HIT Consultant

JUNE 21, 2023

Additionally, Aledade is continuing its momentum by welcoming two new members of its Board of Directors and a senior executive to lead its Medicare Advantage business. From 2011 to 2015, Paul served as chief marketing officer of Booking.com. Dr. Efrem Castillo joins Aledade as senior vice president for Medicare Advantage.

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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.

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Healthcare IT Today

JULY 10, 2023

Company Adds Two Board Members and a Senior Executive to Lead its Medicare Advantage Business Aledade , the largest network of independent primary care practices in the country, today announced the closing of a $260 million Series F funding round to enhance and acquire services and technology to support its practices.

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Medicare Medicare Health Outcomes 52

McGuire Wood

OCTOBER 19, 2022

Frontpoint is a home health and hospice platform focused primarily on servicing Medicare Advantage patients in the Texas market. Founded in 2015, the firm typically invests between $10 million and $30 million per transaction. Terms of the recap were not disclosed.

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Medicare Medicare 52

Med-Net Compliance

JULY 27, 2022

On behalf of the agencies, they certified to Medicare that they would not pay kickbacks in exchange for Medicare beneficiary referrals to the agencies. In total, the agencies submitted over 8,000 claims to Medicare for the cost of home healthcare and hospice services.

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Med-Net Compliance

SEPTEMBER 20, 2022

million scheme to defraud Medicare by billing for services under another doctor’s name after Medicare revoked his privileges to participate in the program. According to court documents and evidence presented at trial, the podiatrist was revoked from participating in the Medicare program in January 2015.

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Fraud US Department of Health and Human Services Medicare Medicare 59

The Health Law Firm

SEPTEMBER 12, 2016

The health care industry has found a similar success in recent years, as federal agents use data mining, predictive analytics, and other modeling approaches to catch Medicare fraud. Medicare Strike Force Enhanced to Reduce Billion-Dollar Losses.

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The Health Law Firm

MARCH 8, 2016

Board Certified by The Florida Bar in Health Law On February 26, 2016, The Centers for Medicare & Medicaid Services (CMS) extended the deadline for eligible hospitals/professionals and critical access hospitals to apply for a hardship exception from the 2015 Medicare Electronic Health Records Incentive Program.

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CMS.gov

MARCH 2, 2018

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program. Jeremy.Booth@c…. Fri, 03/02/2018 - 16:30. Kate Goodrich, M.D., Director, CMS Center for Clinical Standards and Quality & CMS Chief Medical Officer. Billing & payments. Initiatives. Leadership.

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HIT Consultant

JULY 31, 2023

Founded by Chief Medical Officer Dr. Somi Javaid in 2015, HerMD has been revolutionizing the future of women’s healthcare through an integrated, evidence-based model delivering comprehensive women’s healthcare all under one roof. All appointments last between 20 and 60 minutes and all medical services are insurance and Medicare based.

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Medicare Medicare 52

CMS.gov

NOVEMBER 16, 2018

2018 Medicare Fee-For-Service improper payment rate is lowest since 2010. Administrator, Centers for Medicare & Medicaid Services. 2018 Medicare Fee-For-Service improper payment rate is lowest since 2010 Significant progress in saving $4.59B in estimated improper payments for the Medicare Fee-For-Service program.

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Medicare Medicare Overpayments Overpayment 20

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. healthcare system since 2010’s Affordable Care Act.

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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?

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HIPAA Medicare Medicare Compliance 52

Healthcare IT Today

MAY 15, 2023

“Apixio has been a trusted business partner since our relationship began in 2015,” said Sarah M. The Company also contracts with other healthcare and commercial organizations to provide a variety of specialty services focused on treating the whole person. London , Chief Executive Officer at Centene.

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Medicare Medicare Governance Health Insurance 76

Healthcare IT Today

AUGUST 26, 2022

The data shows that fee-for-service still dominates. When VBC programs were expanded as part of the Affordable Care Act in 2010 and the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015, there was hope that the existing fee-for-service model would begin to decline. in surgical specialties, 6.7%

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Health Outcomes Medicare Medicare 80

MedTrainer

JANUARY 12, 2024

With advances in medical technology, new treatment modalities, and an expanding array of healthcare services, the regulatory framework has had to adapt to ensure patient safety, quality of care, and ethical standards. One key driver is the increasingly complex and dynamic healthcare landscape.

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Healthcare IT News - Telehealth

JULY 1, 2020

By April, that response included virtual urgent care, remote patient-monitoring, continuous virtual monitoring for in-unit patients and a shift in ambulatory care services. The VUC system had been in place since 2015, explained the team in the manuscript, with the goal of providing rapid access to care for low-risk clinical conditions.

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The Health Law Firm

AUGUST 18, 2015

Board Certified by The Florida Bar in Health Law On July 14, 2015, Ann Maxwell, Assistant Inspector General for Evaluation and Inspections of the Office of Inspector General (OIG), US Department of Health and Human Services (HHS), gave testimony to Congress on the Medicare Part D Program. Indest III, J.D.,

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US Department of Health and Human Services Medicare Medicare Fraud 40

The Health Law Firm

NOVEMBER 21, 2014

Board Certified by The Florida Bar in Health Law Each new fiscal year, the Office of the Inspector General (OIG) Department of Health and Human Services (HHS) releases its annual Work Plan. A large part of what the OIG does is review and investigate Medicare claims for overpayment. Smith, R.R.T.,

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Overpayments Overpayment Medicare Medicare 40

The Health Law Firm

JUNE 4, 2014

The Health Law Firm On June 1, 2015, doctors and other health care providers will be under tighter restrictions when prescribing to Medicare Part D patients. Most health care providers are already enrolled in Medicare. Leider, J.D.,

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The Health Law Firm

JUNE 6, 2014

Under a rule finalized by the Centers for Medicare and Medicaid Services (CMS) on May 19, 2014, doctors and other health care professionals will be required to enroll in the Medicare program, or have a valid opt-out affidavit on file, for prescriptions to be covered under Part D. The new requirement takes effect on June 1, 2015.

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Healthcare Law Today

JANUARY 2, 2023

If this proposed rule is finalized, the Department of Justice (DOJ) and Health and Human Services (HHS) Office of Inspector General’s (OIG) should be applying the same intent standard to their evaluation of potential reverse false claims and Civil Monetary Penalty liability. ” United States ex rel. Healthfirst, Inc. ,

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Overpayments Overpayment ACA Medicare 52

Healthcare IT Today

JULY 19, 2022

Additionally, with this certification, Canvas customers are now eligible for value-based payment models in Medicare and Medicaid programs, as well as many commercial value-based programs. . Founded in 2015, Canvas is reimagining the EMR for the future of healthcare. About Canvas Medical.

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Medicare Medicare Medicaid Medicaid 52

HIT Consultant

MAY 24, 2023

With an anticipated dramatic rise of Americans diagnosed with AD approaching, broad changes to Medicare are needed. While Medicare and other sources of financial assistance may cover some of these costs, they won’t cover it all, leaving individuals with AD or other dementias and their families with high out-of-pocket costs.

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Medicare Medicare FDA Governance 97

Healthcare IT Today

DECEMBER 17, 2023

Though this is a significant increase from 2012, numbers haven’t budged much since 2015. A survey from Turquoise Health found prices for “shoppable services” in healthcare are increasing roughly at the pace of inflation , though some vaccines have seen price increases of more than 20%.

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Hospitals Nurses Compliance Regulatory Compliance 91

HIPAA Journal

OCTOBER 21, 2022

The reduction in insurance fraud meant that plan members did not have to cover the cost of HIPAA´s portability provisions through increased premiums, while patients requiring health services did not have to wait so long for treatment to be provided. The National Patient Identifier. billion and $11.5

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HIPAA Compliance Medicare Medicare 95

Healthcare IT Today

AUGUST 29, 2022

Programs such as the Medicare Shared Savings Program (MSSP) are mandating high-revenue healthcare organizations, often hospitals and health systems, progress towards downside risk in increasingly shorter timelines. Care coordination has historically been a pure services effort from health systems and payors. About CareHarmony.

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Medicare Medicare Hospitals 59

HIT Consultant

APRIL 12, 2022

Second, the number of unpaid family caregivers in the United States increased by nearly 10 million people between 2015 and 2020 to 54 million. Through interpersonal communication and technology, DUOS identifies and addresses the individual needs of older adults by leveraging Medicare benefits, trusted partners, and local service providers.

Medicare 52

Medicare Medicare COVID-19 Health Insurance 52

Health Law Advisor

FEBRUARY 3, 2022

As it relates to the health care and life sciences industries, the $452 million collected in FY 2021 is the largest recovery since FY 2015 and the second largest recovery in reported history. WHISTLEBLOWER ACTIONS AND AWARDS REACH DECADE LOW. KEY TAKEAWAYS.

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Fraud COVID-19 Governance Medicare 52

The Health Law Firm

NOVEMBER 17, 2015

The United States Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its 2016 Annual Work Plan (Work Plan) on November 2, 2015, with an effective date of October 1, 2015. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

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Fraud Medicaid Medicaid Medicare 40

Provider Trust

JULY 26, 2023

When patients need care, they search through a provider directory to find someone in their healthcare network or plan that can provide them with the medical services they need. The Centers for Medicare and Medicaid Services (CMS) conducted multiple reviews of Medicaid Advantage provider directories between February 2016 and July 2018.

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Medicaid Medicaid Compliance Medicare 52

Hall Render

AUGUST 1, 2022

The OPPS Proposed Rule also discusses quality-reporting requirements for REHs, an expedited Medicare enrollment process and REH-specific Stark Law updates. REHs are intended to help address barriers in access to health care, particularly emergency services and other outpatient services that result from rural hospital closures.

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AIHC

NOVEMBER 6, 2023

government introduced the 21st Century Cures Act, which builds upon the HITECH Act and aims to promote innovation in HIT and improve patient access to healthcare services. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) is the government enforcement agency over both HIPAA and HITECH. In 2020, the U.S.

HIPAA 59

HIPAA Compliance Governance Health Insurance 59

HIT Consultant

OCTOBER 6, 2021

It doesn’t even take you to the Centers for Medicare & Medicaid Services (CMS) website. Instead, many of the search results direct you to sites for social services organizations, Alzheimer’s research, or associations for seniors, like AARP. since 2015, according to a recent report. In addition, President Biden’s $1.9

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HIT Consultant

APRIL 20, 2022

Since the passage of the Medicare Improvements for Patients & Providers Act in 2008, the U.S. healthcare system has been moving towards value-based care (VBC) which encourages health providers to improve care quality by reimbursing them based on successful outcomes rather than individual medical services.

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Medicare Medicare Telemedicine Medicaid 98

AIHC

NOVEMBER 6, 2023

government introduced the 21st Century Cures Act, which builds upon the HITECH Act and aims to promote innovation in HIT and improve patient access to healthcare services. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) is the government enforcement agency over both HIPAA and HITECH. In 2020, the U.S.

HIPAA 52

HIPAA Compliance Governance Health Insurance 52

Hall Render

JULY 25, 2023

Comparative Analysis of OIG’s Advisory Opinion and DOJ Settlement OIG’s December 2022 advisory opinion reviewed an Arrangement involving utilization of a hospital’s APPs to perform services traditionally performed by a patient’s attending physician in certain medical units of one of its hospital campuses.

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