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10 Charged Over BEC Scams Targeting Medicare, Medicaid, and Private Insurance Programs

HIPAA Journal

million being defrauded from Medicaid, Medicare, and private health insurance programs. According to the FBI, more than $43 billion was lost to these scams between June 2016 and December 2021, and in 2021 alone, the FBI Internet Crime Complaint Center received reports of losses of $2,395,953,296 to BEC scams.

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CMS Augments “In Lieu Of Services” Medicaid Guidance to Support State Medicaid Managed Care Efforts to Address Social Determinants of Health

Healthcare Law Blog

To add uniformity to this practice, CMS codified this flexibility in the 2016 Medicaid and Children’s Health Insurance Plan (CHIP) managed care final rule by authorizing coverage for “In Lieu of Service or Settings” (ILOS). [i] ILOSs must advance the objectives of the Medicaid program.

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One in Two Americans with Work-Based Insurance Worries That Healthcare Costs Could Lead to Bankruptcy

Health Populi

with employer-sponsored health insurance worry that a major health event in their household could lead to bankruptcy, according to research gathered by West Health and Gallup in Business Speaks: The Future of Employer-Sponsored Insurance. Health Populi’s Hot Points: U.S. One-half of U.S.

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CMS Issues “In Lieu of” Services Guidance to Address Health-Related Social Needs in Medicaid Managed Care

C&M Health Law

On January 4, in its most recent effort to expand federal support for addressing health-related social needs (HRSNs), the Centers for Medicare & Medicaid Services (CMS) issued guidance to clarify an existing option for states to address HRSNs through the use of “in lieu of” services and settings policies in Medicaid managed care.

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Key Healthcare Compliance Examples To Understand Its Importance

MedTrainer

Advocate Health Care HIPAA Breach (2016) In August 2016, Advocate Health Care Network —one of the largest healthcare systems in Illinois—agreed to settle potential violations of Privacy and Security Rules for $5.55 Many healthcare facilities rely on reimbursements from government programs such as Medicare and Medicaid.

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Payor-Led Initiatives to Strengthen Mental Health Resources

Healthcare Law Blog

The Kaiser Family Foundation surveyed forty-four state Medicaid officials about strategies to address behavioral health workforce shortages and found the following four categories to be most critical. [6] 2] See, e.g., The Behavioral Health Care Affordability Problem , Center for American Progress (May 26, 2022). [3]

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2018 Medicare Fee-For-Service improper payment rate is lowest since 2010

CMS.gov

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.