The Health Law Firm Blog

JANUARY 12, 2024

Board Certified by The Florida Bar in Health Law The nation's largest Medicaid insurer, Centene, has agreed to pay $165.6 million to Texas to resolve claims that it overcharged the state’s Medicaid program for pharmacy services. The deal was signed on July 11, 2022, but wasn’t publicly [.] Indest III, J.D.,

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Fierce Healthcare

DECEMBER 21, 2022

It's finally here': States have long sought Medicaid eligibility redetermination deadline. Wed, 12/21/2022 - 16:58.

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HIPAA Journal

APRIL 14, 2023

The Iowa Department of Health and Human Services (DHHS) has confirmed that the personal information of 20,800 Iowans who receive Medicaid was exposed in a cyberattack at a subcontractor of one of its business associates between June 30, 2022, and July 5, 2022. It is currently unclear how many individuals have been affected.

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Fierce Healthcare

DECEMBER 8, 2022

to settle Medicaid fraud allegations in California. Thu, 12/08/2022 - 16:58. 3 providers to pay $22.5M

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Fierce Healthcare

NOVEMBER 23, 2022

Google rolls out search features that aim to make it easier to sign up for Medicaid, Medicare. Wed, 11/23/2022 - 11:12.

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Fierce Healthcare

NOVEMBER 21, 2022

4 ways Medicaid could manage high-price drugs. Mon, 11/21/2022 - 15:09.

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Fierce Healthcare

NOVEMBER 16, 2022

Urban Institute: Most adults unaware of looming Medicaid eligibility redeterminations. Wed, 11/16/2022 - 17:17.

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Fierce Healthcare

NOVEMBER 8, 2022

Supreme Court hears case on Medicaid patients' rights to sue, with advocates warning of far-reaching implications. Tue, 11/08/2022 - 16:45.

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HIPAA Journal

JUNE 8, 2023

The Iowa Department of Health and Human Services has announced there have been three separate breaches of the protected health information of Iowa Medicaid recipients in the past two months – two hacking incidents and an impermissible disclosure, all three of which involved third-party contractors.

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HIT Consultant

AUGUST 8, 2022

FAIR Health Monthly Telehealth Regional Tracker, May 2022, United States. The data represent the privately insured population, including Medicare Advantage and excluding Medicare Fee-for-Service and Medicaid. – FAIR Health reports national telehealth utilization increased 10.2 percent, from 4.9 percent in May. percent in May.

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Fierce Healthcare

AUGUST 24, 2023

The Centers for Medicare & Medicaid Services (CMS) announced that the Medicare Shared Savings Program (MSSP) has saved a net $1.8 billion in 2022 for accountable care organizations, which is th | Accountable care organizations saved a net $1.8 billion in 2022 from the Medicare Shared Savings Program, CMS said Thursday.

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The Health Law Firm Blog

JULY 13, 2023

Board Certified by The Florida Bar in Health Law On March 13, 2022, a licensed professional counselor (LPC) was sentenced to nearly five years in prison for defrauding the Connecticut Medicaid Program of more than $1.3 By George F. Indest III, J.D., million, announced the U.S. Attorney for the U.S. District of Connecticut. [.]

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HIPAA Journal

AUGUST 15, 2023

Tift Regional Medical Center in Georgia has started notifying 180,142 patients that their personal and protected health information was compromised in a cyberattack that was detected on or around August 16, 2022. The post Tift Regional Medical Center Patients Notified About August 2022 Cyberattack appeared first on HIPAA Journal.

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Fierce Healthcare

NOVEMBER 7, 2022

Expanded Medicaid coverage may lower kidney-related hospitalizations. Mon, 11/07/2022 - 13:04.

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Healthcare IT News - Telehealth

DECEMBER 14, 2021

This is why, as the new year approaches, Healthcare IT News has sat down with an expert in value-based care to get his views on what 2022 will hold for the payment system. Caravan Health President and CEO Tim Gronniger previously was chief of staff and director of delivery system reform at the Centers for Medicare and Medicaid Services.

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Fierce Healthcare

NOVEMBER 9, 2022

South Dakota becomes latest state to expand Medicaid; abortion weighs on voters' minds. Wed, 11/09/2022 - 10:48.

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Medicaid Medicaid 89

Fierce Healthcare

DECEMBER 6, 2022

Urban: 18M could lose Medicaid coverage after COVID-19 emergency expires, likely next year. Tue, 12/06/2022 - 16:07.

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The Health Law Firm Blog

OCTOBER 18, 2022

Board Certified by The Florida Bar in Health Law The nation's largest Medicaid insurer, Centene, has agreed to pay $165.6 million to Texas to resolve claims that it overcharged the state’s Medicaid program for pharmacy services. The deal was signed on July 11, 2022, but wasn’t publicly [.]. Indest III, J.D.,

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Medicaid Medicaid Overpayments Overpayment 52

Healthcare IT Today

OCTOBER 21, 2022

Brave Health , the largest virtual mental health provider and engagement platform focused on serving Medicaid populations, today announced a $40M Series C funding round led by Town Hall Ventures, with existing investors Union Square Ventures, City Light Capital and others joining as well.

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HIT Consultant

NOVEMBER 30, 2022

Key Themes and Ideas Regarding Value-Based Care Reimbursement 2022. Significant Growth Anticipated for Medicaid and Capitation Contracts: Most respondents report strategic plans to expand their VBC contracts over the next three years.

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The Health Law Firm

NOVEMBER 8, 2022

Board Certified by The Florida Bar in Health Law The nation's largest Medicaid insurer, Centene, has agreed to pay $165.6 million to Texas to resolve claims that it overcharged the state’s Medicaid program for pharmacy services. The deal was signed July 11, 2022 but hadn’t been publicly announced until September 19, 2022.

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HIPAA Journal

NOVEMBER 21, 2022

million being defrauded from Medicaid, Medicare, and private health insurance programs. Five state Medicaid programs, two Medicare Administrative Contractors, and two private health insurers were tricked into changing the bank account details for payments. Medicare, Medicaid, and private health insurers suffered losses of more than $4.7

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Medicaid Medicaid Medicare Medicare 103

HIT Consultant

MAY 9, 2022

FAIR Health Monthly Telehealth Regional Tracker, February 2022, National. The FAIR Health data represent the privately insured population, including Medicare Advantage and excluding Medicare Fee-for-Service and Medicaid. percent nationally in February 2022, from 5.4 percent of all medical claim lines1 in January 2022 to 4.9

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Healthcare Law Blog

DECEMBER 1, 2023

The Department of Health and Human Services (HHS) and the Department of Justice (DOJ) recently released its “Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2022 ” (the “Report”), highlighting continued enforcement and recovery actions under the Health Care Fraud and Abuse Control Program (HCFAC).

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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.

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Medicaid Medicaid Medicare Medicare 52

Compliancy Group

NOVEMBER 16, 2022

Under MACRA, the Centers for Medicare and Medicaid Services created regulations for healthcare providers’ use of health information technology. The MIPS score will be compared to the performance threshold determined yearly by the Centers for Medicare and Medicaid Services (CMS). . MIPS and MACRA 2022: Why Should I Care?

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Medicare Medicare HIPAA Medicaid 52

Healthcare Law Blog

FEBRUARY 3, 2023

Part 521 governing the implementation and operation of effective compliance programs for certain “required providers,” including, now for the first time, Medicaid managed care organizations (MMCOs). [1]

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Medicaid Medicaid Compliance Overpayments 52

Health Care Law Brief

FEBRUARY 2, 2024

While still subject to legislative approval, the Executive Budget incorporates the recently approved amendment (“Waiver Amendment”) to New York’s Medicaid Section 1115 Demonstration that includes $7.5 billion in Medicaid investments over the next three years. Services will be delivered via a two-tiered system.

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The Health Law Firm Blog

MARCH 14, 2024

Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. By George F. Indest III, J.D., Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, [.]

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Fraud Medicaid Medicaid Overpayments 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. Additionally, health plans must establish contracts with providers and community-based organizations (CBOs) to provide both ECM and ILOS, starting with serving transitioning populations in early 2022.

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Fierce Healthcare

NOVEMBER 14, 2022

Modernizing Medicaid: Avoiding Pitfalls on the Journey to Modularity. Mon, 11/14/2022 - 16:43.

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Medicaid Medicaid 52

The Health Law Firm Blog

FEBRUARY 23, 2024

Board Certified by The Florida Bar in Health Law On August 24, 2022, managed healthcare company, Centene Corporation, agreed to pay $19 million to the State of Washington to settle fraud allegations. By George F. Indest III, J.D., Centene owns and operates Sunshine State Health Plan, d/b/a Sunshine Health, in Florida. In addition, [.]

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Fraud Medicaid Medicaid Overpayments 52

Healthcare Compliance Blog

JANUARY 24, 2022

On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.

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The Health Law Firm

DECEMBER 6, 2022

Board Certified by The Florida Bar in Health Law On November 10, 2022, the US Supreme Court announced that it would weigh in on what it means to commit identity theft. In the case the Supreme Court accepted for review, the petitioner, a managing partner at a psychological services company, was convicted of Medicaid fraud in Texas in 2013.

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Bill of Health

OCTOBER 28, 2022

2022 Sep 19. 2022 Sep;40(9):1319-1325. 2022 Sep 1;9(2):lsac022. 2022 Sep 27:10234184. Associations Between Copays, Coverage Limits for Naloxone, and Prescribing in Medicaid. 2022 Sep 29;16:11782218221126972. 2022 Sep;172:349-356. FDA validation of surrogate endpoints in oncology: 2005-2022.

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Fierce Healthcare

DECEMBER 20, 2022

8 Ways to Modernize Your Medicaid Program in the New Year. Tue, 12/20/2022 - 17:18.

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Medicaid Medicaid 52

Healthcare Compliance Blog

APRIL 27, 2022

A Georgia district court has issued a summary judgment against a state rehabilitation center for 808 false claims billed to Medicaid and Tricare between November 2015 and June 2020. The hearing is scheduled for May 2, 2022. The court has ordered the parties involved to appear within 30 days for a hearing on the issue of damages.

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