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The History of Healthcare Compliance

MedTrainer

Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation. Affordable Care Act (2010): The ACA introduced the concept of value-based care, emphasizing quality and patient outcomes over quantity of services.

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Will CMS’s Proposed Rule on “Identified Overpayments” Increase Reverse FCA Cases?

Healthcare Law Today

” The currently proposed provision has similar effect to the language CMS proposed in 2012 and, after consideration of comments, ultimately rejected in the 2014 Final Rule (Medicare Advantage and Part D) and 2016 Final Rule (Medicare Part A and Part B). ” United States ex rel. Healthfirst, Inc. , 3d 370, 389 (S.D.

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HHS Proposal for Marketplace Plans Carries a Hefty Dose of Consumer Caution

Kaiser Health News

A spokesperson for the Centers for Medicare & Medicaid Services said in an email that the agency is not seeing a pervasive problem, but he declined to provide data on how often such cases occur or how the agents or brokers get the personal information needed to enroll unsuspecting people.

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Who Is Responsible For Compliance In Healthcare?

MedTrainer

Law by law, regulations were added, increasing the complexity of maintaining compliance for healthcare organizations.

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Wellth Announces $20M Series B for Continued Growth of Behavioral Science-Based Platform

Healthcare IT Today

Uncle Roy spent years on dialysis and passed away after having a stroke in 2015. Notably, our payer clients have measured drastic savings to medical costs by preventing hospitalizations and ED visits, and we’ve helped Medicare Advantage plans achieve higher Star ratings.

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How Skilled Nursing Facilities Can Navigate New Value-Based Purchasing Rules

HIT Consultant

The Affordable Care Act of 2010 (ACA) and the Medicare Access and CHIP Reauthorization Act of 2015 put providers on notice that quality of care measures, like reducing hospital readmissions and improving patient outcomes, would take precedence over fee-for-service models.

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CMS Begins Option to Extend Medicaid Postpartum Coverage

Healthcare Law Blog

On April 1, 2022 , the Centers for Medicare & Medicaid Services (“CMS”) announced states may seek to extend Medicaid postpartum coverage from 60 days to one year through a new state plan option offered by the American Rescue Plan Act (“ARPA”). In states that have not expanded Medicaid, however, many postpartum women lose coverage.