Hanys

JUNE 30, 2023

HANYS standing membership call on state and federal issues July 11 2020 Medicaid DSH audit kick-off July 11 Understanding CMS' new QAPI interpretive guidelines July 13 Emerging strategies to keep staff safe July 13 Government relations update July 14 Patients who stay against medical advice July 20 Fiscal policy update call July 20

Medicaid 40

Medicaid Medicaid Governance 40

Health Law Advisor

AUGUST 25, 2023

It is axiomatic that New York State requires every Medicaid provider to have an “effective” compliance program. These regulations were proposed to implement portions of the New York State 2020-2021 Budget Bill amending the mandatory compliance program requirements. New York Social Services Law § 363-d.

Compliance 52

Compliance Overpayments Overpayment Compliance Officers 52

Hanys

JULY 7, 2023

2020 Medicaid DSH audit kick-off July 11 Understanding CMS' new QAPI interpretive guidelines July 13 Emerging strategies to keep staff safe July 13 Body reservoirs July 13 Government relations update July 14 Patients who stay against medical advice July 20 Fiscal policy update call July 20 HANYS standing membership call on state and federal issues (..)

Medicaid 40

Medicaid Medicaid Governance 40

HIPAA Journal

MARCH 15, 2023

FHKC receives Medicaid funds and state funds for providing health insurance programs for children in Florida. The contract was renewed by FHKC through 2020, with the federal government covering 86% of the payments to Jelly Bean Communications Design.

Health Insurance 72

Health Insurance HIPAA Due Diligence Fraud 72

HIT Consultant

JULY 17, 2023

Cessation of PHE telehealth, prescribing, and mental health access exceptions could impact the Medicaid population the most. Twenty-one percent of Medicaid enrollees have mild, moderate, or severe SUD, compared to 16% of commercially insured individuals. And as of the latest data, 7.3% And as of the latest data, 7.3%

Public Health 98

Public Health Medicaid Medicaid Electronic Medical Records 98

Bill of Health

MARCH 15, 2022

Department of Labor’s Bureau of Labor Statistics , in 2020, only 18% of disabled people were employed, compared to 62% of nondisabled. Moreover, replacing existing safety net programs, like SSI, with universal basic income would simplify the administration of these programs and shrink government spending. According to the U.S.

COVID-19 246

COVID-19 ADA Medicaid Medicaid 246

Bill of Health

MARCH 25, 2022

Biomarker qualification at the European Medicines Agency: a review of biomarker qualification procedures from 2008 to 2020. A New Way to Contain Unaffordable Medication Costs – Exercising the Government’s Existing Rights. Medicaid Expenditures and Estimated Rebates on Line Extension Drugs, 2010-2018. 2022 Feb 9.

FDA 205

FDA COVID-19 Medicaid Medicaid 205

Bill of Health

FEBRUARY 23, 2023

Over the course of the COVID-19 pandemic, now entering its fourth year in 2023, legislators, executives, and judges at every level of government have sought measures to derail efficacious public health interventions. By James G. Local school districts were crafty, too.

COVID-19 176

COVID-19 Public Health COVID-19 Vaccine Governance 176

HIT Consultant

MARCH 8, 2022

The steep incline in unemployment and fears that millions of people would lose their health coverage drove the declaration of the national public health emergency (PHE) on January 31, 2020. Under the PHE, states must keep Medicaid enrollees continuously covered, irrespective of their circumstances. .

Public Health 98

Public Health Medicaid Medicaid Health Insurance 98

Healthcare IT News - Telehealth

OCTOBER 2, 2020

The Telehealth Improvement for Kids’ Essential Services, or TIKES, Act of 2020 would require the Secretary of the U.S. Department of Health and Human Services to issue guidance to states about how to increase access to telehealth under Medicaid and the Children’s Health Insurance Program. WHY IT MATTERS.

US Department of Health and Human Services 158

US Department of Health and Human Services COVID-19 Medicaid Medicaid 158

Healthcare Compliance Blog

APRIL 29, 2022

in restitution for her role in healthcare fraud, wire fraud, and theft of government funds. Court documents show that between 2008 and 2016 the former owner defrauded the Texas Medicaid program by billing for items and services that had not been provided to the clients of the day care centers. US Attorney Ashley C.

Fraud 59

Fraud Compliance Governance Medicaid 59

HIT Consultant

AUGUST 17, 2023

They also serve a majority of Medicaid and non-insured patients, which makes it harder to keep the doors open on maternity wards, whose cost of upkeep can be substantial. One way the government has responded to hospitals’ and health systems’ financial needs is by funding grants to close revenue gaps.

Medicaid 98

Medicaid Medicaid Doctors Telemedicine 98

HIT Consultant

AUGUST 6, 2023

Often, insurance or the government covers part of the healthcare costs, but if a patient doesn’t have healthcare coverage, they will be responsible to reimburse their providers for the entire cost of the care. They are no longer simply a place for aging Medicare and Medicaid patients to live out their final years. percent of U.S.

Nursing Homes 98

Nursing Homes Nurses Medicare Medicare 98

Healthcare IT Today

APRIL 25, 2023

1upHealth’s FHIR®-native platform designed for interoperability and modern computing is used by over 75 enterprise organizations including leading national and regional health plans, the highest performing CMS ACOs, international clinical research organizations, and over 20 state Medicaid agencies.

Medicaid 99

Medicaid Medicaid Health Analytics Governance 99

Healthcare IT News - Telehealth

MAY 15, 2023

As an FQHC, 75% of patients are enrolled in Medicaid or Medicare; another 7% are uninsured. THE PROBLEM Prior to 2020 and the COVID-19 pandemic, there were federal and state policies in place that discouraged FQHCs like Ryan Health from adopting telehealth services due to payment restrictions. All visits were in-person visits.

COVID-19 128

COVID-19 COVID-19 Vaccine Telemedicine Medicaid 128

Health Care Law Brief

JUNE 5, 2023

In 2013, Jelly Bean contracted with the Florida Health Kids Corporation (“ FHKC ”)—a state-created entity that offers health and dental insurance for Florida children—to create, host, and maintain HealthyKids.org, where, in part, parents and others could apply for state Medicaid insurance coverage for eligible children.

Fraud 52

Fraud Due Diligence Medicaid Medicaid 52

Healthcare IT News - Telehealth

JUNE 19, 2023

Sinclair joined the company in 2020 to grow the company’s chronic care business within the Medicare Advantage line of business. According to CMS, this number jumped to 47% of all Medicare fee-for-service members by the second quarter of 2020. And utilization of telehealth has remained high for this population.

Medicare 157

Medicare Medicare Telemedicine Medicaid 157

Healthcare IT Today

MAY 15, 2023

Centene acquired Apixio in December 2020. The Company takes a local approach – with local brands and local teams – to provide fully integrated, high-quality, and cost-effective services to government-sponsored and commercial healthcare programs, focusing on under-insured and uninsured individuals.

Medicare 102

Medicare Medicare Governance Health Insurance 102

MedTrainer

FEBRUARY 12, 2024

government collected $2.2B Knowingly or falsely claiming monies from federal programs such as Medicare and Medicaid has cost healthcare entities $72B since 1986. in settlements and judgments from healthcare organizations accused of filing false claims in fiscal 2022.

Compliance 52

Compliance Fraud Medicaid Medicaid 52

HIT Consultant

APRIL 21, 2022

What You Should Know: – Centers for Medicare & Medicaid Services’ (CMS) payment adjustments did not adequately address hospitals increased costs for FY 2021, according to new data from Premier. percent on a per-paid-hour basis since Q4 2020 (start of government FY 2021) and do not show signs of slowing.

Hospitals 52

Hospitals COVID-19 Payment Systems Medicaid 52

HIT Consultant

AUGUST 3, 2022

million—between February 2020 and November 2021, with decreasing employment nearly every month. Medicaid reimbursement, which comprises the largest share of nursing home reimbursement, has not kept pace, resulting in SNFs and medical providers assuming the burden of those costs. . million to 1.35 As of late February 2022, 35.9%

Nursing Homes 98

Nursing Homes Nurses COVID-19 Medicaid 98

Health Populi

JUNE 3, 2020

There’s been a flurry of research into this question since the hockey-stick growth of telemedicine visits were evident in March 2020, just days after the World Health Organization uttered the “P-word:” pandemic. ” in a May 2020 report out of the company’s consumer survey. Some 3 in 4 U.S.

COVID-19 153

COVID-19 Hospitals Medicaid Medicaid 153

Healthcare IT Today

OCTOBER 12, 2023

The Centers for Medicare & Medicaid Services (CMS) have taken a bold step by mandating a standard for prior authorization. The federal government has been haranguing vendors and clinicians to make interoperable systems since the HITECH act was passed in 2009. A CMS fact sheet offers more details on CMS’s thinking and plans.

Electronic Medical Records 111

Electronic Medical Records Doctors Governance Medicaid 111

Healthcare Law Blog

JANUARY 31, 2023

Prior to the pandemic, telehealth visits for mental health or substance use disorder represented less than 1% of outpatient visits, but by mid-2020 nearly 40% of telehealth outpatient visits were for mental health or substance use. [i] Part 2, which governs the medical records of federally assisted substance use treatment programs.

COVID-19 105

COVID-19 Medicare Medicare Medicaid 105

Innovaare Compliance

MARCH 24, 2024

The Centers for Medicare & Medicaid Services (CMS) reported that in the fiscal year 2020, they recovered $3.1 Retrieved from [link] Centers for Medicare & Medicaid Services. 2020 AMA Prior Authorization (PA) Physician Survey. Retrieved from [link] Centers for Medicare & Medicaid Services. 2021, April).

Fraud 52

Fraud Health Insurance Compliance Medicaid 52

Healthcare Compliance Blog

FEBRUARY 7, 2022

A Michigan woman has pled guilty to stealing government funds that were designated to aid medical providers in the treatment of patients suffering from COVID-19 and acknowledged using the money for her own personal use. Issue: Misuse of allocated public funds can be seen as fraud, waste, and abuse of government funds.

COVID-19 59

COVID-19 Fraud Governance Compliance 59

HIT Consultant

DECEMBER 14, 2021

They are focused on expanding the number of providers who can prescribe the treatment (it requires a special waiver from the federal government) and training more clinicians to provide support needed for the treatment to be successful. government agencies to develop OUD treatment protocols for decades.

Licensing 98

Licensing Governance FDA Telemedicine 98

Health Populi

JULY 16, 2020

The median charge for hospitalizing a patient with COVID-19 ranged from $34,662 for people 23 to 30, and $45,683 for people between 51 and 60 years of age, according to FAIR Health’s research brief, Key Characteristics of COVID-19 Patients published July 14th, 2020. They used two ICD-10-CM diagnostic codes for this research: U07.1,

COVID-19 148

COVID-19 Hospitals Health Insurance Medicare 148

Healthcare IT News - Telehealth

MARCH 18, 2022

Norden is particularly passionate about funding companies focused on the Medicaid population – a traditionally tricky and often ignored area. Fast-forward to March 2020, for the first time, physicians, patients and administrators were forced to utilize digital health tools, and companies like Teladoc and Amwell were rapidly adopted.

Medicaid 212

Medicaid Medicaid COVID-19 Telemedicine 212

HIPAA Journal

SEPTEMBER 29, 2022

The Government Accountability Office (GAO) recently conducted a review of Medicare telehealth services provided during the COVID-19 pandemic, when a waiver was in place that greatly expanded access to telehealth and virtual visits. During the same period in 2020, the number increased to 53 million.

Medicare 76

Medicare Medicare COVID-19 HIPAA 76

HIT Consultant

DECEMBER 26, 2022

4.7bn diagnostic imaging procedures were performed globally in 2021, representing a strong recovery over 2020. Although volumes dipped in 2020, the strong recovery witnessed in 2021 is set to continue with volumes reaching >6bn by 2026. Where access to sub-specialty expertise can be limited in-house (e.g.

Medicare 52

Medicare Medicare COVID-19 Medicaid 52

MedTrainer

NOVEMBER 28, 2023

The Arizona Health Care Cost Containment System (AHCCCS) is Arizona’s Medicaid agency, providing health care programs to serve Arizona residents through managed care, cost containment, and services aimed at improving the health of those it covers.

Compliance 52

Compliance Licensing Public Health Medicaid 52

Healthcare Law Today

DECEMBER 16, 2022

To seek a higher sentencing guidelines range, the government often relies on a defendant’s “intended” loss,” rather than the “actual” loss. In these prosecutions, the government often asserts that the entire amount billed to a payer is the intended loss for purposes of setting the Guidelines range.

Fraud 52

Fraud Governance Medicaid Medicaid 52

Hall Render

FEBRUARY 4, 2022

billion from False Claims Act (“FCA”) cases in the federal fiscal year 2021, “the second largest annual total in False Claims Act history” and more than doubling the FCA recoveries for the DOJ from fiscal year 2020. That figure does not include even more funds recovered for state Medicaid programs.

Fraud 40

Fraud Governance Medicare Medicare 40

Medisys Compliance

MAY 19, 2022

The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. The federal government announced a series of policy changes that broaden Medicare coverage for telehealth during the COVID-19 public health emergency. Changed Telehealth Policies. Eligible services.

COVID-19 52

COVID-19 Medicare Medicare Medical Billing 52

Healthcare IT Today

AUGUST 7, 2022

Cybersecurity company Surfshark found the number of government requests for user data increased 4x from 2013 to 2020 among Apple, Google, Facebook, and Microsoft. The four companies submitted user data to governments between 69% and 80% of the time. Facebook accounted for 40% of all requests, compared to just 7% for Apple.

Governance 98

Governance Telemedicine Medicaid Medicaid 98

Bill of Health

SEPTEMBER 9, 2022

There are no national mandatory standards governing health care access or delivery behind bars. Some states have adopted minimum standards for prisons, jails, or both, but in Louisiana , the standards governing health care in jails have not been updated since 1980. Carceral health care occurs within a regulatory vacuum.

COVID-19 349

COVID-19 COVID-19 Vaccine Medicaid Medicaid 349