C&M Health Law

OCTOBER 18, 2023

Section 504 covers all health care and human services programs and activities funded by HHS, from providers, like hospitals and doctors that accept Medicare or Medicare, to state child welfare programs, as well as Medicare Advantage Plans, and Medicaid Managed Care Plans.

ADA 98

ADA COVID-19 Medicare Medicare 98

AIHC

NOVEMBER 29, 2023

Medicare changed reimbursement methodology in the 1980s by introducing Relative Value Units (RVUs) and the RBRVS (Resource-Based Relative Value System) for physician reimbursement. MA/HMO) is typically used by Health Maintenance Organizations and Medicare Advantage Organizations. healthcare system were exorbitant. Capitation (e.g.,

Medicare 52

Medicare Medicare Medicaid 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

Healthcare Compliance Blog

APRIL 29, 2022

Court documents show that between 2008 and 2016 the former owner defrauded the Texas Medicaid program by billing for items and services that had not been provided to the clients of the day care centers. in restitution for her role in healthcare fraud, wire fraud, and theft of government funds.

Fraud 59

Fraud Compliance Governance Medicaid 59

HIPAA Journal

JANUARY 12, 2024

The addition of standards to account for the passage of the GINA Act 2008. The addition of standards to account for the passage of the GINA Act 2008. The adoption of a four-tired civil monetary penalty structure for violations of HIPAA. The finalization of the Breach Notification Rule and the revised “harm” threshold.

HIPAA 86

HIPAA Compliance Health Insurance Medicaid 86

HIPAA Journal

OCTOBER 21, 2022

Despite the benefits, the cost of implementing NPIs was forecast ( in 2008 ) to be between $1.5 Advocates of NPIs are hoping that the introduction of Medicare Beneficiary Numbers (which went into effect in January 2020) will demonstrate to Congress that the benefits of NPIs far outweigh the costs. #4. billion and $11.5

HIPAA 102

HIPAA Compliance Medicare Medicare 102

The Health Law Firm

AUGUST 20, 2012

Lower Medicare reimbursement rates are coming in October of 2012, to 2,211 hospitals around the country, including 131 in Florida. This is allegedly due to excessive readmission rates in these hospitals between July 2008 and June 2011, according to the Centers for Medicare and Medicaid Services (CMS). Indest III, J.D.,

Medicare 40

Medicare Medicare Hospitals Medicaid 40

The Health Law Firm

FEBRUARY 20, 2018

The department store chain withheld certain information from Medicare Part D, Medicaid and Tricare, the Department of Justice (DOJ) said. The new agreement resolves allegations arising from a 2008 lawsuit brought under the qui tam, or whistle blower, provisions of the False Claims Act (FCA). Indest III, J.D.,

Overpayments 40

Overpayments Overpayment Medicaid Medicaid 40

HIT Consultant

APRIL 20, 2022

Since the passage of the Medicare Improvements for Patients & Providers Act in 2008, the U.S. Hospitals report the data to the Centers for Medicare & Medicaid Services (CMS), which uses that data to create the Overall Hospital Quality Star rating for each hospital.

Medicare 98

Medicare Medicare Telemedicine Medicaid 98

Health Populi

MARCH 11, 2021

health care, patient assistance programs, Medicare Advantage plans, and the bundling of proven high-value preventive services into the Affordable Care Act. In the case of Medicare Part D, the drug benefit, Chandra said, “If you’re sick enough to fall into the donut hole, you may have higher mortality.”

Health Insurance 98

Health Insurance ACA Medicare Medicare 98

Healthcare IT News - Telehealth

MARCH 18, 2022

Norden is particularly passionate about funding companies focused on the Medicaid population – a traditionally tricky and often ignored area. You are passionate about funding companies focused on the Medicaid population – a traditionally tricky and often ignored area. What's happening in this area of digital health?

Medicaid 207

Medicaid Medicaid COVID-19 Telemedicine 207

Innovaare Compliance

JANUARY 3, 2022

January and February are usually busy months for Medicare Advantage Organizations (MAO). The Centers for Medicare & Medicaid Services (CMS) began call-center monitoring for timeliness and accessibility in 2015 and has continued since. Pressure on member-facing staff at the beginning of a new year.

Compliance 40

Compliance Medicare Medicare Medicaid 40

Healthcare Law Blog

DECEMBER 12, 2022

The Centers for Medicare & Medicaid Services (“CMS”) temporarily approved certain telehealth flexibilities during the PHE. The Ryan Haight Act of 2008 generally requires a prescribing practitioner to have conducted at least one in-person medical evaluation of a patient prior to prescribing controlled substances via telehealth.

COVID-19 52

COVID-19 Fraud Telemedicine Public Health 52

Verisys

DECEMBER 22, 2021

Donald Potts has helped healthcare customers define business problems and design innovative solutions since he started at Optum in 2008. As a product manager at the healthcare technology and services company Verisys , he guides many of the solutions that support health plans, health systems, and state Medicare and Medicaid agencies.

Compliance 52

Compliance Regulatory Compliance Healthcare information Technology Health Insurance 52

Health Populi

DECEMBER 19, 2018

in 2008, one in three Americans delayed medical treatment due to costs. Underneath this statistic, it’s important to compare the payor mix of patients delaying care: nearly one-third of people with private, commercial insurance delayed care by 2018; 22% of people enrolled in Medicaid or Medicare put off care.

Medicaid 84

Medicaid Medicaid Medicare Medicare 84

Health Law Advisor

FEBRUARY 10, 2023

Lowest Total Recoveries Since 2008 Record-Shattering Number of New Cases Filed Health Care and Life Sciences Cases Continue to Dominate On February 7, 2023, the U.S. Department of Justice (DOJ) released its annual False Claims Act (FCA) enforcement statistics for fiscal year (FY) 2022, which ended on September 30, 2022. [1]

Fraud 52

Fraud COVID-19 Governance Medicaid 52

Innovaare Compliance

FEBRUARY 14, 2022

This includes CMS regulations for Medicare Plans, regulations for Commercial Plans and Medicaid regulations for state plans. With this in mind, much as possible, find a way to standardize grievance categories so that they can equally apply to CMS reporting, Medicaid reporting and Commercial reporting.

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52

Health Populi

JUNE 13, 2018

Even with moderating medical trend growth, the Centers for Medicare and Medicaid Services (CMS) expect that healthcare spending will account for 20% of the U.S. As with public sector healthcare spending (“entitlements” in the form of Medicare and Medicaid), healthcare spending crowds out U.S. economy by 2026.

Medicaid 63

Medicaid Medicaid Health Insurance Medicare 63

Innovaare Compliance

JANUARY 16, 2022

Leaders of healthcare organizations who must adhere to Medicare or Medicaid regulations face an important decision: manage member issues in a single Member Experience Platform or buy several separate case tracking systems and seamlessly integrate them. The choice seems obvious. Internal urgent alerts on aging cases.

Compliance 40

Compliance Medicaid Medicaid Medicare 40

New Jersey Healthcare Blog

JANUARY 12, 2022

1846(a), the Department of Human Services, Division of Medical Assistance and Health Services published a notice of readoption of New Jersey Care … Special Medicaid Programs Manual. The Manual extends Medicaid eligibility to certain persons not eligible under the provisions at N.J.A.C. On November 1, 2021, at 53 N.J.R.

Licensing 40

Licensing Medicaid Medicaid Nurses 40

Innovaare Compliance

MARCH 30, 2022

On February 2, 2022, the Centers for Medicare & Medicaid Services (CMS) released the CY 2023 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies (Advance Notice). The last day for comments is March 4, 2022.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

JUNE 30, 2023

for physician referral scheme In Los Angeles, hospital CEO pay could be capped Kaiser Permanente ratings affirmed amid healthy financial profile Nurses vote ‘no confidence’ in California hospital administration, board Nursing facility, management company settle physician kickback allegations for $3.8M

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Bill of Health

SEPTEMBER 9, 2022

Consider that between 2008 and 2020, U.S. If the point of “building back better” — to use the Biden administration’s preferred phrase — is enhancing the public health system’s resilience to future crises, using January 2020 as a benchmark is wholly inappropriate. public health expenditures fell by 30 percent.

Public Health 362

Public Health COVID-19 Public Health Professionals Governance 362

Healthcare IT Today

FEBRUARY 7, 2024

History of EPCS Kyle Zebley, head of public policy American Telemedicine Association (ATA) , says that Congress called on the DEA to implement a policy for a special controlled substance registration process in 2008. Kelly says that a federal bill in 2021 required EPCS for Medicare prescriptions.

Telemedicine 113

Telemedicine Doctors COVID-19 Medicare 113

HIT Consultant

JANUARY 5, 2022

The Ryan Haight Act of 2008 generally requires prescribers to conduct in-person evaluations before prescribing buprenorphine but adjusting the rule to allow providers to e-prescribe the life-saving medication more broadly would expedite the start of therapy for thousands of patients.

US Department of Health and Human Services 98

US Department of Health and Human Services Telemedicine Governance Medicaid 98

Bill of Health

SEPTEMBER 30, 2022

Most recently, the Fourth Circuit held that gender dysphoria meets the broad definition of disability articulated by Congress in the ADA in 1990 and reiterated in the ADA Amendments Act in 2008. In doing so, the ADA provided a remedy for misgendering, harassment, and violence experienced by a trans woman in prison.

COVID-19 144

COVID-19 ADA Public Health Nursing Homes 144

Jane Sarashon

DECEMBER 22, 2022

The updated ACO Reach payment model from the Centers for Medicare and Medicaid Services (CMS) sets forth a value-based model of capitated payments to physicians who meet quality and spending targets – combined with a plan to deal with health equity.

COVID-19 52

COVID-19 Health Insurance Public Health Hospitals 52

Innovaare Compliance

NOVEMBER 4, 2021

Armed with this regulatory compliance information, you should be in a better position to create accurate universes that comply with the latest Medicare and Medicaid protocols. Inovaare has been providing healthcare organizations with quality services that help them comply to Medicare/Medicaid regulations since 2008.

Regulatory Compliance 52

Regulatory Compliance Medicaid Medicaid Medicare 52

Healthcare IT News - Telehealth

MAY 14, 2020

"Many areas we provide care to did not have much recovery since [the economic crash of] 2008," said Marshfield Clinic Health System CEO Dr. Susan Turney. " Healthcare leaders agreed that the relaxed telehealth regulations should be made permanent.

Hospitals 200

Hospitals COVID-19 Medicare Medicare 200

Health Populi

JANUARY 24, 2019

Politics underpin what’s happening in health plans in the public sector, and I spoke a bit about Medicare and Medicaid. You can see the latest Medicaid demonstration waiver data from a Kaiser Family Foundation analysis done January 9, 2019 shown in the bar chart.

Medicaid 65

Medicaid Medicaid Doctors Health Insurance 65

HIT Consultant

MARCH 1, 2022

Medicaid systems are struggling as potential expansion looms Clearly, many state unemployment information systems are in dire need of upgrades. For Medicaid, the threat comes as potential expansion looms. Some of today’s Medicaid systems may collapse under the weight of such data and analytics requirements.

Medicaid 52

Medicaid Medicaid Overpayments Overpayment 52