YouCompli

AUGUST 22, 2023

Approximately 65 million Americans are enrolled in Medicare – about 34 million in traditional Medicare and the rest in Medicare Advantage. Traditional Medicare is administered by the federal government, and individuals pay a separate monthly premium for hospital visits, doctors/outpatient, and prescription drugs.

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Medicare Medicare US Department of Health and Human Services Compliance 52

Compliancy Group

FEBRUARY 12, 2024

In one incident, a New Jersey pharmacy admitted to conspiracies to defraud benefits providers, including Medicare and Medicaid, of $65 million for medications never provided to patients. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received.

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Fraud Medicare Medicare US Department of Health and Human Services 52

Med-Net Compliance

OCTOBER 27, 2022

A federal jury convicted a licensed Illinois psychologist of defrauding Medicare over the course of several years by causing the submission of fraudulent claims for psychotherapy services he never provided. He is scheduled to be sentenced on April 18, 2023, and faces a maximum penalty of 10 years in prison on each count.

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

Med-Net Compliance

SEPTEMBER 20, 2022

million scheme to defraud Medicare by billing for services under another doctor’s name after Medicare revoked his privileges to participate in the program. According to court documents and evidence presented at trial, the podiatrist was revoked from participating in the Medicare program in January 2015.

Fraud 59

Fraud US Department of Health and Human Services Medicare Medicare 59

Innovaare Compliance

JUNE 21, 2023

The Inflation Reduction Act of 2022 has wide-ranging impact on payments for drugs used by Medicare beneficiaries, whether they are administered in the provider’s office (Part B) or used in the ambulatory setting (Part D). Part B drugs have had the fastest spending growth for drugs for Medicare. percent annually.

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US Department of Health and Human Services Medicare Medicare Medicaid 52

Jane Sarashon

MARCH 12, 2024

That’s TMI for me to write about in the Health Populi blog, but this story has a current-events twist: the pharmacist could not electronically link with my insurance company to transact my payment. He tried a few work-flows, and ended up using a discount card which in the moment worked for us, and I paid the marked-down discount price.

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US Department of Health and Human Services Hospitals Medicare Medicare 75

Healthcare Law Blog

MARCH 7, 2023

The Centers for Medicare & Medicaid Services (“CMS”), on behalf of the U.S. Department of Health and Human Services (“HHS”), recently issued a proposed rule to adopt standards under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) for “health care attachment” transactions (the “Proposed Rule”).

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US Department of Health and Human Services HIPAA Medicaid Medicaid 52

YouCompli

NOVEMBER 30, 2022

How to use the SBAR Framework. The same tool nurses use to communicate about health emergencies – can help you secure investment in your compliance department. . While its primary use is in clinical cases, healthcare professionals across the organization are finding it useful for communicating with clinical leaders.

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Regulatory Compliance US Department of Health and Human Services Compliance Compliance Officers 52

Natalia Mazina

APRIL 25, 2023

Safety-net providers play a critical role in delivering healthcare services in this country. On another, Medicare Part B recently challenged payments to 340B providers. Medicare reimbursement cut In 2018, CMS implemented a 28.5% As a result, the use of contract pharmacies increased twentyfold. 2023) 58 F.4th

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US Department of Health and Human Services Medicare Medicare Payment Systems 52

C&M Health Law

JANUARY 20, 2023

This builds on the HIPAA Transactions Rule standards for financial and administrative transactions among health care providers and health plans and aligns with Department of Health and Human Services (HHS) interoperability regulations. Comments on the proposed rule are due March 21, 2023.

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HIPAA US Department of Health and Human Services Compliance Health Insurance 52

Healthcare IT News - Telehealth

SEPTEMBER 28, 2022

David Gray When President Joe Biden recently declared on national television that “the pandemic is over,” he offered a glimpse into the strategy his administration will be using on COVID-19 going forward: We’re ready to move on. What this means for telehealth and connected health policy.

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COVID-19 Public Health US Department of Health and Human Services Medicare 159

Healthcare IT News - Telehealth

SEPTEMBER 27, 2022

David Gray When President Joe Biden recently declared on national television that “the pandemic is over,” he offered a glimpse into the strategy his administration will be using on COVID-19 going forward: We’re ready to move on. What this means for telehealth and connected health policy.

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COVID-19 Public Health US Department of Health and Human Services Medicare 151

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. Ankit Gupta, CEO at Bicycle Health.

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US Department of Health and Human Services Doctors Telemedicine Public Health 101

HIPAA Journal

MARCH 29, 2024

While it is currently unclear what types of data were stolen in the attack, UnitedHealth Group said personally identifiable health information, eligibility and claims information, and financial information are likely to have been compromised. United Health Group has also confirmed that it has paid out more than $3.3 40% of the $3.3

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Ransomware US Department of Health and Human Services HIPAA Hospitals 95

Verisys

AUGUST 14, 2023

US Drug Enforcement Administration (DEA): Public Notice: The DEA has issued a notice of a public listening session requesting input concerning the practice of telemedicine with regards to controlled substances and potential safeguards that could effectively prevent and detect diversion of controlled substances prescribed via telemedicine.

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US Department of Health and Human Services Licensing Telemedicine Medicare 52

AIHC

FEBRUARY 16, 2024

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.” The result?

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

AIHC

FEBRUARY 16, 2024

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.” The result?

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

Healthcare IT News - Telehealth

JANUARY 4, 2021

Financial/Revenue Cycle Management Population Health Precision Medicine Telehealth Workforce From vaccines to virtual care, enterprise imaging to precision medicine, these are the growth areas that will shape the direction of healthcare, this year and beyond.

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US Department of Health and Human Services COVID-19 COVID-19 Vaccine Hospitals 218

Healthcare IT News - Telehealth

DECEMBER 5, 2022

Health equity and technological innovation are top priorities for the healthcare industry – with new standards, technology and policy driving the way. Despite innovations, a new study from the Yale School of Public Health finds the nation is losing ground on access to healthcare, with more barriers now than 20 years ago.

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US Department of Health and Human Services Medicaid Medicaid Department of Veterans Affairs 207

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

Bill of Health

SEPTEMBER 19, 2024

This post launches a new Digital Symposium: Supreme Court Preview: Key Health Law Issues for the 2024 Term , guest edited by Cary Franklin , Professor of Law, McDonald/Wright Chair of Law, and Faculty Director of the Center on Reproductive Health, Law, and Policy and the Williams Institute at UCLA Law; and Lindsay F.

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US Department of Health and Human Services Public Health FDA Health Care Access 100

Hall Render

FEBRUARY 2, 2024

NATIONAL Amazon Pharmacy, One Medical pilot program integrates medication consultations Bad news for FTC’s noncompete ban Cigna to sell Medicare business to HCSC for $3.3B

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses Hospitals 40

Hall Render

JUNE 7, 2024

News ranks hospitals in health equity. These hospitals earn top honors. These hospitals earn top honors. facility Southern Research CEO talks biotech incubator, future of Birmingham medicine ALASKA Juneau’s hospital is bleeding cash. list includes 3 from Arizona ARKANSAS Children’s Miracle Network Raises $5.4M

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US Department of Health and Human Services Nurses Hospitals Nursing Homes 40

Hall Render

JUNE 21, 2024

NATIONAL 50% of U.S. to buy property. NATIONAL 50% of U.S. to buy property. NATIONAL 50% of U.S. to buy property. The deal fell through, but that won’t solve Bartlett’s budget issues. Kenai Peninsula Borough Assembly considers $38.5M Kenai Peninsula Borough Assembly considers $38.5M

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US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

JUNE 28, 2024

NATIONAL 50% of physicians are thinking of leaving the field due to shortage AHA backs bid to repeal nursing home staffing rule AHA wins lawsuit against HHS over third-party web tracking AHA responds to study blaming hospital prices for societal issues AHA slams study tying unemployment to hospital price increases Behind the battle against corporate (..)

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US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

OCTOBER 11, 2024

NATIONAL 92% Of U.S.

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US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

DECEMBER 13, 2024

operating margin in Q3 JLL Arranges $13.4M operating margin in Q3 JLL Arranges $13.4M operating margin in Q3 JLL Arranges $13.4M operating margin in Q3 JLL Arranges $13.4M operating margin in Q3 JLL Arranges $13.4M

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US Department of Health and Human Services Nursing Homes Hospitals Nurses 40

Hall Render

SEPTEMBER 20, 2024

Mesa hospital Phoenix bioscience boom poised to improve health care and local economy, proponents say What’s next for Steward hospitals in Arizona?

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US Department of Health and Human Services Nurses Hospitals Nursing Homes 40

Hall Render

DECEMBER 29, 2023

NATIONAL 4 largest healthcare data breaches of 2023 Anesthesia practices sue CMS over reimbursement method Antitrust enforcements hit a high in 2022, with health deals impacted ASCs face leadership exodus CMS floats appeals process over observational stays CMS proposes additional Medicare appeals processes FTC eyes healthcare mergers, report shows (..)

Nursing Homes 40

Nursing Homes US Department of Health and Human Services COVID-19 Nurses 40

Hall Render

JUNE 14, 2024

NATIONAL AHA Comments on CMS’ Inpatient Payment Proposal for FY 2025 AHA urges CMS to make Transforming Episode Accountability Model voluntary AMA adopts new policy to create equity in clinical trials and research DOJ loses bid to toss Humana Medicare Advantage case Drug shortages hit highest number since 2001, impacting patients, hospitals and pharmacies (..)

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

OCTOBER 6, 2023

The CDC has stopped printing them Telehealth Visits Decline 46%, But Telebehavioral Healthcare Still High URAC to offer health equity accreditation Walgreens CIO is latest to leave in company’s C-suite shakeup AI is creating a complex landscape for healthcare executives ALABAMA Alabama hospital to remain on Cerner after sale Alabama gets $3.6M

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

OCTOBER 6, 2023

The CDC has stopped printing them Telehealth Visits Decline 46%, But Telebehavioral Healthcare Still High URAC to offer health equity accreditation Walgreens CIO is latest to leave in company’s C-suite shakeup AI is creating a complex landscape for healthcare executives ALABAMA Alabama hospital to remain on Cerner after sale Alabama gets $3.6M

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

MARCH 31, 2023

in 2022, survey finds Senate votes to end COVID-19 national emergency Why are 600+ rural hospitals at risk of closing? in 2022, survey finds Senate votes to end COVID-19 national emergency Why are 600+ rural hospitals at risk of closing? What happens if it disappears?

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US Department of Health and Human Services Nursing Homes COVID-19 Nurses 40

Hall Render

JULY 28, 2023

million for rural hospital expansion Hospices in Arizona & other states receive scrutiny over concerns of fraud, waste & abuse Phoenix Children’s Building New 44,000-Square Foot Level IV Neonatal Intensive Care Unit Firefighters oppose Banner’s planned $400M hospital There’s a growing nurse shortage in Arizona.

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US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

APRIL 29, 2022

CMS’ Brooks-LaSure defends 2023 pay bump for hospitals that groups charge is too small. County Struggles with Income Affect Social Determinants of Health. HHS puts $90 million toward addressing health disparities through data. Hospitals sue HHS over Medicare billing calculation. CMS Proposes $1.6B

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COVID-19 US Department of Health and Human Services Nursing Homes Nurses 40

Hall Render

MAY 26, 2023

Experts say why it matters.

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Nursing Homes US Department of Health and Human Services Nurses COVID-19 40

Hall Render

SEPTEMBER 16, 2022

4 Health Systems Join Provider-Created Data Collective to Improve Care. House passes reform to Medicare Advantage prior authorizations. Why asking about social determinants of health is so important. Alabama Women’s Health Center Suffers Data Breach, 34K Impacted. Banner Health’s big bet on population health.

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US Department of Health and Human Services COVID-19 Nurses Nursing Homes 40