Jane Sarashon

FEBRUARY 4, 2024

Furthermore, health plan members now see themselves as medical bill payers, seeking value and consumer-level services for their health insurance premium investment. According to the online Merriam-Webster dictionary , the first use of the phrase “health insurance” occurred in 1901. Consulting Noah Webster….and

US Department of Health and Human Services 70

US Department of Health and Human Services Health Insurance Medicare Medicare 70

Healthcare Compliance Blog

MARCH 31, 2022

The agencies received millions of dollars in funding from Medicaid, which is funded in part by the federal government, and much of that money was meant to pay the wages and benefits of their aides. Under the Wage Parity Law, which is funded by Medicaid, aides are to be paid a minimum amount in total compensation.

Medicaid 59

Medicaid Medicaid Governance Fraud 59

CMS.gov

NOVEMBER 16, 2018

2018 Medicare Fee-For-Service improper payment rate is lowest since 2010. Fri, 11/16/2018 - 18:46. Administrator, Centers for Medicare & Medicaid Services. Most notably: The 2018 Medicare-FFS improper payment rate decreased from 9.51 percent in 2018. Home health corrective actions resulted in a significant $6.92

Medicare 20

Medicare Medicare Overpayments Overpayment 20

Health Populi

NOVEMBER 1, 2018

Among people who have health insurance, managing the costs of their medical care doesn’t rank as a top frustration. Instead, attending to health and wellbeing, staying true to an exercise regime, maintaining good nutrition, and managing stress top U.S. health-insured adults in July 2018.

Health Insurance 69

Health Insurance Doctors Medicaid Medicaid 69

Health Populi

SEPTEMBER 5, 2018

The largest patient experience workflows included shopping for health insurance, preparing to see a healthcare provider, connecting with that provider, managing a diagnosis, shopping for services, receiving treatment, and finally, paying for the services. At this moment in U.S.

Health Insurance 63

Health Insurance Medical Billing Medicaid Medicaid 63

Healthcare Law Blog

JANUARY 26, 2023

The PHS Act requires post-graduate physician training programs that do not perform induced abortions to be deemed accredited and protects governmental payments provided as reimbursement for carrying out health related activities. Medicaid and Medicare The Balanced Budget Act of 1997, Public Law 105–33, 111 Stat.

ACA 105

ACA Medicaid Medicaid Compliance 105

Health Populi

DECEMBER 4, 2019

With new rules emanating from the White House this month focusing on health care price transparency, health care costs are in the spotlight at the Centers for Medicare and Medicaid Services.

Medicaid 83

Medicaid Medicaid Medicare Medicare 83

Kaiser Health News

JULY 11, 2023

The public school system here had to scramble in 2018 when the local hospital, newly purchased, was converted to a tax-exempt nonprofit entity. The takeover by Tower Health meant the 219-bed Pottstown Hospital no longer had to pay federal and state taxes. POTTSTOWN, Pa. —

Hospitals 66

Hospitals Medicaid Medicaid Medical Billing 66

Health Law RX

DECEMBER 21, 2023

Department of Health and Human Services (HHS) Office for Civil Rights (OCR) is signaling that it is cracking down on healthcare organizations that fail to identify and address cybersecurity vulnerabilities as required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA Rules).

HIPAA 52

HIPAA Ransomware Compliance Medicaid 52

Healthcare Law Blog

APRIL 24, 2023

On April 17, 2023 , the Centers for Medicare & Medicaid Services (“CMS”) released the U.S. Department of Health and Human Services (“HHS”) Notice of Benefit and Payment Parameters for 2024 Final Rule (the “Notice”) that includes standards for issuers and Marketplaces, and requirements for agents, brokers, web-brokers and others.

Medicaid 52

Medicaid Medicaid Compliance Health Insurance 52

Hall Render

AUGUST 10, 2023

On August 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its Final Hospital Inpatient Prospective Payment System (“IPPS”) and Long-Term Care Hospital (“LTCH”) PPS rule for fiscal year (“FY”) 2024 (“Final Rule”). The Final Rule increases the rate for IPPS payments by 3.3% in FY 2024 but applies a 0.2%

Hospitals 40

Hospitals Medicare Medicare Medicaid 40

Health Populi

FEBRUARY 14, 2018

of health spending per person. Three factors will drive healthcare costs to 2026: prices for medical goods and services, changes in income growth, and shifting enrollment from private health insurance to Medicare — driven by the aging of Boomers. That equates to 18.4% of the Gross Domestic Product (GDP) and $12,230.40

Health Insurance 79

Health Insurance Medicare Medicare Medicaid 79

Health Populi

JUNE 13, 2018

The 6% trend is equal to that of 2018, illustrating a flat scenario, roughly the same trend seen in 2016 at 6.2%. Even with moderating medical trend growth, the Centers for Medicare and Medicaid Services (CMS) expect that healthcare spending will account for 20% of the U.S. That’s one-half the high point at nearly 12% in 2007.

Medicaid 63

Medicaid Medicaid Health Insurance Medicare 63

Health Populi

MAY 14, 2019

The mainstreaming of SDoH speaks to the awareness that health is made where we live, work, play, pray, learn and shop… beyond the health”care” system of hospitals, doctors’ offices, and prescription drug dispensaries. adults between 18 and 64 years of age in December 2018.

Health Insurance 101

Health Insurance Public Health Hospitals Medicaid 101

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.

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

Healthcare Law Today

FEBRUARY 6, 2023

As of 2019 almost 95% of such persons had Medicare coverage and about half of those also had some sort of supplemental health insurance coverage. 2 See Trust for America’s Health: The State of Obesity: Policies for a Healthier America, 2022 (September 2022). 4 PYA, Compensation Study: Spotlight on Cardiology (2018).

US Department of Health and Human Services 52

US Department of Health and Human Services Electronic Medical Records Medicare Medicare 52

Health Populi

AUGUST 24, 2020

Ranking top for great or high harm, three in four physicians said that the, “loss of health insurance because of employment changes caused by COVID-19” would cause great harm to patients. Furthermore, nine in ten companies plans to offer virtual care for telemental health, a fast-growing aspect of virtual care.

COVID-19 154

COVID-19 Telemedicine Doctors Medicare 154

Kaiser Health News

JUNE 6, 2022

For the second time in three years, Espinosa faces the prospect of losing permission to work, which would cost him not only his job providing tech support at a software company, but also his health insurance. Without health insurance, his daughter would lose her eligibility for transplants.

Health Insurance 73

Health Insurance Doctors Governance Licensing 73

Health Populi

MARCH 1, 2018

To more effectively help patients manage diabetes , CentraForce Health used geospatial mapping of SBDoH data to develop deeper insights into peoples’ health needs and behaviors — such as eating fast food in the past 30 days, sufficient time to eat healthy food, and tendency to follow a doctor’s recommendations.

Health Insurance 79

Health Insurance Medicaid Medicaid Public Health 79

HIPAA Journal

JULY 24, 2023

HHS was one of the first Departments to have an Office of Inspector General in 1976 due to billions of dollars being lost each year to Medicaid fraud. Subsequent Acts of Congress increased the OIG’s regulatory authority to prevent crimes against the Department. HCFAC gave HHS’ OIG the resources to enforce §1128 of the Social Security Act.

Fraud 52

Fraud Medicare Medicare Medicaid 52

Florida Health Care Law Firm

DECEMBER 9, 2021

On January 1, 2022, a new federal law, “ Requirements Related to Surprise Billing, Part I ” (“The Rule”), goes into effect for health care providers and facilities and for providers of air ambulance services. The Rule will restrict excessive out-of-pocket costs to consumers which resulting from surprise billing and balance billing.

Medical Billing 40

Medical Billing Medicare Medicare Compliance 40

Health Populi

JANUARY 18, 2019

Research published in JAMA Internal Medicine in December 2018 found that as out-of-pocket costs for insulin have increased over the past few years, many patients use less insulin than needed. As patients continue to morph into consumers who pay for health care services, they are seeking price transparency — but not finding it so easy.

Prescription Drug Pricing 64

Prescription Drug Pricing Health Insurance Doctors Medicare 64

HIPAA Journal

MAY 29, 2023

It has been 27 years since President Clinton signed the Health Insurance Portability and Accountability Act (HIPAA) into law, but compliance is still proving a challenge for many HIPAA-regulated entities. reduction in total penalties compared to 2018, falling from $28.7 million in 2018 to just $1.6 million in 2022.

HIPAA 93

HIPAA Compliance Due Diligence COVID-19 93

Health Populi

AUGUST 5, 2019

Power,” your mind probably imagines reviews of automotive performance, retail shopping experiences, or perhaps even health insurance plan customer service. Expanding its report-card role in the health ecosystem. In 2019, 28 states have payment parity policies for Medicaid. When you think “J.D.

Telemedicine 81

Telemedicine Doctors Medicaid Medicaid 81

Health Populi

JUNE 14, 2018

parents are sobering up to the risks of social mobility in America for their children: in 2018, 51% of U.S. This is unique compared with people living in other OECD countries, only 37% of whom agree with the education statement. In the U.S., social mobility is not evenly distributed across the generations.

Medicaid 76

Medicaid Medicaid Health Insurance Public Health 76

Hall Render

FEBRUARY 23, 2024

CT’s Medicaid reimbursement rates lower than peer states: report Better safety training, reporting, escorts for CT home health care workers focus of new legislation D.C. Acquisition of BCBSLA Paused a Second Time It was the biggest health care deal in Louisiana history. What they say sets them apart.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Health Populi

JULY 16, 2018

HealthyCapital develop a Health Management Retirement Index to calculate an individual’s percentage of retirement healthcare costs that can be funded by savings from improved health. Health Populi’s Hot Points: In the U.S.,

Health Insurance 54

Health Insurance Medicaid Medicaid Doctors 54

New Jersey Healthcare Blog

JANUARY 12, 2022

1791(c), the Department of Human Services, Division of Aging Services, Office of the State Health Insurance for the Aged and Disabled, readopted a rule regarding the Senior Gold Prescription Program Manual. 10:37 (Community Mental Health Services Act) with technical amendments. On October 18, 2021, at 53 N.J.R.

Licensing 40

Licensing Medicaid Medicaid Nurses 40

Health Populi

FEBRUARY 11, 2019

That wand has begun to initiate its magic in the physician community, based on a wonderful essay in JAMA published 20 December 2018 titled, Social Determinants of Health in the Digital Age: Determining the Source Code for Nurture. Yet it’s older people who are more at-risk for SD0H challenges.

Medicare 90

Medicare Medicare Doctors Health Insurance 90

Healthcare Law Blog

MAY 5, 2022

The Report is another example of the OIG fanning the fire of criticism of MAOs by ignoring the overwhelming evidence that MAOs provide access to medically necessary services and also minimized the program requirements and guidance from the Centers for Medicare and Medicaid Services (“CMS”), with which MAOs must comply. The OIG Report.

Medicare 52

Medicare Medicare Licensing Health Insurance 52

CMS.gov

JUNE 11, 2018

Mon, 06/11/2018 - 12:04. Medicaid & CHIP. However, it is important for our beneficiaries across the country to know that the Centers for Medicare & Medicaid Services (CMS) is exploring all of our options to address this national crisis. out of 1,000 Medicaid beneficiaries are impacted by OUD. CMS Opioids Roadmap.

Medicaid 20

Medicaid Medicaid Medicare Medicare 20

Healthcare IT News - Telehealth

DECEMBER 16, 2020

The virtual trial, to be sure, is not a new concept: One team of researchers counted more than 1,100 trials listed on ClinicalTrials.gov employing connected digital products for remote data collection in both 2017 and 2018, the organization observed.

COVID-19 207

COVID-19 Hospitals Doctors Health Insurance 207

Hall Render

APRIL 28, 2023

on EHR upgrade New SSM Health children’s developmental center opening today Illinois Capitol bills would give more money to community health centers Illinois physician selected for year-long NASA Mars simulation HSHS St.

Nurses 40

Nurses Nursing Homes COVID-19 Hospitals 40

HIPAA Journal

JANUARY 9, 2023

The Health Insurance Portability and Accountability Act was signed into law in 1996 and while there have been some significant HIPAA updates over the last two decades, the last set of major HIPAA updates occurred in 2013 with the introduction of the HIPAA Omnibus Final Rule.

HIPAA 107

HIPAA COVID-19 COVID-19 Vaccine Compliance 107

Hall Render

JUNE 9, 2023

million from Miracle Day Arkansas Hospice Takes Over LifeTouch Hospice Arkansas hospitals say they are struggling; report questions those claims Arkansas law allows physician assistants to be rendering providers for Medicaid Arkansas rural hospitals work to keep their doors open Panda Express Pledges $1.2M

Nurses 40

Nurses COVID-19 Nursing Homes Hospitals 40

Hall Render

JULY 14, 2023

to do so Confusion remains over when abortion is legal to save life What happens when a health insurance company fails After court rulings, Oklahoma doctors are still confused about when abortion is legal to save a patient’s life OREGON Legacy Health to sell off labs as part of financial recovery effort OHSU $4.9B

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

MARCH 17, 2023

‘Not what we were looking for,’ CEO says Data shows mental health, education declines for Hoosier kids Joint venture to build specialty hospital in Fort Wayne Bills would cut hospital services in Indiana not just reduce costs Ascension St. in Indiana aging-in-place work. nursing home Massachusetts hospitals spent $1.5B

US Department of Health and Human Services 40

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