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. Comments may be submitted until November 13, 2023.

ADA 98

ADA COVID-19 Medicare Medicare 98

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 96

HIPAA Compliance Medicare Medicare 96

Healthcare IT Today

JUNE 29, 2023

Medicare Certification ASCs must sign a contract with Medicare and meet its Conditions for Coverage (CFC) to be paid. ASCs must also meet Medicare’s Conditions for Coverage. Medicare Payment Resources CMS implemented an Ambulatory Payment Classification-based payment methodology in 2008.

Compliance 52

Compliance Medicare Medicare Medical Billing 52

Electronic Health Reporter

MARCH 26, 2019

Pharmaceutical manufacturers face growing pressure from legislators, employers and consumers to control prescription drug costs, which have increased by as much as 15 percent between 2008 and 2016. In late February, a congressional committee grilled executives from seven pharmaceutical companies over relentless price hikes and […].

Medicare 96

Medicare Medicare 96

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 59

Medicare Medicare Medicaid Medicaid 59

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

Bill of Health

MARCH 25, 2022

Biomarker qualification at the European Medicines Agency: a review of biomarker qualification procedures from 2008 to 2020. Bakker E, Hendrikse NM, Ehmann F, van der Meer DS, Llinares Garcia J, Vetter T, Starokozhko V, Mol PGM. Clin Pharmacol Ther. 2022 Feb 9. Epub ahead of print. PMID: 35137949.

FDA 205

FDA COVID-19 Medicaid Medicaid 205

Verisys

DECEMBER 1, 2023

It allows organizations to stay compliant with state and federal requirements and maintains their accreditation with Medicare, Medicaid, TRICARE, and other programs. Verisys has been NCQA and URAC accredited since 2008. NCQA certification has become essential to identifying industry standards and quality.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

CMS.gov

SEPTEMBER 22, 2020

Want to know the percentage of people who have a Medicare Advantage plan compared to all people with Medicare in Maryland from 2007 to 2011? Or perhaps the top 10 Healthcare Common Procedure Coding System (HCPCS) codes for services provided in 2008?

Medicare 20

Medicare Medicare 20

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

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 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

Health Law Advisor

FEBRUARY 3, 2022

According to DOJ’s statistics, the government paid out $238 million to relators in FY 2021, the lowest number since FY 2008. WHISTLEBLOWER ACTIONS AND AWARDS REACH DECADE LOW. Total awards to relators also fell in FY 2021 to the lowest number in over a decade. INCREASE IN RECOVERIES FROM DECLINED QUI TAM CASES.

Fraud 52

Fraud COVID-19 Governance Medicare 52

Jane Sarashon

JUNE 23, 2022

emerged from the Great Recession of 2008. billion savings that Medicare Part D could accrue if the program bought generic drugs at the prices offered through the Mark Cuban Cost Plus Drug Company. Yes, that Mark Cuban).

Medical Billing 96

Medical Billing Medicare Medicare Hospitals 96

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. Tom Zaubler, MD, Chief Medical Officer of NeuroFlow.

Medicare 98

Medicare Medicare Telemedicine Medicaid 98

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

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

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

American Medical Compliance

FEBRUARY 23, 2023

Health plans, healthcare providers, healthcare clearinghouses, and Medicare part D plans are all examples of covered entities. The Genetic Information Nondiscrimination Act (GINA) Congress passed the Genetic Information Nondiscrimination Act (GINA) into law in 2008. A covered entity is any company that must follow HIPAA rules.

HIPAA 52

HIPAA Compliance Governance Health Insurance 52

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

Health Populi

MARCH 7, 2018

There’s an old saw that the US government is an insurance company with an army” quips @PaulKrugman @HIMSS #HIMSS18 #HX360 #Healthinsurance #Medicare #Healthcare #Healthcosts. Fastest growing jobs in US are in #healthcare says @paulkrugman at #hx360 @himss #himss18 #Healtheconomics is US are tightly integrated into overall American economy.

ACA 48

ACA Governance Nurses Medicare 48

Health Populi

APRIL 16, 2018

Here’s one description about the chain’s plans to use $200 mm to expand in Florida (THINK: the state will be home to 4,5 million people age 65 and over in 2020, potential candidates for Humana’s Medicare programs. Just sayin’]).

Health Insurance 54

Health Insurance Medicare Medicare Doctors 54

Hall Render

JANUARY 21, 2022

In 2008, the plaintiff physician joined a Michigan-based health system (the “Hospital”) as a member of its medical staff. Specifically, the physician plaintiff reported that Hospital’s employees allegedly submitted fraudulent Medicare claims. Case Background. JCC vote) took place.

Hospitals 40

Hospitals Medicare Medicare Governance 40

Innovaare Compliance

FEBRUARY 14, 2022

This includes CMS regulations for Medicare Plans, regulations for Commercial Plans and Medicaid regulations for state plans. Inovaare has been delivering a compliance-driven Appeals and Grievances management platform to healthcare organizations since 2008.

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

Health Care Law Brief

APRIL 11, 2022

Similar to the AKS, the OIG may initiate administrative proceedings against the person offering or transferring the remuneration. However, through its advisory opinion process, OIG has blessed certain arrangements when cash equivalents have been offered or provided to beneficiaries.

Fraud 52

Fraud Medicare Medicare Compliance 52

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

Health Care Law Brief

FEBRUARY 8, 2024

To recruit and retain mental health providers, Governor Hochul proposes requiring commercial plans to pay for outpatient mental health and substance use services performed by Office of Mental Health (“OMH”) or Office of Addiction Services and Supports licensed providers at least at the Medicaid rate.

Medicaid 52

Medicaid Medicaid Nurses Licensing 52

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 111

Telemedicine Doctors COVID-19 Medicare 111

Healthcare It News

MARCH 18, 2022

For many years, mental health has lagged between physical health both in access to treatment and reimbursement – this is despite the mandates of the Mental Health Parity and Addiction Equity Act of 2008. Worse yet, COVID-19 has exacerbated mental and behavioral health issues.

Medicaid 357

Medicaid Medicaid COVID-19 Telemedicine 357

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

New Jersey Healthcare Blog

JANUARY 12, 2022

2008(a), the Department of Health issued a notice of readoption of Licensure Standards for Mental Health Programs with technical changes and recodification of N.J.A.C. The technical changes include: correcting all references to “Department of Health” to reflect the current name of that Department pursuant to P.L.

Licensing 40

Licensing Medicaid Medicaid Nurses 40

Health Law Advisor

MARCH 7, 2023

Background on the Ryan Haight Act The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (the “Ryan Haight Act”) made certain amendments to the CSA which established controls on the remote prescribing of controlled substances. 18 U.S.C. §

Telemedicine 52

Telemedicine COVID-19 FDA Compliance 52

YouCompli

AUGUST 16, 2023

For example, let’s say there was an audit that identified a billing error which resulted in a six-figure repayment to Medicare. For example, let’s assume you have been made aware that the organization inadvertently billed Medicare for a particular procedure in error (e.g., the wrong procedure code was billed).

Compliance 52

Compliance HIPAA Medicare Medicare 52

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