Med-Net Compliance

JUNE 15, 2022

California Attorney General Rob Bonta announced a settlement against a Southern California doctor for submitting false claims to Medicare and Medi-Cal between the years of 2011 and 2018 for drugs, procedures, services, and tests that were never administered to patients. two whistleblowers were the doctor’s former?medical

Fraud 59

Fraud Doctors Elder Abuse Medicare 59

Hall Render

FEBRUARY 14, 2023

Further, CMS estimates that beginning with payment year 2018, it will identify approximately $479 million per audit year in overpayments to MAOs. Extrapolation For audits for payment year 2018 forward, CMS will implement extrapolation of audit findings against the MAOs plan’s entire audit population to derive the overpayment amount.

Overpayments 40

Overpayments Overpayment Medicare Medicare 40

Healthcare Law Blog

JANUARY 26, 2023

Medicaid and Medicare The Balanced Budget Act of 1997, Public Law 105–33, 111 Stat. The Medicaid and Medicare statutes also contain conscience provisions related to the performance of advanced directives, religious nonmedical healthcare providers and their patients.

ACA 105

ACA Medicaid Medicaid Compliance 105

Provider Trust

JANUARY 26, 2022

Let’s start with the role of the OIG, which is tasked with ensuring that dollars for federal healthcare programs such as Medicare, Medicaid, CHIPS, and TriCare, as well as other healthcare federal grant monies, are judiciously spent and awarded as reimbursements for quality care that is not fraudulent. So what are the risk categories?

Fraud 52

Fraud US Department of Health and Human Services Medicaid Medicaid 52

Health Populi

FEBRUARY 14, 2018

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. Together, these three categories will comprise just over 80% of health spending in 2020. That equates to 18.4%

Health Insurance 79

Health Insurance Medicare Medicare Medicaid 79

Hall Render

NOVEMBER 28, 2023

On November 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update Final Rule (“2024 Final Rule”), which has since been filed in the Federal Register. 7,872 2018 5,851 77.1% 7,589 2019 5,871 79.3%

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

AIHC

APRIL 5, 2022

If the payer, such as Medicare, performs an extrapolation, reducing each overpayment dollar through appeal can mean thousands less to pay back. A great free modifier resource to share with you is the CMS Medicare Administrative Contractor (MAC) “WPS” learning center with on-demand training materials.

Fraud 52

Fraud Compliance Medicare Medicare 52

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 addition, the suit involved alleged submission of false claims for reimbursement to the Massachusetts Medicaid Agency. The defendants settled and paid $19.95

Compliance 52

Compliance Due Diligence Medicaid Medicaid 52

Hall Render

JULY 14, 2023

On Friday, June 20, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update (“PPS Rule”), which has since been published in the Federal Register and is currently open for comment. Physical Therapy 3.30

Medicare 52

Medicare Medicare Payment Systems Governance 52

HIPAA Journal

JANUARY 9, 2023

OCR responded to feedback from healthcare industry stakeholders by issuing a request for information (RFI) in December 2018 on potential changes to the HIPAA Rules. The CMS has also expanded telehealth to include all Medicare and Medicaid beneficiaries. In each category, a maximum penalty of $1.5

HIPAA 107

HIPAA COVID-19 COVID-19 Vaccine Compliance 107

Health Populi

MAY 6, 2018

Universal health care was covered in a section on 28 April 2018, and coverage on financial inclusion was bundled into the 5th May edition. Oakam, for example, offers an in-app game in which customers climb a “ladder” of client categories to earn a higher status and discounts.

Medicaid 54

Medicaid Medicaid Medicare Medicare 54

AIHC

FEBRUARY 16, 2024

To begin, the authors use Medicare patients who are diagnosed with aspiration pneumonia: “This study, one of the largest undertaken of aspiration pneumonia, confirms that patients with aspiration pneumonia are older, have more comorbidities, and are more likely to die than with other forms of pneumonia. Causes will expose themselves.

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

AIHC

FEBRUARY 16, 2024

To begin, the authors use Medicare patients who are diagnosed with aspiration pneumonia: “This study, one of the largest undertaken of aspiration pneumonia, confirms that patients with aspiration pneumonia are older, have more comorbidities, and are more likely to die than with other forms of pneumonia.

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

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. In 2018, they launched the IZ Gateway project.

Public Health 52

Public Health Governance Doctors Medicare 52

Health Populi

DECEMBER 13, 2018

Health insurance in-security is mainstream as of November 2018, when Gallup polled U.S. Gallup notes their October 2018 poll learned that voters were most concerned about healthcare, immigration and the economy as key midterm voting issues. adults about views on healthcare costs. Gallup conducted this survey among 1,037 U.S.

Health Insurance 89

Health Insurance Medicaid Medicaid Medicare 89

Health Populi

DECEMBER 25, 2018

We know that a top issue driving American voters to the 2018 mid-term polls was health care, in at least two dimensions: direct costs to the voters (as patients and taxpayers); and, personal and collective concerns about losing coverage due to pre-existing conditions. Expect health care costs and access to be at least as important to U.S.

Health Insurance 104

Health Insurance Hospitals Doctors Medicaid 104