Fierce Healthcare

AUGUST 11, 2023

Access to care for Medicaid fee-for-service beneficiaries with substance use disorder has improved from 2014 until 2021, but much more can be done to improve it further, researchers say. Nonetheless, there’s room for yet more improvement.

Medicaid 98

Medicaid Medicaid 98

The Health Law Firm Blog

MARCH 26, 2024

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., Mahsa Azimirad, was the office manager for Universal Smiles, a D.C.-based based dental practice, according [.]

Medicaid 52

Medicaid Medicaid Fraud Medicare 52

HIPAA Journal

APRIL 4, 2023

On November 5, 2021, AHCV determined that the email accounts of two of its employees had been accessed by unauthorized individuals after the employees responded to phishing emails. On December 21, 2021, AHCV determined that one of the email accounts did contain patient information, which may have been accessed in the attack.

Hospitals 96

Hospitals Medicaid Medicaid HIPAA 96

The Health Law Firm Blog

MARCH 26, 2024

Board Certified by The Florida Bar in Health Law The Florida Department of Health's Quarterly Performance Report (QPR) for the Third Quarter of Fiscal Year 2020-2021, was recently released. It provides information and statistics on actions involving licensed health professionals through March 2021. Indest III, J.D.,

Licensing 52

Licensing Nurses Fraud Medicaid 52

Healthcare IT News - Telehealth

JANUARY 4, 2021

The following 10 predictions that we have made for the global healthcare will define new ways of rethinking business and growth opportunities in 2021, and will help determine the future direction of the industry. By the end of 2021, about 4 billion COVID-19 vaccine doses will be delivered globally.

US Department of Health and Human Services 212

US Department of Health and Human Services COVID-19 COVID-19 Vaccine Hospitals 212

Healthcare IT News - Telehealth

JULY 9, 2020

The Centers for Medicare and Medicaid Services has put together further detailed guidance for how healthcare providers should be documenting and reporting electronic clinical quality measures for telehealth encounters. The 39 telehealth-eligible eCQMs for the 2021 performance period can be found here.

Payment Systems 180

Payment Systems Medicaid Medicaid Medicare 180

Fierce Healthcare

SEPTEMBER 23, 2021

CMS official says Medicaid must cover Aduhelm as industry awaits national coverage decision. Thu, 09/23/2021 - 10:54.

Medicaid 145

Medicaid Medicaid 145

Healthcare IT Today

DECEMBER 11, 2020

As 2020 comes to a close, healthcare industry leaders are looking ahead to 2021 with excitement and anticipation. The following is a guest article by Mike Noshay, MSE, Founder and Chief Strategy & Marketing Officer at Verinovum.

COVID-19 Vaccine 145

COVID-19 Vaccine COVID-19 Fraud Medicaid 145

Fierce Healthcare

SEPTEMBER 15, 2021

Aetna misrepresented network to secure Pennsylvania Medicaid contract, lawsuit claims. Wed, 09/15/2021 - 11:33.

Medicaid 128

Medicaid Medicaid 128

The Health Law Firm Blog

MARCH 11, 2024

Board Certified by The Florida Bar in Health Law The Florida Department of Health's Quarterly Performance Report (QPR) for the Third Quarter of Fiscal Year 2020-2021, was recently released. It provides information and statistics on actions involving licensed health professionals through March 2021. Indest III, J.D.,

Licensing 52

Licensing Nurses Fraud Medicaid 52

Fierce Healthcare

NOVEMBER 22, 2021

Survey: Majority of Medicaid managed care plans offered health equity benefits in 2020. Mon, 11/22/2021 - 14:40.

Medicaid 124

Medicaid Medicaid 124

Fierce Healthcare

SEPTEMBER 24, 2021

Brooks-LaSure: ACA marketplace key to Medicaid redeterminations after COVID-19 PHE ends. Fri, 09/24/2021 - 09:57.

COVID-19 131

COVID-19 ACA Medicaid Medicaid 131

Fierce Healthcare

DECEMBER 10, 2021

Study: Medicaid expansion not a 'panacea' for solving critical access hospitals' financial woes. Fri, 12/10/2021 - 12:11.

Medicaid 122

Medicaid Medicaid Hospitals 122

Fierce Healthcare

DECEMBER 21, 2021

CMS: Medicaid, CHIP enrollment increases by 433K in June and 17% since start of pandemic. Tue, 12/21/2021 - 12:36.

Medicaid 132

Medicaid Medicaid 132

Health Law RX

FEBRUARY 15, 2023

Medicaid providers and suppliers have likely discovered this the hard way. A provider’s or supplier’s enrollment in the Medicaid program may be insufficient to assure that their provision of a covered and medically necessary good or service to a Medicaid patient will be deemed reimbursable. First, get the word out.

Medicaid 52

Medicaid Medicaid Health Care Lawyers Compliance 52

Fierce Healthcare

SEPTEMBER 21, 2021

OIG: Most states not doing enough to monitor Medicaid telehealth fraud for behavioral health services. Tue, 09/21/2021 - 16:26.

Fraud 126

Fraud Medicaid Medicaid 126

Fierce Healthcare

NOVEMBER 4, 2021

5 to continue Medicare, Medicaid participation. Thu, 11/04/2021 - 09:51. CMS: Healthcare workers must receive their first COVID vaccine by Dec.

Medicaid 122

Medicaid Medicaid Medicare Medicare 122

HIT Consultant

OCTOBER 26, 2021

What You Should Know: – Brave Health , a Miami-based virtual behavioral health provider for Medicaid, today announced it has closed a $10M Series B round ($20.75M in total) led by City Light Capital, Union Square Ventures and Able Partners, bringing its total funding to $20.75M. Recent Traction/Milestones. ”

Medicaid 97

Medicaid Medicaid Health Outcomes Public Health 97

Fierce Healthcare

NOVEMBER 11, 2021

Urban Institute: Benefits of closing Medicaid coverage gap outweigh proposed DSH cuts. Thu, 11/11/2021 - 13:01.

Medicaid 110

Medicaid Medicaid 110

Fierce Healthcare

SEPTEMBER 16, 2021

Study: 15M people could lose Medicaid coverage after COVID-19 emergency ends. Thu, 09/16/2021 - 15:06.

COVID-19 119

COVID-19 Medicaid Medicaid 119

Kaiser Permanente

JANUARY 1, 2022

Medicaid and the Children’s Health Insurance Program (CHIP) have served as critical supports to children, pregnant women, parents, seniors, and individuals with disabilities – covering 80 million individuals during the COVID-19 pandemic. Since February 2020, Medicaid enrollment has grown sharply to cover an additional 9.9

Medicaid 92

Medicaid Medicaid Medicare Medicare 92

HIPAA Journal

MAY 16, 2022

According to the April 29, 2022, notification on the healthcare provider’s website, “We recently discovered unauthorized access to our network occurred between May 31, 2021, and June 1, 2021.” The post Refuah Health Center Alerts 260K Patients About May 2021 Cyberattack appeared first on HIPAA Journal.

Health Insurance 103

Health Insurance Ransomware HIPAA Licensing 103

Fierce Healthcare

OCTOBER 26, 2021

Startup Brave Health picks up $10M to expand access to behavioral health care for Medicaid patients. Tue, 10/26/2021 - 07:03.

Medicaid 119

Medicaid Medicaid 119

HIPAA Journal

NOVEMBER 21, 2022

million being defrauded from Medicaid, Medicare, and private health insurance programs. According to the FBI, more than $43 billion was lost to these scams between June 2016 and December 2021, and in 2021 alone, the FBI Internet Crime Complaint Center received reports of losses of $2,395,953,296 to BEC scams. million, and $6.4

Medicaid 77

Medicaid Medicaid Medicare Medicare 77

Health Populi

JULY 20, 2021

Furthermore, the flow of medical debt was greater among health citizens living in states that did not expand Medicaid as part of the Affordable Care Act, compared with patients who reside in Medicaid expansion states, according to an original research essay, Medical Debt in the US, 2009-2020 published in JAMA on 20 July 2021.

Medicaid 88

Medicaid Medicaid ACA Doctors 88

Fierce Healthcare

DECEMBER 20, 2021

Drug price reforms, Medicaid coverage gap in balance after Manchin opposition to Build Back Better Act. Mon, 12/20/2021 - 15:20.

Medicaid 105

Medicaid Medicaid 105

Healthcare IT News - Telehealth

DECEMBER 16, 2020

This is according to a new annual report from research and consulting giant PwC entitled “Top health industry issues of 2021: Will a shocked system emerge stronger?” ” Sixty-eight percent of provider executives surveyed by HRI said they plan to use more care navigators and coordinators in 2021.

COVID-19 208

COVID-19 Hospitals Doctors Health Insurance 208

Fierce Healthcare

AUGUST 31, 2021

Uber Health to expand nonemergency medical transportation to Texas Medicaid recipients. Tue, 08/31/2021 - 12:38.

Medicaid 94

Medicaid Medicaid 94

Fierce Healthcare

SEPTEMBER 30, 2021

Centene to pay more than $71M to settle Medicaid overpayment cases in Illinois, Arkansas. Thu, 09/30/2021 - 16:43.

Overpayments 105

Overpayments Overpayment Medicaid Medicaid 105

Med-Net Compliance

JULY 11, 2022

The report says that in FY 2021 the DOJ opened 831 new criminal healthcare fraud investigations. HHS-OIG also excluded 1,689 individuals and entities from participation in Medicare, Medicaid, and other federal healthcare programs. In FY 2021, the FBI opened 593 new healthcare fraud investigations.

Fraud 59

Fraud Compliance Medicaid Medicaid 59

Fierce Healthcare

OCTOBER 19, 2021

Senate bill aims to make it easier for Americans to qualify for coverage such as Medicaid, ACA subsidies. Tue, 10/19/2021 - 16:35.

ACA 105

ACA Medicaid Medicaid 105

The Health Law Firm Blog

MAY 12, 2023

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 [.]

Medicaid 52

Medicaid Medicaid Fraud Licensing 52

Healthcare Law Blog

JANUARY 20, 2023

To add uniformity to this practice, CMS codified this flexibility in the 2016 Medicaid and Children’s Health Insurance Plan (CHIP) managed care final rule by authorizing coverage for “In Lieu of Service or Settings” (ILOS). [i] ILOSs must advance the objectives of the Medicaid program.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

The Health Law Firm Blog

JANUARY 28, 2023

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 Carole C. Schriefer, J.D. Mahsa Azimirad, was the office manager for Universal Smiles, a D.C.-based based dental practice, according to the U.S. Attorney’s Office for Washington, D.C.

Medicaid 52

Medicaid Medicaid Fraud Medicare 52

The Health Law Firm Blog

FEBRUARY 11, 2023

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., Mahsa Azimirad, was the office manager for Universal Smiles, a D.C.-based based dental practice, according [.]

Medicaid 52

Medicaid Medicaid Fraud Medicare 52

Healthcare Law Blog

MAY 16, 2022

More than 13 million people were enrolled in Medi-Cal in California in September 2021, making it the largest Medicaid program in the nation. In 2015, DHCS launched the WPC Pilots as part of its Medi-Cal 2020 Section 1115 Demonstration.

Medicaid 59

Medicaid Medicaid Nurses Health Care Access 59

McBrayer Law Blog

APRIL 16, 2021

Posted In Centers for Medicare & Medicaid Services (“CMS”) , Code Enforcement , Medicare In addition to staying up to date on the constantly changing landscape of COVID-19 requirements, healthcare providers must also stay well-informed of industry changes unrelated to the pandemic.

COVID-19 52

COVID-19 Medicaid Medicaid Medicare 52