2015 and Medicare - Health Care Compliance Brief

The Impact of MACRA on Cardiology Billing

Medisys Compliance

APRIL 25, 2024

Introduction The ever-evolving world of healthcare billing can feel complex, and with the introduction of MACRA (Medicare Access and CHIP Reauthorization Act) in 2015, cardiology practices have faced some adjustments. MACRA replaced the previously used Sustainable Growth Rate (SGR) formula for Medicare physician payments.

Medical Billing Outsourcing

Medical Billing Outsourcing Medical Billing Medicare Medicare

MIPS Rules for 2023: Onward and Upward

Compliancy Group

OCTOBER 5, 2023

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law to improve patient healthcare outcomes. Under MACRA, the Centers for Medicare and Medicaid Services (CMS) created regulations to encourage healthcare providers to use secure health information technology. What Are the MIPS Rules for 2023?

HIPAA

HIPAA Medicare Medicare Compliance

MIPS and MACRA 2022: What’s New?

Compliancy Group

NOVEMBER 16, 2022

In 2015, legislation known as the Medicare Access and CHIP Reauthorization Act (MACRA) was enacted. Under MACRA, the Centers for Medicare and Medicaid Services created regulations for healthcare providers’ use of health information technology. MIPS is composed of four performance categories, on which providers are graded.

Medicare

Medicare Medicare HIPAA Medicaid

Medicare Advantage 2024 Rate Announcement – Further Impacts to Risk Adjustment

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 ). 1395w-23): Medicare Advantage Organizations (MAOs) are paid a base rate by CMS. Risk Adjustment.

Medicare

Medicare Medicare Overpayments Overpayment

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

Healthcare IT Today

APRIL 10, 2023

Uncle Roy spent years on dialysis and passed away after having a stroke in 2015. Beyond capital, our new investors SignalFire and Frank Williams (Co-Founder and Former CEO at Evolent Health), bring a whole new set of expertise in scaling category-leading companies. trillion in annual health care costs.

Health Outcomes

Health Outcomes Hospitals ACA Doctors

What is a HIPAA Violation?

HIPAA Journal

DECEMBER 31, 2022

HIPAA Violation Categories. There are four HIPAA violation categories. Two of the HIPAA violation categories are designated for Covered Entities and Business Associates that can demonstrate reasonable due diligence, whereas the other two are for entities guilty of willful neglect. HIPAA Violation Penalties.

HIPAA

HIPAA Due Diligence Compliance Fraud

How HHS-OIG, Regulators Enforce Vendor Compliance

Provider Trust

MAY 18, 2022

If the answer is yes, then the best mechanism for limiting CMP liability is to screen all persons that perform under that contract or that are in that job category. In January 2015, the OIG settled for $96,259 with a Minnesota Pharmacist, Joseph C. at a provider that furnishes items or services payable by Federal health care programs.

Compliance

Compliance Due Diligence Medicaid Medicaid

Medicaid and Health Equity: CalAIM’s Bold Experiment

Healthcare Law Blog

MAY 16, 2022

In December 2021, the Centers for Medicare & Medicaid Services (CMS) approved the California Department of Health Care Services’ (DHCS’) request for a five-year extension of its Medicaid section 1115 demonstration and a five-year extension of its Medicaid managed care section 1915(b) waiver.

Medicaid

Medicaid Medicaid Nurses Health Care Access

Compliance lessons from recent fraud cases

Health Care Performance

JULY 20, 2022

A New York ENT physician was convicted of filing false claims with Medicare and Medicaid. The physician submitted claims totaling about $585,000 to Medicare and Medicaid and was paid roughly $191,000. million in fraudulent payments between 2015 and 2021. Fraudulent documentation was submitted in response to Medicare audits.

Fraud

Fraud Compliance Medicaid Medicaid

OIG Issues Information Blocking Penalties Final Rule: Health IT Developers and Health Information Exchanges/Networks Have a Million Reasons to Care

Health Law RX

JULY 18, 2023

2] The information blocking provisions of the Cures Act apply to three categories of actors: healthcare providers, Developers, and HIN/HIEs. As context, between 2015 and 2022, the DOJ reported FCA settlements with health IT vendors in an amount exceeding $500 million. What would such collaboration look like?

Fraud

Fraud Compliance Medicaid Medicaid

Gearing up for Immunizations

Redox

DECEMBER 4, 2020

Those challenges can be broken down into two general categories: How do we get it to everyone? Perhaps more importantly, Meaningful Use spurred adoption on the provider side, requiring that providers use certified EHRs to receive Medicare and Medicaid funds. EHR vendors geared up to take on this new challenge.

Public Health

Public Health Governance Doctors Medicare

Americans Across Political Party Worry About Prescription Drug Prices – Especially to Deal with COVID-19

Health Populi

JUNE 18, 2020

By demographics, more women than men are concerned about rising costs for the three health care spending categories the survey studied: drug prices, insurance premiums, and healthcare costs (medical care services spending). Across-the-board, nonwhites are more concerned than whites on the three spending categories, as well. bn to $9.9

Prescription Drug Pricing

Prescription Drug Pricing COVID-19 Medicaid Medicaid

Logical Contradiction Doctrine: Buckman for Textualists

Drug & Device Law

JANUARY 30, 2023

280 (1995), decision that he joined in 1995 He joined a decision that found no preemption by virtue of a governmental decision not to regulate in Myrick and did not object to boilerplate description of obstacle preemption as an accepted preemption category Then in the 5-4 Geier v. Davidowitz , 312 U.S. Myrick , 514 U.S. Walsh , 538 U.S.

FDA

FDA Fraud Governance Medicare

FDA and Off-Label Communication – Getting Closer to Truth