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

JUNE 9, 2022

In March of 2022, in a related matter, the man pleaded guilty to Healthcare Fraud, Money Laundering, and Theft of Public Money for defrauding Medicare, Medicaid, and the US Department of Health and Human Services between 2016 and 2020. Providers must ensure that the claims they submit to Medicare and Medicaid are true and accurate.

US Department of Health and Human Services 59

US Department of Health and Human Services Medicare Medicare Overpayments 59

YouCompli

FEBRUARY 22, 2023

Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. For example, in 2020, OIG audited an Arkansas facility regarding its outpatient outlier payments. Return illegitimate reimbursement and overpayments quickly. The government has a 60-day overpayment rule.

Compliance 52

Compliance US Department of Health and Human Services Overpayments Overpayment 52

AIHC

SEPTEMBER 5, 2023

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. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs. This is also called “store-and-forward telemedicine.”

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

Hall Render

JUNE 22, 2022

On Friday, June 17, 2022, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2023 Home Health Prospective Payment System Rate Update (“PPS Rule”). The industry has been waiting for CMS to assess behavior again since 2020. is a decline from 2020, in which 8.9%

COVID-19 40

COVID-19 Payment Systems Medicare Medicare 40

Hall Render

DECEMBER 6, 2022

As part of the final regulations released by the Centers for Medicare & Medicaid Services (“CMS”) effective January 19, 2021, CMS finalized a new exception for arrangements where an entity pays a physician less than $5,000 over the course of a calendar year in exchange for items or services. New Exception for Limited Remuneration.

COVID-19 40

COVID-19 Hospitals Overpayments Overpayment 40

Hall Render

APRIL 19, 2024

to Study Treatments for Vascular Abnormalities Federal Appeals Court Hears Arguments on Nation’s First Ban on Gender-affirming Care for Minors Jason Demke Hired as COO at Mercy Hospital Fort Smit Pulaski Tech Awarded $5.7M Can lawmakers do anything about it?

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

AIHC

MARCH 28, 2022

billion in financial benefits in fiscal year 2020— a return of about $114 for every $1 invested. The Centers for Medicare & Medicaid Services (CMS) owns the NCCI program and is responsible for all decisions regarding its contents. Auditing and denying claims after the claims have been paid is “big money” for the government.

Medicare 52

Medicare Medicare Compliance Governance 52

Healthcare Law Blog

JANUARY 5, 2023

Just in time for the holidays, the Centers for Medicare and Medicaid Services (“CMS”) issued the Contract Year 2024 Proposed Rule for Medicare Advantage organizations (“MAOs”) and Part D sponsors (the “Proposed Rule”). We’ve summarized some of the key changes in the Proposed Rule. Comments on due February 13, 2023. Star Ratings.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

JANUARY 19, 2024

Workers at another D.C. Here’s how much more they’ll be paying St. Bipartisan Ky. hospital company Kansas City Orthopaedic Institute appoints new CEO Kansas City University’s new research center aims to answer: ‘How do we keep people well?’

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

AUGUST 26, 2022

CMS bulletin presses states on Medicaid nursing home spending. CMS proposes mandatory Medicaid, CHIP quality reporting. Tie nursing home Medicaid payments to care quality, CMS tells states. Medicaid Contract Remains in Limbo. ‘Not on the same page’: No deal yet on NC Medicaid expansion. NORTH DAKOTA.

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40