Healthcare IT News - Telehealth

JANUARY 25, 2021

The Protecting Access to Post-COVID-19 Telehealth Act of 2021 legislation was introduced this past week by Rep. Authorize the Centers for Medicare and Medicaid Service to continue reimbursement for telehealth for 90 days beyond the end of the public health emergency. A bipartisan group of U.S. Mike Thompson, D-Calif.,

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COVID-19 Medicare Medicare Telemedicine 208

Healthcare Law Blog

MAY 5, 2022

Department of Health and Human Services Office of Inspector (“OIG”) released a report that studied prior authorization denials and payment denials by Medicare Advantage Organizations (“MAOs”) (the “Report”). Thirteen percent of denied prior authorization requests met Medicare coverage rules. The OIG Report. additional test results).

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Medicare Medicare Licensing Health Insurance 52

Bill of Health

FEBRUARY 23, 2023

Over 1,500 state anti-public health bills – introduced to thwart emergency powers, dismiss emergency declarations, prohibit masks, eliminate vaccine mandates, and restrict social distancing – were introduced between January 1, 2021 – May 20, 2022. Yet, only 185 of these bills actually passed. Local school districts were crafty, too.

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COVID-19 Public Health COVID-19 Vaccine Governance 176

HIPAA Journal

FEBRUARY 16, 2022

Family Christian Health Center (FCHC) in Illinois has announced it was the victim of a ransomware attack in November 2021 that compromised the protected health information of 31,000 patients. The attackers compromised FCHC’s old dental system which contained the PHI of patients who had received dental services prior to August 31, 2020.

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Ransomware Hospitals Licensing HIPAA 119

The Health Law Firm Blog

FEBRUARY 15, 2022

Board Certified by The Florida Bar in Health Law On October 1, 2021, a former dental office manager was sentenced to 12 months in prison for her role in a Medicaid fraud scheme. By George F. Indest III, J.D., The office manager for Universal Smiles, a D.C.-based based dental practice was sentenced for her.

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Medicaid Medicaid Fraud Licensing 52

HIPAA Journal

MARCH 25, 2022

The forensic investigation revealed the email accounts were accessed by unauthorized individuals between April 7, 2021, and June 2, 2021. AHA provided notice about the attack on January 6, 2021. UMC was a victim of a REvil ransomware attack in June 2021 that resulted in the theft of the protected health information of 1.3

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Health Insurance Licensing Ransomware Fraud 104

NY Health Law

FEBRUARY 13, 2024

On January 9, 2024, the federal Centers for Medicare and Medicaid Services (CMS) finally approved New York State’s 1115 waiver amendment to establish the New York Health Equity Reform (NYHER) Program. Workforce: Workforce investments with a goal of equitable and sustainable access to care in Medicaid.

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Medicaid Medicaid Nurses Medicare 52

HIPAA Journal

MARCH 14, 2022

Capital Region Medical Center (CRMC) in Jefferson City, MO has recently confirmed patient information was accessed by unauthorized individuals in a December 2021 cyberattack that took its network and phone systems offline for several days. The attack was detected on December 17, 2021, when network systems were disrupted.

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Electronic Medical Records Health Insurance HIPAA Licensing 128

Healthcare Law Today

NOVEMBER 9, 2022

Starting January 1, 2023, Medicare will expand and increase coverage of certain services and providers to advance access to prevention and treatment services for substance use disorders (SUD) and mental health services. The combination of the opioid crisis and the COVID-19 pandemic have led to record need for behavioral health treatment.

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Medicare Medicare COVID-19 Licensing 52

Med-Net Compliance

SEPTEMBER 7, 2022

A 49-year-old Texas physician assistant was arrested and charged for his role in a scheme to defraud Medicaid by working with a suspended medical license. On July 20, 2021, the Texas Medical Board allegedly ordered the immediate suspension of his physician assistant license, deeming him to be a “continuing threat to public welfare.”

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Medicaid Medicaid Licensing Medical Personnel 59

HIPAA Journal

OCTOBER 17, 2022

RAA said suspicious activity was detected within its environment in August 2021. The forensic investigation confirmed that unauthorized individuals had access to certain systems between July 22, 2021, and August 3, 2021, and copied files from its network that contained patient data.

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Licensing HIPAA Health Insurance Medicaid 55

Verisys

JUNE 13, 2023

Centers for Medicare & Medicaid Services : The US Department of Health and Human Services has issued a final rule update concerning guidelines for COVID-19 vaccination requirements for Long-Term Care Facilities (LTC) and Intermediate Care for Individuals with Intellectual Disabilities (ICFs-IID).

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COVID-19 Vaccine US Department of Health and Human Services COVID-19 Licensing 52

HIPAA Journal

JUNE 8, 2023

According to the May 22, 2023, breach notice, the incidents occurred in 2021. PVOC discovered on March 3, 2022, that malware had been installed on the servers of the vendors between November 13, 2021, and November 15, 2021.

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Ransomware HIPAA Licensing Health Insurance 93

Provider Trust

AUGUST 9, 2023

Through collaborative efforts with partners such as the Department of Justice (DOJ), Medicaid Fraud Control Units (MFCUs), and various federal, state, and local law enforcement agencies, the OIG employs a comprehensive and data-driven approach to detect, investigate, and prosecute instances of fraud.

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Nursing Homes COVID-19 Fraud Medicaid 52

Provider Trust

JULY 26, 2023

These directories allow patients to connect with healthcare providers and licensed practitioners to make appointments, find and exchange information, and pay for services. The Centers for Medicare and Medicaid Services (CMS) conducted multiple reviews of Medicaid Advantage provider directories between February 2016 and July 2018.

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Medicaid Medicaid Compliance Medicare 52

YouCompli

APRIL 27, 2022

The Nurse Licensure Compact (NLC) is an interstate agreement allowing nurses to practice in multiple states with one multistate license issued from their home state. The compact enables nurses to provide nursing services to patients located in other NLC states via telehealth without obtaining additional licenses.

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Compliance Officers Licensing Compliance Nurses 52

HIPAA Journal

APRIL 8, 2022

Advanced Medical Practice Management Sends Notification Letters About July 2021 Cyberattack and Data Theft Incident. AMPM identified suspicious activity related to files within its IT environment on August 5, 2021, and immediately secured its network.

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Medical Billing Licensing Health Insurance Medicaid 110

HIPAA Journal

APRIL 13, 2022

The email accounts were discovered to have been compromised between December 6, 2021, and January 3, 2022. Wellstar Health learned about the security breach on February 7, 2022, with the forensic investigation confirming that the breach was limited to two email accounts. No other systems were compromised.

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Ransomware Licensing HIPAA Health Insurance 111

Med-Net Compliance

NOVEMBER 8, 2022

The inspection objective was to determine whether the direct care licensed nursing hours recorded at the nursing home supported the hours submitted to the US Centers for Medicare & Medicaid Services (CMS) in compliance with federal requirements.

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Nursing Homes Nurses US Department of Health and Human Services Licensing 59

Provider Trust

JULY 25, 2022

ProviderTrust analyzed the public outpatient Medicare claims data of a large health system. Between January and September 2021, nearly 40,000 unique providers offered care through this particular organization, billing over $5.4 billion in Medicare charges. Acquiring license information about providers can be difficult.

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Electronic Medical Records Licensing Medicare Medicare 52

Healthcare IT Today

FEBRUARY 27, 2024

Drawing on decades of experience as a trusted resource in the home, in 2021 we created the Hamilton Beach Health brand. The product is patent protected, FDA cleared, and FSA, HSA, Medicare, and Medicaid eligible. Postal Service’s approved mail-back program.

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FDA Licensing Medicaid Medicaid 81

YouCompli

JUNE 29, 2022

A measure in the Consolidated Appropriations Act signed into law in March, extended Medicare telehealth reimbursement for 151 days following?the To stay current on interstate telemedicine licensing requirements, compliance officers should set monthly or quarterly monitoring reminders to ensure they are up to date. the end of COVID-19.

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Compliance Officers Compliance Telemedicine COVID-19 52

AIHC

MAY 31, 2022

When the federal government covers items or services rendered to Medicare and Medicaid beneficiaries, the federal fraud and abuse laws apply. Government programs, such as the Centers for Medicare & Medicaid Services (CMS), find the investment in their audit and monitoring programs are effective.

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Fraud Compliance Officers Compliance Medicare 52

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%

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Hospitals Medicare Medicare Medicaid 40

Health Care Law Brief

JANUARY 19, 2022

On December 31, 2021, New York Governor Kathy Hochul signed landmark legislation to increase the transparency of prescription drug pricing and to establish requirements on pharmacy middlemen. This new law is amongst 100 [1] state bills introduced in 2021 that shed light on the business practices of pharmacy benefit managers (PBM).

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Prescription Drug Pricing Licensing Compliance Medicaid 52

Healthcare IT News - Telehealth

FEBRUARY 5, 2024

Patients with mental health issues frequently must wait many months before getting seen by a licensed clinician who can prescribe psychotropic medication. You contend telepsychiatry will continue to grow because it enables access to mental healthcare – which is a big challenge today.

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COVID-19 Public Health Licensing FDA 144

Health Populi

MAY 21, 2020

Among those covered with insurance, one-half had employer-sponsored insurance, 1 in 4 Medicare, and 13%, individual cover. Another 8% had Medicaid or a state health insurance program. That anxiety comes from the fact that most folks in this study believed it likely there would be a resurgence of COVID-19 in the fall or winter.

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COVID-19 Doctors Health Insurance Medicare 159

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.

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HIPAA Health Insurance Licensing Medicaid 62

Healthcare Compliance Blog

MAY 25, 2022

The Louisiana Department of Health revoked the facilities’ licenses to operate as nursing homes due to multiple violations of state law that left seven residents dead and hundreds of others neglected and vulnerable following Hurricane Ida in August 2021. As a result, OIG has excluded the nursing homes and their owner.

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Nursing Homes Nurses Licensing Medicaid 59

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.

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Fraud US Department of Health and Human Services Medicaid Medicaid 52

HIPAA Journal

JUNE 26, 2023

For example, the Secretary can waive the requirements for out-of-state healthcare professionals to be licensed before being allowed to practice, or exercise discretion when investigating violations of the physician self-referral law (§1877 of the Social Security Act).

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HIPAA COVID-19 COVID-19 Vaccine Public Health 68

Healthcare Law Today

JANUARY 20, 2022

On November 22, 2021, the Centers for Medicare & Medicaid Services (CMS) published a guidance document titled Over The Counter (OTC) Home Testing and CLIA Applicability Frequently Asked Questions (the Guidance Document).

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COVID-19 FDA Licensing Medicaid 52

Healthcare Law Blog

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”).

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Medicare Medicare COVID-19 Medicaid 98

Healthcare IT News - Telehealth

OCTOBER 20, 2021

Early on in the pandemic, the Centers for Medicare & Medicaid Services (CMS) extended telehealth waivers that helped bring virtual care services into the mainstream. Then you can practice at the top of your license again without being in a documentation nightmare and so focused on CPT codes that you can't see straight.

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COVID-19 Hospitals Telemedicine Licensing 154

HIPAA Journal

OCTOBER 14, 2022

2021 saw 714 data breaches of 500 or more records reported to the OCR – an 11% increase from the previous year. Healthcare data can be used to impersonate patients to obtain expensive medical services, Medicare and Medicaid benefits, healthcare devices, and prescription medications.

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Ransomware HIPAA Health Insurance Hospitals 108

Healthcare Law Blog

DECEMBER 19, 2022

In 2021, COVID-19 immunization rates among nursing home staff quickly rose due to federal vaccine mandates for healthcare workers and long-term care facilities participating in the Federal Pharmacy Partnership for Long-Term Care Program. iv] (DHHS – HC Staff Vaccination Requirement) – 2021-23831.pdf pdf (federalregister.gov).

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COVID-19 Vaccine COVID-19 Nursing Homes Nurses 52

Healthcare Law Blog

MAY 31, 2022

For example, services that are billed to Medicaid or Medicare must comply with regulations that may not apply to services that are paid for in cash. How healthcare providers are licensed in the metaverse is also an open question. 1, 2021). [2] Licensure and its enforcement can also occur at the state level.

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FDA HIPAA Medicare Medicare 90