Bill of Health

JULY 26, 2022

Iora Health was acquired by ONEM in September 2021 for approximately $2.1 Amazon now has an important foothold in the Medicare market. This is not meant to be a victory lap as the stars of the Iora Health story were squarely the management team, particularly the founding CEO, Rushika Fernandopulle. Amazon Health Insurance?

US Department of Health and Human Services 173

US Department of Health and Human Services Health Insurance HIPAA Medicare 173

Health Populi

JULY 11, 2019

This research organization will develop medicines targeting older adults — which makes sense because Clover Health’s target consumer market is Medicare Advantage beneficiaries. Health Populi’s Hot Points: These three transactions represent non-drug companies’ drug company gestures.

Department of Veterans Affairs 91

Department of Veterans Affairs Medicare Medicare Health Insurance 91

Health Populi

OCTOBER 8, 2018

It’s National Health IT Week in the US, so I’m kicking off the week with this post focused on how digital health can bolster economic development. As the only health economist in the family of the 2018 HIMSS Social Media Ambassadors, this is a voice through which I can uniquely speak. GDP, in 2018.

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Hospitals Health Insurance Health Outcomes Telemedicine 61

Health Populi

JULY 26, 2022

Goldman Sachs and Morgan Stanley put the deal together , with Morgan having led ONEM’s acquisition of Iora Health last year. Iora Health has focused on the Medicare-enrolled population, distinct from ONEM’s target patient market of younger, employed consumers. bn and MGM Studios for $8.5 bn and MGM Studios for $8.5

Health Insurance 165

Health Insurance Doctors Medicare Medicare 165

Health Populi

APRIL 2, 2018

Healthcare — availability and affordability — is a more intense worry for Americans in March 2018 than crime and violence, Federal spending, guns, drug use, and hunger and homelessness. were worried about the economy, and 23% about unemployment, in March 2018. adults 18 and over between 1st-8th March 2018.

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ACA Health Insurance Public Health Health Outcomes 69

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 73

Health Insurance Doctors Medicaid Medicaid 73

Healthcare Law Blog

MAY 5, 2022

Department of Health and Human Services Office of Inspector (“OIG”) released a report that studied prior authorization denials and payment denials by Medicare Advantage Organizations (“MAOs”) (the “Report”). Thirteen percent of denied prior authorization requests met Medicare coverage rules. The OIG Report.

Medicare 52

Medicare Medicare Licensing Health Insurance 52

Health Populi

DECEMBER 6, 2018

In 2006, Medicare Part D launched, which may have boosted consumers’ faith in Federal healthcare programs. But while there’s majority support for universal health care, we should think broadly about this concept at this moment. This asked people whether they would prefer a government-run health system.

Governance 73

Governance Medical Billing Medicaid Medicaid 73

Health Populi

FEBRUARY 6, 2018

If you’re reading Health Populi , then you’re keen on health policy, health economics, most of all, patients: now playing starring roles as consumers, caregivers, and payors in their own care. Thus, American patients draw a very stark line between accessing health care versus accessing health insurance.

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Health Insurance Medicaid Medicaid Medicare 89

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%

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Health Insurance Medicare Medicare Medicaid 79

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.

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Health Insurance Public Health Hospitals Medicaid 103

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.

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Medicaid Medicaid Medicare Medicare 83

Physician Credentialing Company

DECEMBER 20, 2024

Health insurance companies also allow credentialed providers to submit claims for healthcare services. This ensures that health payers should also know that these claims are submitted by locum physicians. Medicare guidelines should be checked if you are billing this payer.

Medical Billing 52

Medical Billing Compliance Malpractice Regulatory Compliance 52

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. Retail health-meets-Medicare.

US Department of Health and Human Services 75

US Department of Health and Human Services Health Insurance Medicare Medicare 75

Health Populi

OCTOBER 17, 2019

adults in September 2019 on issues concerning health care costs, shopping, value, saving and spending. points in 2018 to 57.9 While two-thirds of consumers say they understand their insurance coverage, only one-half of them can correctly answer questions about the definition of premiums and deductibles. households.

Health Insurance 61

Health Insurance Medicare Medicare Governance 61

HIT Consultant

NOVEMBER 24, 2022

The regulations may provide an opportunity for health insurers to attract new members – and retain existing ones – with hearing loss. Health plans could, for example, consider covering OTC hearing devices as part of the hearing benefits package provided to their Medicare Advantage plan members. Expanding membership.

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FDA Public Health Fraud Medicare 98

Health Populi

MARCH 1, 2018

To optimize communication strategies for attracting Medicare Advantage enrollment , a Mid-Atlantic health plan studied the media and social consumption patterns for older people, learning that the target population was more tech-savvy than presumed.

Health Insurance 82

Health Insurance Medicaid Medicaid Public Health 82

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. .”

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Medicare Medicare Doctors Health Insurance 95

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.

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Medicaid Medicaid Health Insurance Medicare 63

Healthcare Law Blog

JANUARY 25, 2023

Introduction: Defining Interprofessional Consultation In a January 5, 2023, letter to state health officials, the Centers for Medicare & Medicaid Services (“CMS”) clarified a Medicaid and Children’s Health Insurance Program (“CHIP”) policy on the coverage and payment of interprofessional consultations (the “Guidance”).

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Medicaid Medicaid Medicare Medicare 52

Healthcare Law Blog

MARCH 25, 2022

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger insurers. New Mexico Health Connections v. United States Dep’t of Health & Human Servs. ,

ACA 52

ACA US Department of Health and Human Services Health Insurance Medicaid 52

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. percent in 2018. percent in 2018.

Medicare 20

Medicare Medicare Overpayments Overpayment 20

Health Populi

JANUARY 18, 2019

As the Harvard Chan-POLITICO study points out, prescription drug costs are top-of-mind for health consumers in America. 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.

Prescription Drug Pricing 66

Prescription Drug Pricing Health Insurance Doctors Medicare 66

Health Populi

JUNE 4, 2019

the American Benefits Council (which represents employers), the American Federation of Teachers (AFT), First Focus (a bipartisan children’s advocacy organization), and the Pacific Business Group on Health (PBGH), the innovative employer health coalition representing businesses on the west coast. Millions of U.S.

Health Insurance 59

Health Insurance Fraud Medicare Medicare 59

CMS.gov

AUGUST 23, 2018

Person-Centered Strategies: Health Savings Accounts. Thu, 08/23/2018 - 12:29. CMS Deputy Administrator and the Director of the Center for Consumer Information and Insurance Oversight. August 23, 2018 By Randy Pate, CMS Deputy Administrator and the Director of the Center for Consumer Information and Insurance Oversight. .

Health Insurance 42

Health Insurance Medicare Medicare 42

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). See 2020 Profile of Older Americans (Published May 2021).

US Department of Health and Human Services 52

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

Jane Sarashon

JULY 29, 2022

” Well beyond our individual genetic codes, our health is made where we live, work, play, pray, learn, and shop… also well beyond hospitals and doctors’ offices in-between appointments, and often paid-for out-of-pocket quite separate from peoples’ health insurance plans. billion in 2018.

COVID-19 72

COVID-19 Health Insurance Telemedicine Doctors 72

C&M Health Law

DECEMBER 21, 2022

If the proposed rule is finalized, covered entities would have to comply within 24 months after the effective date of the final rule, and small health plans would have 36 months to comply. HHS also adopted the NCPDP Batch Standard Medicaid Subrogation Implementation Guide, Version 3, Release 0 (Version 3.0)

HIPAA 52

HIPAA Medicaid Medicaid Health Insurance 52

HIPAA Journal

APRIL 27, 2025

territory of Guam, was investigated after a complaint was received about a December 2018 ransomware attack. A misconfigured server had exposed protected health information on the Internet and files had been indexed by search engines. The data was exposed online between August 2015 and July 2018. Warby Parker, Inc.,

HIPAA 85

HIPAA Ransomware Hospitals Compliance 85

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.,

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Health Insurance Medicaid Medicaid Doctors 54

Health Populi

MARCH 7, 2018

I greatly appreciated the opportunity today to attend a luncheon at the HX360 meeting which convened as part of the 2018 HIMSS Conference. There’s an old saw that the US government is an insurance company with an army” quips @PaulKrugman @HIMSS #HIMSS18 #HX360 #Healthinsurance #Medicare #Healthcare #Healthcosts.

ACA 48

ACA Governance Nurses Medicare 48

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

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%

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Hospitals Medicare Medicare Medicaid 40

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

HIPAA Journal

JULY 24, 2023

The False Claims Amendment Act in 1986 lowered the bar for proof of fraud and increased the fines the OIG could impose, while the Health Insurance Portability and Accountability Act ( HIPAA ) in 1996 established the Health Care Fraud and Abuse Control (HCFAC) Program. What is the HHS OIG Exclusions List?

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Fraud Medicare Medicare Medicaid 52

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 72

Hospitals Medicaid Medicaid Medical Billing 72

Compliancy Group

AUGUST 19, 2022

The original request for records was submitted in writing by a former ACPM patient on November 13, 2018. The patient stated that he needed the requested medical records to appeal an unfavorable decision made by his health insurance company for the payment of a bill related to treatment provided by ACPM. No Response.

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HIPAA COVID-19 Compliance Health Insurance 52