HIPAA Journal

OCTOBER 7, 2022

On August 5, 2022, Anthem discovered that an unauthorized individual had gained access to a database and downloaded files containing plan members’ protected health information, including names, addresses, dates of birth, phone numbers, email addresses, Medicare ID numbers, and Medicaid ID numbers.

HIPAA 99

HIPAA Health Insurance Medicaid Medicaid 99

MedTrainer

MAY 6, 2024

Here are the key steps: Gather Training and Education Gather Licensing and Certification Gather Work History Details Gather Payer-Specific Requirements Following Application Submission Get the tools you need to eliminate delays in your provider enrollment process. Easily assign multiple enrollments to staff, update statuses, and prioritize.

Licensing 52

Licensing Malpractice Health Insurance Medicaid 52

Health Care Law Brief

FEBRUARY 8, 2024

billion to fund Medicaid, $4.8 In addition to the 1115 Waiver, which funds the Medicaid Hospital Global Budget for financially distressed safety net hospitals transitioning from volume-based reimbursement models to value-based models, the HMH Bill would also establish the Healthcare Safety Net Transformation Program (“HSNT Program”).

Medicaid 52

Medicaid Medicaid Nurses Licensing 52

MedTrainer

MAY 29, 2024

The interactive PDF is available through the Texas Department of Insurance, but providers or credentialers can easily download a pre-filled application from CAQH — the format changes slightly per payer, but it includes almost the same information as any other “standard” application. Primary Source Verification.

Medicaid 52

Medicaid Medicaid Malpractice Licensing 52

MedTrainer

APRIL 11, 2024

Noncompliance: Providers must maintain specific licenses and certifications to provide patient care services. These include a national provider identification number , state licensure, drug enforcement agency license , and state pharmacy license. Get the tools you need to eliminate delays in your provider enrollment process.

Licensing 52

Licensing Medicaid Medicaid Medicare 52

Verisys

NOVEMBER 8, 2023

The NPI improves the Medicare and Medicaid programs, other federal and private health programs, and the overall effectiveness and efficiency of the healthcare industry by simplifying administration and enabling the efficient electronic transmission of health information. Learn More About NPIs When Did NPI Numbers Begin?

Fraud 97

Fraud HIPAA Medicare Medicare 97

MedTrainer

JULY 28, 2023

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. Download “Compliance Reports You Can’t Live Without” for OIG reporting templates and tips. What Prompts an OIG Inspection?

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Fraud Compliance Medicaid Medicaid 98

MedTrainer

JANUARY 12, 2024

Here are some of the key organizations involved in regulating healthcare compliance: Centers for Medicare & Medicaid Services (CMS): CMS is a federal agency within the U.S. Department of Health and Human Services responsible for administering and regulating healthcare programs such as Medicare and Medicaid.

Compliance 52

Compliance Fraud Medicaid Medicaid 52

MedTrainer

MARCH 14, 2024

The specialist authenticates the provider’s education, work history, licenses, and other information during provider credentialing. Download Now What are Provider Privileges? Credentialing specialists employed at the healthcare organization or through a contracted credentialing service typically complete this process.

Malpractice 52

Malpractice Licensing Hospitals Compliance 52

HIPAA Journal

MARCH 10, 2022

Individuals whose Social Security number, driver’s license, state identification number, or financial account information may have been involved have been offered complimentary credit monitoring services. The breach has been reported to the HHS’ Office for Civil Rights as affecting up to 25,745 individuals. Dr. Douglas C.

Ransomware 123

Ransomware Licensing Health Insurance Hospitals 123

MedTrainer

DECEMBER 4, 2023

The Mississippi Division of Medicaid administers health coverage programs to eligible residents, providing vital healthcare services to underserved and vulnerable populations in the state. These agencies help maintain the integrity and quality of healthcare services in Mississippi , protecting the public and promoting patient safety.

Compliance 52

Compliance Telemedicine Licensing Public Health 52

MedTrainer

APRIL 18, 2024

Download Now Common Challenges in Behavioral Health Credentialing Where behavioral health credentialing diverges from typical provider credentialing is Medicare enrollment. Get the tools you need to eliminate delays in your provider enrollment process. CMS has guidelines around each of those relating to education, state licensure, and more.

Medicare 52

Medicare Medicare Licensing Compliance 52

Verisys

DECEMBER 5, 2023

State licensing boards verify practitioner license type and status. The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs. Here are some examples: Medical schools verify completion of education. The Primary Source Organizations.

Governance 52

Governance Licensing Malpractice Medicaid 52

MedTrainer

NOVEMBER 17, 2023

Download Now What Does a Credentialing Expert Do in Healthcare? Credentialing teams gather and validate healthcare providers’ qualifications, licenses, and certifications. Secure Document Sharing Platforms: A credentialer needs to know how to navigate document sharing platforms, such as PAVE or state licensing portals.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

MARCH 28, 2024

Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care. Clinical & Administrative Departments Adheres to regulations and guidelines within their specific licensing boards and department policies and procedures. Automated escalation speeds up resolution.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

Verisys

FEBRUARY 1, 2022

In July 1993, the Centers for Medicare and Medicaid Services ( CMS ) undertook a project to develop a healthcare provider identification system to meet the needs of the Medicare and Medicaid programs and the needs of a national identification system for all providers. When Did NPI Numbers Begin? The NPI Final Rule, published on Jan.

Fraud 52

Fraud Medicare Medicare HIPAA 52

MedTrainer

MAY 4, 2023

This article will focus on the federal changes, but make sure to check with all states where your providers are licensed to stay up-to-date. CMS Burden Reduction Final Rule (84 FR 51732) The Centers for Medicare & Medicaid Services (CMS) permanently extended changes made to the Burden Reduction Final Rule.

Public Health 52

Public Health Compliance COVID-19 COVID-19 Vaccine 52

Verisys

MARCH 1, 2022

State licensing boards verify practitioner license type and status. The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs. Here are some examples: Medical schools verify completion of education. The Primary Source Organizations.

Governance 52

Governance Licensing Malpractice Medicaid 52

AIHC

APRIL 25, 2022

Are providers and professionals allowed to download mobile applications to mobile devices? When telehealth is used, it is considered to be rendered at the physical location of the patient, and therefore a provider typically needs to be licensed in the patient’s state. Click Here for Cross-State Licensing information.

HIPAA 52

HIPAA Compliance COVID-19 Compliance Officers 52

HIPAA Journal

JANUARY 2, 2023

Downloading PHI onto Unauthorized Devices. Employees need to be aware that there are privacy and security risks associated with downloading ePHI to unauthorized portable electronic devices. Care must also be taken to ensure that the correct patient’s records are released. Are HIPAA violations common? HIPAA Compliance Infographics.

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HIPAA Compliance Hospitals Medicare 109

Healthcare IT News - Telehealth

MAY 6, 2020

In 2019, Fitbit unveiled a more data-driven personal health subscription service for consumers that, among other features, generates personal reports that a user can download and share with their physician, nutritionist or personal trainer.

COVID-19 188

COVID-19 FDA Hospitals Elder Care 188

Hall Render

FEBRUARY 4, 2022

Florida’s ACA enrollment is tops nationally, but Medicaid expansion questions remain. Nurse accused of falsifying patient’s COVID-19 test results will keep her license. Digital vaccine cards now available for download in Nevada. Up to 80,000 Ohioans could end up on different health plan in reformed Medicaid system.

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COVID-19 US Department of Health and Human Services Nursing Homes Nurses 40