Provider Trust

JANUARY 25, 2024

Ensuring the Financial Integrity of HHS Programs In fiscal year (FY) 2022, improper payments within healthcare programs like Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) were estimated at a staggering $131.6 With Medicaid, the challenges are equally formidable.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

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

JUNE 27, 2022

Declines in preventive care services like cancer screenings and blood glucose testing concern employers, whose continued to cover health insurance for employees during the pandemic. But Castlight expects a flat-line in PMPM spending for 2022, leveling out at $4,232 per member/per month for commercially-insured employees.

COVID-19 121

COVID-19 Health Insurance Medicaid Medicaid 121

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 70

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

Bill of Health

MAY 19, 2022

from 2018-2019. Therapeutic Value Assessments of Novel Medicines in the US and Europe, 2018-2019. Hospital-Administered Cancer Therapy Prices for Patients With Private Health Insurance. The post Monthly Round-Up of What to Read on Pharma Law and Policy appeared first on Bill of Health. JAMA Oncol. JAMA Netw Open.

Health Insurance 205

Health Insurance Hospitals FDA Medicaid 205

HIPAA Journal

JUNE 28, 2023

A lawsuit – Young, et al. Good Samaritan Hospital ­­ – was filed in the California Superior Court for Los Angeles County against the hospital on behalf of individuals impacted by the data breach.

Hospitals 76

Hospitals Fraud Licensing HIPAA 76

Healthcare Law Today

FEBRUARY 6, 2023

According to the Administration for Community Living (ACL), 1 as of 2019, people 65 and older represented 16% of the population of the United States; that is approximately 54 million people. 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.

US Department of Health and Human Services 52

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

HIPAA Journal

NOVEMBER 3, 2022

The breach involved names, Social Security numbers, dates of birth, driver’s license numbers, financial account information, health insurance policy numbers, medical record numbers, Medicaid/Medicare IDs, and health information, including diagnosis and treatment information. The tool was removed in August 2022.

HIPAA 62

HIPAA Health Insurance Licensing Medicaid 62

Health Populi

JULY 16, 2020

FAIR Health based these numbers on private insurance claims associated with COVID-19 diagnoses, evaluating patient demographics (age, gender, geography), hospital charges and estimated allowed amounts, and patient comorbidities. privately-insured people. They used two ICD-10-CM diagnostic codes for this research: U07.1,

COVID-19 145

COVID-19 Hospitals Health Insurance Medicare 145

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

NOVEMBER 19, 2019

In research from HealthPocket , 2 in 5 Americans said they needed to reduce other household expenses to be able to afford their monthly insurance premiums. Four in ten consumers said their monthly health insurance premiums were increasing. on an annual basis as of October 2019. in the 12 months including October 2019.

Health Insurance 68

Health Insurance Hospitals Doctors Nurses 68

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

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

Health Populi

JUNE 6, 2021

Commercial Member Health Plan Study. exploring consumer satisfaction with some 150 health insurance plans operating in 22 regions around the U.S. Power assessed the opinions of 32,066 commercial health plan members between January and March 2021. Power has conducted the U.S. This year, J.D.

Patient Satisfaction 81

Patient Satisfaction COVID-19 Telemedicine Medicaid 81

AIHC

SEPTEMBER 5, 2023

Behavioral telehealth may also be referred to as telebehavioral health, telemental health, telepsychiatry, or telepsychology. Higher rates of use of telehealth are now standard in many practices since the coronavirus disease 2019 (COVID-19) pandemic. This is also called “store-and-forward telemedicine.”

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

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

Health Populi

JANUARY 18, 2019

I’m glad to be getting back to health economic issues after spending the last couple of weeks firmly focused on consumers, digital health technologies and CES 2019. There’s a lot for me to address concerning health care costs based on news and research published over the past couple of weeks.

Prescription Drug Pricing 64

Prescription Drug Pricing Health Insurance Doctors Medicare 64

Health Populi

JUNE 13, 2018

That’s how media outlets will cover the top-line of PwC’s report Medical cost trend: Behind the numbers 2019. medical trend growth projected for 2019 that will impact healthcare providers, insurers, and suppliers to the industry. However, there are other forces underneath the stable-looking 6.0% economy by 2026.

Medicaid 63

Medicaid Medicaid Health Insurance Medicare 63

Healthcare Law Blog

MARCH 7, 2023

The Centers for Medicare & Medicaid Services (“CMS”), on behalf of the U.S. Department of Health and Human Services (“HHS”), recently issued a proposed rule to adopt standards under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) for “health care attachment” transactions (the “Proposed Rule”).

US Department of Health and Human Services 52

US Department of Health and Human Services HIPAA Medicaid Medicaid 52

Health Populi

MAY 14, 2019

Respondents were both uninsured and insured through individual coverage, Medicare, Medicaid, and dual enrollees. To further bolster SDoHs that address health equity, public policies can and must also be baked with health, from transportation to food systems and education.

Health Insurance 101

Health Insurance Public Health Hospitals Medicaid 101

Health Populi

NOVEMBER 6, 2019

adults age 18 and over in June 2019. Health Populi’s Hot Points: The 2019 Stress in America survey published this week from the American Psychological Association found that 7 in 10 Americans find that the issues of mass shootings and health care are significant sources of stress. Medicare, Medicaid).

Doctors 66

Doctors Medicaid Medicaid Medicare 66

Health Populi

NOVEMBER 19, 2019

In the past decade, I’ve been spending a lot of time considering SDoH through a variety of lenses across the health/care ecosystem, including care providers like hospitals, health insurance companies, pharma and life science, retail health care front doors, and non-profits and foundations.

Health Care Access 59

Health Care Access Medicare Medicare Health Insurance 59

Health Populi

FEBRUARY 11, 2019

Patients most-trust their clinicians, physicians and nurses, as safe places in which to have an honest SDoH discussion, compared with a health insurance representative. To mitigate SDoH risks for older Americans, Medicare has begun to pay for services that promote coordinated care.

Medicare 90

Medicare Medicare Doctors Health Insurance 90

Hall Render

APRIL 19, 2024

NATIONAL 96% of hospitals share website data: Study 5 numbers on the rise of Stark law violations Aetna lawsuit could reshape MA supplemental benefits AHA concerned over penalties for cybersecurity standards Corporate groups pass hospitals in ownership of physician practices Doctors suggest ways to improve Medicare for physician payments, patient care (..)

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Healthcare Law Blog

MARCH 8, 2023

Medical Coding ChatGPT can potentially be trained to comprehend Medicare and Medicaid codes, prepare billing reports, and process claims, which would significantly reduce the workload for coders and also provide a potential backup confirmation to reduce potential billing and coding errors. 9] Minimum Necessary Requirement | HHS.gov

HIPAA 52

HIPAA Licensing Compliance Health Insurance 52

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

Healthcare Law Blog

APRIL 6, 2022

On April 1, 2022 , the Centers for Medicare & Medicaid Services (“CMS”) announced states may seek to extend Medicaid postpartum coverage from 60 days to one year through a new state plan option offered by the American Rescue Plan Act (“ARPA”). This option is available for five years and ends on March 31, 2027.

Medicaid 52

Medicaid Medicaid ACA Public Health 52

C&M Health Law

JANUARY 20, 2023

Volume 1 — Introductory Material, June 2019 with Errata HL7 Implementation Guide for CDA Release 2: Consolidated CDA Templates for Clinical Notes (US Realm) Draft Standard for Trial Use Release 2.1,

HIPAA 52

HIPAA US Department of Health and Human Services Compliance Health Insurance 52

HIPAA Journal

DECEMBER 31, 2022

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was introduced to simplify the administration of healthcare, eliminate wastage, prevent healthcare fraud, and ensure employees could maintain healthcare coverage between jobs. . What is HIPAA and Who Does It Apply To? OCR Reinterprets HITECH Act Penalty Increases.

HIPAA 132

HIPAA Due Diligence Compliance Fraud 132

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”).

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIPAA Journal

OCTOBER 18, 2022

A review of the account confirmed no financial information was compromised; however, there may have been unauthorized access to names, dates of birth, Social Security numbers, medical record numbers, health insurance information, and limited clinical information related to billing, such as diagnosis codes and treatment information.

HIPAA 112

HIPAA Health Insurance Licensing Medicaid 112

Redox

FEBRUARY 7, 2019

Is 2019 the year we see telemedicine take the leap? Now that we are all on the same page, let’s explore what new developments make 2019 feel like the year telemedicine utilization takes a leap. For 2019, CMS has implemented a few changes that promise to have a significant impact on the telemedicine industry. Learn more.

Telemedicine 40

Telemedicine Public Health Medicaid Medicaid 40

HIT Consultant

JULY 24, 2022

For example, while Medicare only accounts for approximately 20% of the country’s population, data from the Centers for Medicare and Medicaid Services (CMS) detailing utilization for this small segment of Americans have not only served as the foundation for regulatory decisions but has also become the industry proxy for other population segments. .

COVID-19 98

COVID-19 Medicare Medicare Health Insurance 98

Health Populi

OCTOBER 8, 2019

In “Waste in the US Health Care System,” a team from Humana and the Univrsity of Pittsburgh recalibrated the previous finding of 30% of wasted spending to the 25%, which equates to a waste-range of $760 bn to $935 bn. That’s the Holy Grail and vision in my book, HealthConsuming: From Health Consumer to Health Citizen.

Prescription Drug Pricing 104

Prescription Drug Pricing Medicare Medicare ACA 104

CMS.gov

JANUARY 31, 2019

Medicare’s Role in Reducing Senior Poverty. Thu, 01/31/2019 - 15:23. Director, CMS Office of Minority Health & Director, Federal Coordinated Health Care Office, respectively. Rural health. Medicare’s Role in Reducing Senior Poverty. Jeremy.Booth@c…. James and Tim Engelhardt. Initiatives. Prescription drugs.

Medicare 49

Medicare Medicare Health Insurance Medicaid 49

Hall Render

AUGUST 19, 2022

Anchorage’s Mobile Crisis Team hopes funding to operate 24/7 will expand ability to address mental health crises. Health Affairs report shows Alaskans spent more out-of-pocket dollars on health care than residents in any other state in 2019. Connecticut ditches $20M health information exchange software.

COVID-19 40

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

Kaiser Health News

JUNE 16, 2022

Ariane Buck, a young father in Arizona who sells health insurance, couldn’t make an appointment with his doctor for a dangerous intestinal infection because the office said he had outstanding bills. And they had retiree health insurance through Con Edison. Many hospitals thrived even through the pandemic.

US Department of Health and Human Services 145

US Department of Health and Human Services Medical Billing Hospitals Medicare 145