Health Populi

FEBRUARY 14, 2018

In 2020, national health expenditures (NHE) in the United States will exceed $4 trillion to cover 334.5 of health spending per person. The three largest line items of NHE in 2020 will be: Hospitals = $1,326 trillion = 38% of NHE. Together, these three categories will comprise just over 80% of health spending in 2020.

Health Insurance 79

Health Insurance Medicare Medicare Medicaid 79

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

Compliance Now

DECEMBER 28, 2022

Late in the afternoon on December 23, 2022, the Administration issued Affordable Care Act FAQ #56 , and in doing so gave a little holiday gift to all group health plans nationwide. This deadline and enforcement relief is transitional and only applies to the 2020 and 2021 calendar year submissions that were originally due on December 27, 2022.

Health Insurance 100

Health Insurance Compliance Medicaid Medicaid 100

Healthcare IT News - Telehealth

MARCH 25, 2021

Using data from Blue Health Intelligence data repository – an independent data and analytics company that is a licensee of the Blue Cross and Blue Shield Association – researchers from the Johns Hopkins Bloomberg School of Public Health compared claims data from March through June 2019 with March through June 2020.

COVID-19 200

COVID-19 Public Health Medicare Medicare 200

American Medical Compliance

DECEMBER 26, 2023

On December 27, 2020, the United States Congress adopted the No Surprises Act (NSA) as part of the Consolidated Appropriations Act of 2021, which has various provisions to assist in protecting customers against unexpected costs beginning January 1, 2022. The following course highlights the NSA and how it impacts healthcare.

Health Insurance 52

Health Insurance Compliance Medical Billing Medicaid 52

Innovaare Compliance

MARCH 24, 2024

According to the National Health Care Anti-Fraud Association, the financial losses due to healthcare fraud are estimated to be in the billions of dollars annually. The Centers for Medicare & Medicaid Services (CMS) reported that in the fiscal year 2020, they recovered $3.1

Fraud 52

Fraud Health Insurance Compliance Medicaid 52

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. As a result, commercial healthcare spending fell in 2020, rebounding in 2021. compared with 916,7 visits per 1000 members in 2020.

COVID-19 121

COVID-19 Health Insurance Medicaid Medicaid 121

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. this summer.

US Department of Health and Human Services 149

US Department of Health and Human Services COVID-19 Medicaid Medicaid 149

Kaiser Health News

NOVEMBER 11, 2021

Finding the best private Medicare drug or medical insurance plan among dozens of choices is tough enough without throwing misleading sales tactics into the mix. The problems are especially prevalent during Medicare’s open-enrollment period, which began Oct. “You’re not from Medicare,” Heimer told her.

Medicare 144

Medicare Medicare Doctors Fraud 144

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. Similarly, our health care system is a significant barrier to employment because most private health insurance companies do not cover critical supports for disabled people, such as personal assistant services.

COVID-19 246

COVID-19 ADA Medicaid Medicaid 246

Compliance Now

JANUARY 13, 2022

The limits for 2023, as announced by the Centers for Medicare and Medicaid Services, are listed below in comparison to the 2022 limits: Out-of-Pocket Limits Coverage Type 2022 2023 Self-Only Coverage $8,700 $9,100 Family Coverage $17,400 $18,200. This is a $.13

ACA 113

ACA Health Insurance Medicaid Medicaid 113

Health Populi

MAY 21, 2020

adults 18 to 74 years of age in the first week of May 2020. There are other forms of fear taking hold of the COVID-19 era health consumer: namely, financial anxiety in the wake of the pandemic. Nearly every respondent in the study reported having health insurance coverage. ACHP and AMCP polled 1,263 U.S.

COVID-19 159

COVID-19 Doctors Health Insurance Medicare 159

Healthcare IT Today

FEBRUARY 17, 2023

Amid swirling accusations that Medicare Advantage Organizations (MAOs) are overbilling the U.S. government and calls for better oversight , the Centers for Medicare & Medicaid Services announced in early February that it would investigate overbilling by those plans. They expect to recoup 4.7 But the needles pile up fast.

Overpayments 87

Overpayments Overpayment COVID-19 Medicare 87

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. privately-insured people.

COVID-19 145

COVID-19 Hospitals Health Insurance Medicare 145

C&M Health Law

NOVEMBER 7, 2022

The EO comes two months after the president signed the Inflation Reduction Act (IRA) which promises to lower the cost of prescription drugs for many Medicare beneficiaries. This is not the first time that the White House will try to leverage CMMI’s testing authority to create models that would lower drug costs in Medicare.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare IT News - Telehealth

SEPTEMBER 15, 2021

Telehealth providers saw a rapid rise in the need for remote services with the initial spread of the COVID-19 pandemic in early 2020. The Centers for Medicare and Medicaid Services (CMS) began to allow for reimbursement for videoconferencing between healthcare provider and patient.

Telemedicine 178

Telemedicine COVID-19 Medicare Medicare 178

C&M Health Law

DECEMBER 23, 2022

The regulations impact CMS-regulated payers and provide incentives for providers and hospitals that participate in the Medicare Promoting Interoperability Program and the Merit-based Incentive Payment System (MIPS). The below summary does not focus on the Medicaid and Children’s Health Insurance Program (CHIP) Fee for Service (FFS) proposals.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Health Law Advisor

MAY 22, 2023

Senate Committee on Health, Education, Labor and Pensions (the “HELP Committee” or the “Committee”) passed a bipartisan bill to expand federal regulation of pharmacy benefit managers (“PBMs”) for group health plans. [1] Unlike the IRA, which targeted the Medicare program, the provisions of S. 1339 the Committee passed last week.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare IT Today

MAY 15, 2023

Centene acquired Apixio in December 2020. Apixio improves administrative, clinical and financial outcomes for some of the nation’s leading health plans and provider groups using its proprietary clinical data curation and artificial intelligence engine.

Medicare 75

Medicare Medicare Governance Health Insurance 75

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

Health Populi

FEBRUARY 17, 2021

A new report from CoverMyMeds details the current state of medication access weaving together key health care industry and consumer data. The reality even before the coronavirus crisis emerged in early 2020 was that U.S. patients were already making painful trade-offs, some of which are illustrated in the first chart from the report.

COVID-19 141

COVID-19 Health Insurance Health Outcomes Medicaid 141

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. But transparency extends beyond consumer-facing costs, that must be personalized based on an individual’s health plan.

Medicaid 83

Medicaid Medicaid Medicare Medicare 83

Health Populi

AUGUST 24, 2020

The Physicians Foundation surveyed 3,513 physicians in July 2020 on their perspectives on COVID-19 and how the pandemic has impacted practices and patients. consumers, conducted in August 2020. Two-thirds of doctors are also concerned about closure of practices due to COVID-19 causing great harm to patients.

COVID-19 154

COVID-19 Telemedicine Doctors Medicare 154

Health Populi

NOVEMBER 19, 2019

This role of patient-as-the-payor crosses consumers’ ages and demographics, and is heating up health care as the top political issue for the 2020 elections at both Federal and State levels. Four in ten consumers said their monthly health insurance premiums were increasing. health consumer-voters, shown here.

Health Insurance 68

Health Insurance Hospitals Doctors Nurses 68

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

CMS.gov

NOVEMBER 26, 2018

Proposed Changes to Lower Drug Prices in Medicare Advantage and Part D. Medicare Part D. Proposed Changes to Lower Drug Prices in Medicare Advantage and Part D. Today the Centers for Medicare & Medicaid Services (CMS) announced proposed changes to Medicare Part D to lower prescription drug costs for beneficiaries.

Medicare 52

Medicare Medicare Pharmaceutical Industry Health Insurance 52

Bill of Health

MAY 19, 2022

Incremental benefits of novel pharmaceuticals in the UK: a cross-sectional analysis of NICE technology appraisals from 2010 to 2020. Value Health. Hospital-Administered Cancer Therapy Prices for Patients With Private Health Insurance. Polak TB, Cucchi DGJ, Darrow JJ, Versteegh MM. 2022 Apr 8;12(4):e058279. 2022 Apr 18.

Health Insurance 205

Health Insurance Hospitals FDA Medicaid 205

Health Populi

JULY 13, 2020

“The COVID-19 pandemic…has highlighted like never before the pitfalls of paying for healthcare based on the number of patients seen and services rendered,” a Modern Healthcare article asserted in mid-June 2020. billion a day in March 2020 based on declining patient volumes. economic outlook for 2020 to 2030 on July 1, 2020.

COVID-19 106

COVID-19 Medicare Medicare Hospitals 106

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. Please reach out to the authors, your Foley relationship partner, or to our Health Care Practice Group with any questions. 25, 2019).

US Department of Health and Human Services 52

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

Health Populi

MARCH 11, 2021

[Note: I may be biased as a University of Michigan graduate of both the School of Public Health and Rackham School of Graduate Studies in Economics]. health care, patient assistance programs, Medicare Advantage plans, and the bundling of proven high-value preventive services into the Affordable Care Act.

Health Insurance 98

Health Insurance ACA Medicare Medicare 98

Kaiser Health News

DECEMBER 10, 2021

The Cuthbert home where Gipson lived was less than a mile from Southwest Georgia Regional Medical Center, but the ambulance couldn’t take her to the one-story brick hospital because it had closed three months earlier, in October 2020. that closed in 2020. . that closed in 2020.

Hospitals 136

Hospitals Medicaid Medicaid COVID-19 136

Kaiser Health News

JULY 11, 2023

Policy analysts at KFF estimated the total value of nonprofit hospitals’ exemptions in 2020 at about $28 billion, much higher than the $16 billion in free or discounted services they provided through the charity care portion of their community benefits. “It’s not clear what a hospital has to do to justify a tax exemption.

Hospitals 66

Hospitals Medicaid Medicaid Medical Billing 66

HIT Consultant

APRIL 12, 2022

Second, the number of unpaid family caregivers in the United States increased by nearly 10 million people between 2015 and 2020 to 54 million. Through interpersonal communication and technology, DUOS identifies and addresses the individual needs of older adults by leveraging Medicare benefits, trusted partners, and local service providers.

Medicare 52

Medicare Medicare COVID-19 Health Insurance 52

HIPAA Journal

OCTOBER 21, 2022

The passage of HIPAA resulted in multiple benefits for the health insurance industry, the healthcare industry, and the people that they serve. For example, the Administrative Requirements (Part 162) helped reduce insurance fraud and accelerated eligibility inquiries, authorization requests, and claims processing.

HIPAA 95

HIPAA Compliance Medicare Medicare 95

Compliancy Group

MAY 27, 2022

35% of healthcare breaches involved ransomware attacks, vs. 20% in 2020. The average ransomware payment for healthcare was $875,784, about one-third less than the 2020 payment. Highlights included: 23% of all incidents affected healthcare organizations – the most targeted sector of the economy.

HIPAA 98

HIPAA Ransomware Compliance Hospitals 98

AIHC

SEPTEMBER 5, 2023

Medicare covers many telebehavioral and telemental health services including audio-only services. Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations.

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

Healthcare Law Blog

MAY 31, 2022

As the metaverse market continues to grow, with some estimates potentially approaching $800 billion in 2024 (or a $300 billion increase from 2020 estimates), technology leaders in various industries, including healthcare, have begun to expand their presence in this new platform. [1] Code § 321(h). [4]

FDA 90

FDA HIPAA Medicare Medicare 90