIPAA Medicaid 91

Healthcare IT Today

JANUARY 10, 2023

As we head into 2023, we wanted to kick off the new year with a series of 2023 Health IT predictions. 2023 will mark a peak opportunity for healthcare entities to take a hard look at how they spend their dollars to become better stewards in caring for their community. The cost cannot simply get transferred to the patient.

Health Outcomes 84

Health Outcomes Health Care Access Medicaid Medicaid 84

YouCompli

JANUARY 18, 2023

Featured speakers : Eric Gold , Chief, Massachusetts Attorney General’s Office Healthcare Division; Jennifer Goldstein , Managing Attorney, Medicaid Fraud Division, Massachusetts Attorney General’s Office; and Steven Sharobem , Assistant US Attorney, District of Massachusetts. Priorities for Massachusetts’s Medicaid Fraud Division.

Fraud 52

Fraud COVID-19 Compliance Medicaid 52

The Health Law Firm Blog

FEBRUARY 8, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one [.] By George F. Indest III, J.D.,

Medicare 52

Medicare Medicare Fraud Governance 52

The Health Law Firm Blog

JANUARY 18, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one [.] By George F. Indest III, J.D.,

Medicare 52

Medicare Medicare Fraud Governance 52

Verisys

FEBRUARY 8, 2024

Arizona BON License Renewals California : As of September 23, 2023, all California boards within the DCA must remove and replace the name and gender of a qualified licensee whose name or gender has officially been changed, on all licenses and related records. If the license is not renewed, it will expire on 8/2/2024.

Regulatory Compliance 52

Regulatory Compliance Compliance Licensing Nurses 52

The Health Law Firm Blog

DECEMBER 28, 2023

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On August 12, 2023, federal prosecutors recommended a life sentence for the Florida ex-CEO of a laboratory company who had been found guilty of fraudulently billing Medicare over one [.] By George F. Indest III, J.D.,

Medicare 52

Medicare Medicare Fraud Governance 52

Health Law Advisor

AUGUST 30, 2023

On August 24, 2023, the U.S. In a decision that significantly levels the field for providers, the District Court ruled in part for the provider plaintiffs and in part for the Government in the TMA III ruling. The Centers for Medicare & Medicaid Services (“CMS”) responded to the ruling by temporarily suspending all Federal (i.e.,

Governance 105

Governance Medicaid Medicaid Medicare 105

Jackson Lewis

JUNE 21, 2023

22-111 (June 1, 2023). Following the Court’s decision, Medicare and Medicaid providers and other federal contractors should practice caution when submitting claims to the U.S. government. SuperValu Inc. , 21-1326, together with U.S. Safeway, Inc. , Read more.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Health Law Advisor

AUGUST 25, 2023

It is axiomatic that New York State requires every Medicaid provider to have an “effective” compliance program. The regulations were finalized in December 2022, with an effective date of March 28, 2023, and an enforcement moratorium that has just ended. New York Social Services Law § 363-d.

Compliance 52

Compliance Overpayments Overpayment Compliance Officers 52

Healthcare IT Today

AUGUST 20, 2023

That said, 66% trust their health plan more that the government or non-traditional entities such as Amazon or Walmart to their health insurance. MedArrive and Heartbeat Health are collaborating to provide on-demand cardiovascular services to Medicaid beneficiaries.

Health Insurance 88

Health Insurance Medicaid Medicaid FDA 88

HIT Consultant

MARCH 21, 2023

It’s been a hot topic for revenue cycle management professionals for years that’s only getting hotter with the increasing pressures of staffing shortages, challenges with staff turnover and training and ever-changing policies and protocols at the government and payer levels.

US Department of Health and Human Services 52

US Department of Health and Human Services Patient Satisfaction Medicaid Medicaid 52

AIHC

MARCH 12, 2024

Written by the AIHC Education Department This article provides an overview of how the media and government are reacting to the potential of artificial intelligence (AI) and potential threats associated with this advanced technology. A Government-Commissioned Report Released February 2024 The U.S. How does it work?

Ransomware 59

Ransomware Governance Compliance HIPAA 59

AIHC

MARCH 12, 2024

Written by the AIHC Education Department This article provides an overview of how the media and government are reacting to the potential of artificial intelligence (AI) and potential threats associated with this advanced technology. A Government-Commissioned Report Released February 2024 The U.S. How does it work?

Ransomware 52

Ransomware Governance Compliance HIPAA 52

HIT Consultant

JULY 17, 2023

So, with the end of the public health emergency (PHE) on May 11, 2023, and the cessation of PHE-related exceptions that increased access to mental health resources, there is reason for concern. Cessation of PHE telehealth, prescribing, and mental health access exceptions could impact the Medicaid population the most.

Public Health 98

Public Health Medicaid Medicaid Electronic Medical Records 98

C&M Health Law

FEBRUARY 6, 2023

21-3167 (1/30/2023). The court rejected the government’s contrary interpretation that would have required manufacturers to deliver drugs to any location designated by the covered entity. 16, 2022), and the government prevailed in Sanofi-Aventis U.S., Sanofi-Aventis U.S., HHS , Case No. Becerra , 2022 WL 484587 (D. HHS , 570 F.

Medicaid 52

Medicaid Medicaid Governance 52

Healthcare Law Blog

MAY 16, 2022

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). Enrollee Participation in Dual Eligible Special Needs Plan (“D-SNP”) Governance (§ 422.107).

Medicare 52

Medicare Medicare Medicaid Medicaid 52