Innovaare Compliance

NOVEMBER 29, 2023

On October 13, 2023, the Centers for Medicare & Medicaid Services (CMS) published the Readiness List for CY 2024. This has been a very useful tool for Medicare Advantage Organizations (MAO) to check their readiness to fulfill requirements in the new contract year.

Medicare 52

Medicare Medicare Compliance Medicaid 52

HIT Consultant

JANUARY 26, 2023

The Improving Seniors’ Timely Access to Care Act mandates the adoption of electronic PA for Medicare Advantage (MA) plans and requires plans to offer greater policy transparency, approval rates, and rationale for denials. If the bill passes in the Senate as expected, it could be law in early 2023. LinkedIn – [link].

Regulatory Compliance 52

Regulatory Compliance Medicare Medicare Medicaid 52

Healthcare IT Today

JUNE 7, 2023

Many of our concerns center on the proposed implementation timeframes associated with various concepts included in HTI-1, as well as ONC’s failure to sufficiently consider the burden compliance will place on provider organizations and health IT developers. 31, 2024, compliance timeline is unrealistic.

FDA 97

FDA Compliance Regulatory Compliance Medicaid 97

Health Care Law Brief

FEBRUARY 16, 2024

In August 2023, DFS issued proposed regulations addressing consumer protection, conflicts of interest, and transparency issues related to PBM industry practices, including a dispensing fee of $10.18 from the August 2023 proposed rules. The draft regulations contemplate an enforcement date beginning July 1, 2025.

Licensing 52

Licensing Medicare Medicare Regulatory Compliance 52

Health Care Law Brief

JANUARY 19, 2022

In an approval memo, Governor Hochul described the New York legislation as the most comprehensive regulatory framework in the country for PBMs. The new law requires PBMs to register with the State Department of Financial Services (DFS) by April 1, 2022 and thereafter to be licensed by January 1, 2023. Disclosure requirements.

Prescription Drug Pricing 52

Prescription Drug Pricing Licensing Compliance Medicaid 52

Health Care Law Brief

FEBRUARY 2, 2024

The Waiver Amendment was approved on January 9, 2024, by the Centers for Medicare & Medicaid Services (“CMS”) under Section 1115(a) of the Social Security Act and will expire on March 31, 2027. The rates must be at least 80% of Medicare rates. billion in Medicaid investments over the next three years.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

AIHC

NOVEMBER 3, 2023

Weight and Height Juxtaposition in the Electronic Medical Record Causing an Accidental Medication Overdose (posted on the Patient Safety Network October 31, 2023) A 2-year-old girl presented to the emergency department (ED) with joint swelling and rash following an upper respiratory infection. 1 through June 30, 2023.

Department of Veterans Affairs 59

Department of Veterans Affairs Hospitals Compliance Nurses 59

MedTrainer

AUGUST 2, 2023

Listen to a candid discussion on lessons learned from the 2023 federal investigation that uncovered fraudulent medical practice nationwide in this on-demand webinar: Moving Forward From the Nursing Fraud Scheme. However, it’s important to remember how critical this process is for mitigating risk, improving compliance, and earning trust.

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

HIT Consultant

DECEMBER 6, 2022

trillion Consolidated Appropriations Act of 2022, which extended Medicare coverage related to telemedicine practices. Telemental health providers were not immune to this activity in 2022, and providers should prioritize regulatory compliance as the industry looks ahead to 2023. “As

Compliance 98

Compliance Medicaid Medicaid COVID-19 98

Health Care Law Brief

MARCH 8, 2022

On February 24, 2022, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), announced the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, which will begin January 1, 2023, and replace the Global and Professional Direct Contracting (GPDC) Model.

Medicare 52

Medicare Medicare Fraud Compliance 52

Drug & Device Law

DECEMBER 29, 2023

In 2023 there seemed to be an unusually large number of other decisions that are likely to have a substantial impact on what we or our clients do, but involve either different products, non-product claims, or both. In 2023, these include United States ex rel. 2023) (no medical monitoring in Delaware) ( here ); Brown v.

FDA 105

FDA US Department of Health and Human Services COVID-19 Informed Consent 105

Drug & Device Law

JANUARY 25, 2024

23-cv-01060-AJB-DDL, 2023 WL 9010545 (S.D. 15, 2023), a California plaintiff alleged that the medical walker he purchased broke, causing him to fall and sustain injury. In those cases , the question is often whether the claims put FDA compliance at issue or whether the defenses do. In Rubalcava v. Medline Indus.,

Medicare 52

Medicare Medicare FDA Regulatory Compliance 52