HIPAA Journal

SEPTEMBER 11, 2023

Care Health Plan to assess the state of HIPAA compliance, the first of which was in response to a media report about impermissible disclosures of protected health information (PHI) via its member portal and the second was in response to a breach that was reported to OCR involving the PHI of 1,498 members. million members. OCR informed L.A.

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HIPAA Compliance Medicaid Medicaid 71

Health Populi

MARCH 22, 2022

CFPB published the report marking two years into the pandemic, discussing concerns about medical debt collections and reporting that grew during the COVID-19 crisis. Let’s connect the dots on: A joint announcement this week from three major credit agencies, agreeing to eliminate about 70% of medical debt from consumer credit reports.

COVID-19 68

COVID-19 Medicaid Medicaid Medical Billing 68

Verisys

MARCH 23, 2023

3 Healthcare Fraud and Abuse Laws Providers Should Know About In 2021, the Department of Justice reported recovering over $5.5 This is the largest amount recovered under the False Claims Act since 2014. This guide will cover three federal fraud and abuse laws that healthcare providers need to know about.

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Fraud Medicaid Medicaid Medicare 52

HIT Consultant

FEBRUARY 20, 2024

Nathaniel Arana, CEO at NGA Healthcare As a society, we should all be concerned about the increasing rate at which private equity firms are acquiring physician groups. Insurance payers are becoming more discerning about private equity’s influence and are reevaluating their support for private practices.

Health Insurance 52

Health Insurance Medicaid Medicaid Governance 52

HIT Consultant

MARCH 20, 2024

The Centers for Medicare and Medicaid Services (CMS) estimated that for payment year 2018 alone , it will recover $428.4 About Sachin Patel Sachin Patel is the Chief Executive Officer of Apixio , an AI platform that improves administrative, clinical, and financial outcomes for health plans and providers. million (net) and $4.7

Overpayments 52

Overpayments Overpayment Medicare Medicare 52

The Health Law Firm

APRIL 4, 2014

The Health Law Firm On February 28, 2014, the Centers for Medicare and Medicaid Services (CMS) issued its revised emergency preparedness checklist for health care facility planning. By Lenis L. Archer, J.D.,

Medicaid 40

Medicaid Medicaid Medicare Medicare 40

Hall Render

JANUARY 12, 2023

On December 27, 2022, the Centers for Medicare & Medicaid Services (“CMS”) published a proposed rule that could potentially have a significant impact on enrollees’ obligations under the “60-day” overpayment rule. Please advise if you are interested in submitting comments on your own or as part of a group of affected providers.

Overpayments 40

Overpayments Overpayment Medicare Medicare 40

HIT Consultant

APRIL 20, 2022

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. Analysts looked at the health care costs of individuals enrolled in commercial insurance, Medicare, and Medicaid in the United States. About Tom Zaubler, MD.

Medicare 98

Medicare Medicare Telemedicine Medicaid 98

The Health Law Firm

APRIL 21, 2014

Board Certified by The Florida Bar in Health Law For years, the Centers for Medicare and Medicaid Services (CMS) kept private its records on Medicare reimbursement payments made to physicians, however, on April 9, 2014, that all changed. Indest III, J.D.,

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Healthcare IT Today

JANUARY 4, 2023

When friends meet for dinner, there’s no confusion about which dining hall they’re going to; no fragmentation. When the same group of friends meets at the dining hall, there needs to be more specificity about which location they’re referencing. About Nate Maslak. billion in 2014.

US Department of Health and Human Services 64

US Department of Health and Human Services Doctors Health Outcomes COVID-19 64

Healthcare IT News - Telehealth

AUGUST 21, 2020

Most of its patients fall below the poverty line, and most qualify for Medicaid. MEBS already had been using Azalea Health’s electronic health record software since 2014. "Kids also enjoy listening to stories, so bibliotherapy has been useful to help kids learn about emotions and coping techniques. THE PROBLEM.

COVID-19 205

COVID-19 Telemedicine Medicaid Medicaid 205

Medval Compliance Blog

MARCH 10, 2022

Last week, the Centers for Medicare & Medicaid Services (CMS) advanced the rulemaking process in two long-awaited areas. After closure of the ANPRM commentary period in February 2014, there was no activity until publication of a proposed rule in February 2020 with another commentary period ending on April 20, 2020.

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Medicaid 52

Health Care Law Brief

JUNE 26, 2022

To determine how much it will pay MA plans, CMS requires MA plans to submit certain information about its enrollees, including diagnosis codes that support the items and services furnished. 29844, 29921 (May 23, 2014). Azar , Civil Case No. 16-157 (RMC), 330 F. 3d 173 (Sep. 7, 2018), reconsideration denied Jan.

Overpayments 52

Overpayments Overpayment Medicare Medicare 52

Innovaare Compliance

FEBRUARY 7, 2022

Health plans (collectively, “plan sponsors”) that contract with the Centers for Medicare & Medicaid Services (CMS) to provide health services to eligible Medicare beneficiaries are responsible for legal, contractual, and fiduciary obligations whether performed by the plan or those to whom the company delegates those obligations.

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Compliance Medicare Medicare Medicaid 52

Health Populi

AUGUST 24, 2018

The line chart come from a new study into Multimorbidity Trends in United States Adults, 1988-2014 , published in the July-August 2018 issue of the Journal of the American Board of Family Medicine. It’s about way more than food access, coupons, and well-intended nutrition education programs.

Public Health 72

Public Health Doctors Medicaid Medicaid 72

Compliancy Group

AUGUST 23, 2023

In a shocking turn of events, a dental office manager from Worcester has been sentenced for participating in a scheme to defraud the Massachusetts Medicaid program, MassHealth. Deceiving MassHealth: The Disturbing Truth Behind Dental Services From 2014 to 2018, a shocking scheme unfolded within the realm of dental services.

Fraud 52

Fraud Medicaid Medicaid Governance 52

CMS.gov

MARCH 6, 2013

By: Christine Stahlecker, Director, Administrative Simplification Group, Office of E-Health Standards and Services, Centers for Medicare & Medicaid Services. Visit our ICD-10 website for the latest news and resources to help you prepare for the October 1, 2014 , deadline. And please stop by our booth (#2868) in the exhibit hall.

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ACA HIPAA Medicaid Medicaid 30

CMS.gov

NOVEMBER 15, 2018

Administrator, Centers for Medicare & Medicaid Services. Approximately 60 million people live in rural areas – including millions of Medicare and Medicaid beneficiaries. Empower patients in rural communities to make decisions about their healthcare. On National Rural Health Day, We Recommit to Improving Rural Health. Leadership.

Medicare 50

Medicare Medicare Payment Systems Medicaid 50

Health Care Law Brief

APRIL 3, 2023

On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ( Rate Announcement ). We summarize the key factors and adjustments to the overall expected average rate increase of 3.32% (which is about $13.8

Medicare 52

Medicare Medicare Overpayments Overpayment 52

Healthcare Law Blog

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). Additional Opportunities for Integration through State Medicaid Agency Contracts.

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Medicare Medicare COVID-19 Medicaid 98

Healthcare IT Today

NOVEMBER 25, 2022

” Since 2014, Maven has led the category in innovation, offering the only end-to-end global reproductive health and family care platform that integrates support across the entire family journey, from fertility and family building through maternity, parenting, pediatrics and menopause. ” About Maven Clinic.

Health Outcomes 98

Health Outcomes Medicaid Medicaid Telemedicine 98

HIT Consultant

FEBRUARY 8, 2023

Kishore Pendyala, CEO of KP-Tech Services The Fast Healthcare Interoperability Resources (FHIR) standard was introduced by HL7 in 2014 as a significant replacement for the HL7 V2 and V3 standards. Interoperability presents concerns about how to map data while upholding the same level of confidentiality for transferred data as with other PHI.

HIPAA 52

HIPAA Medicaid Medicaid Compliance 52

AIHC

DECEMBER 7, 2021

I found myself constantly searching for ways to become fired up again about correct reimbursement to ultimately receive the current and most optimal reimbursement available. Be sure you have on the correct uniform – and I’m not talking about your jeans Sometimes, the right outfit makes you feel great. 2014, October 10).

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare Law Blog

JANUARY 11, 2023

There is no statutory requirement currently for two-way coding to be used (a 2014 CMS proposed regulation was never put into effect), but it is considered to be best practice. That error rate changes and historically has ranged around 5% and somewhat higher, reaching about 7.5% Food for Thought. On to Day 3 of the 41 st Annual J.P.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Redox

DECEMBER 4, 2020

Given that the problems that I focus on most are integration in clinical workflows (and that there are many other smart minds writing about logistics – the best is Olivia’s here ), I’m probably best equipped to opine on that second problem. – Administration of the vaccine and associated understanding of our progress in that area.

Public Health 52

Public Health Governance Doctors Medicare 52

CMS.gov

MARCH 7, 2013

Stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. We encourage you to learn more about CMS’ efforts during the CMS Quality Measurement Session at HIMSS13 today. By Patrick Conway, MD, MSc. How will this next phase improve health care and reduce the burden on providers? Learn more at HIMSS.

Medicaid 32

Medicaid Medicaid Medicare Medicare 32

Hall Render

APRIL 1, 2022

Lawmakers not giving up on bill to expand Medicaid to undocumented kids. What We Know About BA.2 One of Brevard’s only mental health crisis units about to close amid care shortage. Rural healthcare providers feel the pain of North Carolina’s “Medicaid gap”. to settle Medicaid contractor dispute. NORTH DAKOTA.

COVID-19 40

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

Hall Render

SEPTEMBER 22, 2023

Medical tech device manufacturer to quadruple facility space with move to Parker Why Centura split and what’s next Colorado whistleblower’s complaint about double billing leads to $1.9 So far, Georgia has only one Bull Realty Brokers $5.9M So far, Georgia has only one Bull Realty Brokers $5.9M

Nursing Homes 40

Nursing Homes COVID-19 Nurses COVID-19 Vaccine 40

Health Law Advisor

AUGUST 10, 2023

But the question is, to what extent do health care providers need to worry about FDA requirements as they use AI? But what is significant about that passage is the detail provided regarding a health care facility that modifies software for regulated intended purpose, making it a manufacturer. The allure is obvious. 3] 21 U.S.C.

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FDA Licensing Hospitals Medicaid 98

HIT Consultant

JANUARY 29, 2024

For example, payers are typically concerned about managing financial risk, while providers are primarily focused on clinical outcomes; regulatory bodies require lots of paperwork, and providers would rather focus their time on patients. About Loral Patchen Loral Patchen , Ph.D., This is where technology can make an impact.

Health Outcomes 109

Health Outcomes Hospitals Medicaid Medicaid 109

Health Law Advisor

SEPTEMBER 1, 2023

On August 29, 2023, the Centers for Medicare & Medicaid Services (CMS) announced the ten (10) Medicare Part D drugs selected for the first round of negotiations of the Medicare Drug Price Negotiation Program (Program)—a few days before the September 1, 2023, statutory deadline imposed by the Inflation Reduction Act (IRA).

Medicare 69

Medicare Medicare Licensing Medicaid 69

Health Populi

APRIL 2, 2018

Last month, Amazon extended discounted Prime membership to people enrolled in Medicaid plans and SNAP food benefit programs. Emma Court pointed out the potential for Walmart + Humana at the grocery, which I’ve been evangelizing for a few years now – that link will take you to a post written in 2014.

Health Insurance 48

Health Insurance Medicaid Medicaid 48

Health Populi

MAY 8, 2019

In a call with analysts this week in which I participated, Murray Aitken discussed the report which looks back at 2018 and forward to 2023 with scenarios about what the U.S. On a per capita basis, those $344 bn calculated to $1,044, about $10 up from 2017 and $44 up over a decade ago. Welcome to Medicine Use and Spending in the U.S. ,

Prescription Drug Pricing 59

Prescription Drug Pricing Medicare Medicare Health Insurance 59

Kaiser Health News

DECEMBER 10, 2021

About 20 minutes after the emergency call, it arrived. Health care experts and recent studies say Medicaid expansion helps keep hospitals afloat because it increases the number of adults with low incomes who have health insurance. CUTHBERT, Ga. Lacandie Gipson struggled to breathe. “They’re going to run out of cash.”

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Hospitals Medicaid Medicaid COVID-19 136

HIPAA Journal

DECEMBER 14, 2022

The Centers for Medicare and Medicaid Services (CMS) also published an interoperability rule in March 2020 that applies to Medicare- and Medicaid-participating short-term acute care hospitals, long-term care hospitals, rehabilitation hospitals, psychiatric hospitals, children’s hospitals, cancer hospitals, and critical access hospitals (CAHs).

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HIPAA COVID-19 COVID-19 Vaccine Compliance 126

Kaiser Health News

JANUARY 6, 2022

South Dakota voters will decide in November whether the state should become the 39th to expand Medicaid under the Affordable Care Act, a move that would provide coverage to 42,000 low-income residents. Kristi Noem, a Republican, strongly opposes Medicaid expansion, even though the federal government picks up most of the cost.

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Medicaid Medicaid ACA Governance 121

Health Populi

JULY 31, 2019

Health care is the top issue Democrats want to hear about in the debates, well ahead of climate change, women’s issues, immigration and gun policy. The most favored public plan is Medicare, beloved by 83% of Americans, where Medicaid is favored by 75% of people. So only one-half of Americans think favorably about the ACA.

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ACA Health Care Reform Health Insurance Medicare 56