HIT Consultant

NOVEMBER 9, 2023

Director of Healthcare Strategy, LexisNexis Risk Solutions During the peak of the Covid-19 pandemic, over 10 million Americans enrolled in Medicaid – nearly a 14% increase from the beginning of 2020. A month before the public health emergency ended on May 11, 2023, 87 million individuals were enrolled in Medicaid.

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Medicaid Medicaid Health Insurance Health Outcomes 64

HIPAA Journal

JANUARY 31, 2024

Report: Security Breaches in Healthcare (Direct Download PDF, 1.9MB, 16 pages) An unwanted record was set in 2023 with 725 large security breaches in healthcare reported to the Department of Health and Human Services (HHS) Office for Civil Rights (OCR), beating the record of 720 healthcare security breaches set the previous year.

Ransomware 121

Ransomware HIPAA Hospitals Compliance 121

Medisys Compliance

DECEMBER 23, 2022

The internet is ringing with the news of the CMS Updates Final rule for the 2023 Medicare Physician Fee Schedule. The finalized 2023 Medicare Physician Fee Schedule was announced by the Centers for Medicare & Medicaid Services (CMS) on November 1 2022. Effects of the PFS in 2023 on providers. Principles of PFS.

Medicare 98

Medicare Medicare Medical Billing Medical Billing Outsourcing 98

Healthcare IT Today

APRIL 26, 2023

The following is a guest article by Ashley Perry, MPH, Chief Strategy and Solutions Officer at Socially Determined When Congress passed the Consolidated Appropriations Act of 2023 , it decoupled the Public Health Emergency (PHE) from the Medicaid program’s continuous enrollment provision, which was implemented as part of the PHE in March 2020.

Medicaid 64

Medicaid Medicaid Public Health Health Outcomes 64

MedTrainer

MAY 4, 2023

The end of the federal Public Health Emergency (PHE) will reinstate regulations that have been absent for years… and many healthcare workers have never had to follow. There are plenty of compliance implications for the end of the Public Health Emergency on May 11, 2023 , and an assessment is a great place to start.

Public Health 52

Public Health Compliance COVID-19 COVID-19 Vaccine 52

Provider Trust

AUGUST 9, 2023

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has released its latest 2023 Spring Semiannual Report to Congress, providing a comprehensive overview of its activities from October 2022 to March 2023. Led by acting Inspector General Christi A.

Nursing Homes 52

Nursing Homes COVID-19 Fraud Medicaid 52

Healthcare IT Today

JANUARY 6, 2023

As we head into 2023, we wanted to kick off the new year with a series of 2023 Health IT predictions. An end to the Public Health Emergency (PHE) is likely to be announced and end mid-January followed by a grace period of approximately 5 months. With the market downturns we’ve seen in 2022, that trend will shift.

US Department of Health and Human Services 104

US Department of Health and Human Services Doctors Telemedicine Public Health 104

Healthcare Law Today

NOVEMBER 30, 2022

On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) released its final 2023 Medicare Physician Fee Schedule (PFS) rule. With the extension of the PHE through January 11, 2023, virtual direct supervision will be available through at least the end of 2023.

Medicare 132

Medicare Medicare Telemedicine Nurses 132

Bill of Health

FEBRUARY 23, 2023

Over the course of the COVID-19 pandemic, now entering its fourth year in 2023, legislators, executives, and judges at every level of government have sought measures to derail efficacious public health interventions. By James G. And that’s where they are wrong. Some victories came easy.

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COVID-19 Public Health COVID-19 Vaccine Governance 176

HIT Consultant

APRIL 4, 2023

What You Should Know: 2023 started off with the hallmarks of a rebound year. While Q4 2022 signaled the tail end of the digital health funding cycle, January and February funding numbers began to suggest that sector investment was slowly but surely inching back upwards. digital health funding closed with $3.4B and Q3 2022’s $2.2B

FDA 52

FDA Medicaid Medicaid COVID-19 52

HIPAA Journal

MAY 29, 2023

State attorneys general also enforce the HIPAA Rules and 2023 has already seen several enforcement actions over violations of HIPAA and state privacy laws. Reducing risk exposure from vendor relationships is one of the biggest security challenges in healthcare in 2023 and a pressing issue, as hackers are actively targeting the supply chain.

HIPAA 96

HIPAA Compliance Due Diligence COVID-19 96

Bill of Health

NOVEMBER 9, 2023

To design systems and policies that promote the right to health, a holistic and proactive approach is needed, one in which people, institutions, and corporations have a shared responsibility in promoting physical, mental, and social well-being. health care system. America is the only wealthy nation to lack universal health coverage.

COVID-19 157

COVID-19 Public Health ACA Health Insurance 157

Center for Health Insurance Reform

DECEMBER 8, 2022

States are expected to resume redeterminations of Medicaid eligibility in early 2023, resulting in a projected 15 million people losing access to Medicaid. Ensuring these individuals transfer to another source of coverage smoothly and seamlessly is a particular challenge for states.

Medicaid 57

Medicaid Medicaid Health Insurance Public Health 57

Hall Render

JULY 28, 2023

Starting on August 1, 2023, Medicare validation edits will be activated to require service location addresses on the UB-04 hospital claim form to match exactly with the service location enrolled in Medicare’s Provider Enrollment, Chain, and Ownership System (“PECOS”). UB claim).

Medicare 40

Medicare Medicare Compliance COVID-19 40

Health Law Advisor

AUGUST 14, 2023

3] As indicated above, the temporary waiver that allowed mailing or home delivery of DME during the COVID-19 PHE expired May 11, 2023 and is no longer available. 2, 2023). [2] 2, 2023). [4] 2, 2023). [2] 2, 2023). [4] 11, 2023) 51011, 51019 (Sept. 5, 2007) (emphasis added). [5] at 51020. [6]

COVID-19 52

COVID-19 Medicare Medicare Public Health 52

Innovaare Compliance

OCTOBER 6, 2022

According to the Centers for Medicare & Medicaid Services (CMS), enrollment in MAPD keeps rising. And, in 2023, there will be more enrollees in MAPD than in original Medicare. Another highly anticipated change to begin on January 1, 2023 pursuant to the IRA is the $35 cap per month on out-of-pocket costs to Medicare beneficiaries.

Medicare 52

Medicare Medicare Compliance Public Health 52

Bill of Health

JANUARY 23, 2024

Medicaid pays for more than 40% of births in the U.S., Examining efforts at the federal and state level, I highlight three options, leveraging Medicaid as a policy lever. In the past, when individuals were Medicaid-eligible due to pregnancy, federal law required states to provide coverage for at least 60 days postpartum.

Medicaid 111

Medicaid Medicaid Patient Satisfaction Health Insurance 111

Hall Render

MAY 2, 2023

CMS expects all providers to be in compliance with the requirements for PASARR with all admissions taking place after May 11, 2023. The CMS Memo provides that this means that all new SNF stays beginning on or after May 12, 2023 will require a qualifying hospital stay before Medicare coverage. Benefit Period Blanket Waiver.

Nursing Homes 40

Nursing Homes Public Health Nurses COVID-19 40

Healthcare IT News - Telehealth

FEBRUARY 3, 2023

The Telehealth Benefit Expansion for Workers Act would amend the Public Health Service Act, the Employee Retirement Income and Security Act of 1974 and the Internal Revenue Code of 1986 to allow employers to treat benefits for telehealth services like excepted benefits. In an announcement about the bipartisan bill, Rep.

Public Health 157

Public Health COVID-19 Medicare Medicare 157

Health Populi

JUNE 23, 2023

If you live in Massachusetts, Hawaii, and New Hampshire, you win a kind of state lottery for public health and well-being, based on this year’s read of the 2023 Scorecard on State Health System Performance from The Commonwealth Fund. states ranked by a mash-up of health system indicators.

COVID-19 129

COVID-19 Health Outcomes Medicaid Medicaid 129

Jane Sarashon

JUNE 5, 2023

in 2023, and millions of more people worldwide. Just in time for #ASCO2023, the IQVIA Institute published their annual report on Global Oncology Trends 2023 – Outlook to 2027 , an update featuring pipelines, therapy approvals, research updates, costs of oncology products, and patients. .”

Medicaid 52

Medicaid Medicaid Health Insurance COVID-19 52

HIPAA Journal

APRIL 25, 2023

Data breaches have recently been announced by Santa Clara Family Health Plan, United Steelworkers Local 286, Robeson Health Care Corporation, Two Rivers Public Health Department, and NewBridge Services. According to the notification, malware was detected within its network on February 21, 2023.

Health Insurance 84

Health Insurance Public Health Ransomware Fraud 84

Healthcare IT Today

NOVEMBER 12, 2023

News The 2024 Medicare Physician Fee Schedule continues many telehealth flexibilities first adopted during the public health emergency, such as an expanded scope of originating sites an expanded definition of qualified practitioners. As a result, these flexibilities will be in place until at least Dec. 1, 2024.

Payment Systems 109

Payment Systems Public Health Medicare Medicare 109

Healthcare IT Today

APRIL 2, 2023

With the end of the public health emergency, DEA is proposing a rollback on flexibility for remote prescribing. If the DEA’s proposed rules become final, ATA warned in a statement , patients “will fall through the cracks, creating a significant and avoidable public health crisis.”

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Nurses Medical Billing Telemedicine Public Health 85

Healthcare Law Blog

MAY 16, 2022

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). Additional Opportunities for Integration through State Medicaid Agency Contracts (§ 422.107).

Medicare 52

Medicare Medicare Medicaid Medicaid 52

HIT Consultant

JANUARY 23, 2023

What to expect in US healthcare in 2023 and beyond The US healthcare industry faces demanding conditions in 2023, including recessionary pressure, continuing high inflation rates, labor shortages, and endemic COVID-19. But players are not standing still.

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COVID-19 Medicaid Medicaid Public Health 52

Health Law RX

APRIL 27, 2023

On April 11, 2023, the Department of Health and Human Services’ Office for Civil Rights (OCR) confirmed that four notifications of enforcement discretion regarding enforcement of the HIPAA Privacy, Security, and Breach Notification Rules (the HIPAA rules) during the COVID-19 public health emergency (PHE) will expire at the end of the PHE.

COVID-19 52

COVID-19 COVID-19 Vaccine HIPAA Public Health 52

Bill of Health

DECEMBER 6, 2023

The Consolidated Appropriations Act of 2023 requires Medicaid plans to publish and update accurate and searchable provider directories. Both private and public insurance reimbursement rates are not comparable to what mental health providers could make if they charged patients out-of-pocket.

Governance 144

Governance Medicaid Medicaid Medicare 144

Hall Render

DECEMBER 6, 2022

non-cash or cash equivalent) compensation to physicians up to an aggregate amount of $489 for calendar year 2023. The $5,000 limit is adjusted annually for inflation and will increase from the 2022 limit of $5,270 to $5,702 beginning January 1, 2023 for the 2023 calendar year. New Exception for Limited Remuneration.

COVID-19 40

COVID-19 Hospitals Overpayments Overpayment 40

HIT Consultant

AUGUST 5, 2022

CMS Proposed Changes to the Physician Fee Schedule 2023 : On July 7, 2022, the CMS announced that it is soliciting public comment on proposed policy changes for Medicare payments under the Physician Fee Schedule (“PFS”) effective on or after January 1, 2023. in CY 2023. from $34.61 in CY 2022 to $33.08 in the quarter.

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Telemedicine Medicaid Medicaid Malpractice 95

Healthcare Law Blog

NOVEMBER 1, 2022

CMS announced today a further extension until February 1, 2023, of the deadline for its publication of the long-awaited final rule on the use of extrapolation and the application of a fee-for-service adjuster (FFS Adjuster) in risk adjustment data validation (RADV) audits of Medicare Advantage organizations (MAOs). FOOTNOTES. [1]

Medicare 52

Medicare Medicare COVID-19 Public Health 52

Healthcare IT Today

APRIL 21, 2023

Funding Will Grow Medication Adherence Services for Medicaid and Other Under-Resourced Populations Scene Health , the leading medication engagement company, has closed an oversubscribed $17.7 Originally announced April 11th, 2023 This financing brings the total investment in Scene to over $25 million since its founding in 2014.

Medicaid 57

Medicaid Medicaid Medicare Medicare 57

Hall Render

JUNE 5, 2023

On May 31, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released a final rule (“Final Rule”) that withdraws the COVID vaccine requirement for health care workers of Medicare-certified and Medicaid-certified long-term care facilities (“LTC Facilities”). The Final Rule will be effective on August 4, 2023.

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COVID-19 Medicaid Medicaid Medicare 40

HIPAA Journal

JUNE 26, 2023

In the context of HIPAA enforcement discretion, the Secretary can waive sanctions and penalties that result from non-compliance with the following standards of the Privacy Rule: 164.510 – Uses and disclosures of Protected Health Information requiring an opportunity for the individual to agree or object.

HIPAA 70

HIPAA COVID-19 COVID-19 Vaccine Public Health 70

Jane Sarashon

FEBRUARY 27, 2024

The aspirational document sets out the mission that “every individual deserves the right to obtain health care that is comprehensive, equitable and compassionate.” Health Populi’s Hot Points: Is there an American Civil Right for health care?

ACA 113

ACA Prescription Drug Pricing Health Insurance Hospitals 113

Kaiser Health News

MARCH 15, 2022

But the new benefit for people enrolled in Medi-Cal, the state’s Medicaid health insurance program, has been delayed twice as the state and doulas — nonmedical workers who help parents before, during, and after birth — haggle over how much they should get paid.

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Medicaid Medicaid Health Insurance Public Health 80

Healthcare Law Blog

JANUARY 31, 2023

[ii] Investments in behavioral digital health services have the potential to transform the healthcare system in several key areas. In November 2020, Oregon became the first state to legalize psilocybin-assisted therapy and began accepting applications for licensure on January 2, 2023. [v] vi] “Psychedelic Therapeutics Market Worth $8.31

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COVID-19 Medicare Medicare Medicaid 105