Healthcare IT Today

OCTOBER 12, 2023

I talked to Nikki Henck, Senior Director of Utilization Management at Sagility , about the implementation and potential impact of this proposed requirement, which, if finalized, will be enacted in January 2026. The Dilemma of Prior Authorization Prior authorization, also known as a pre-approval, strikes fear into both patients and providers.

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Electronic Medical Records Doctors Governance Medicaid 104

MedTrainer

NOVEMBER 30, 2023

Signed into law on August 28, 2023 with an enforcement date of January 1, 2026, Missouri joins other states in mandating surgical smoke evacuation systems within hospitals and ambulatory surgery centers (ASCs).

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Compliance Compliance Officers Hospitals Public Health 52

Healthcare IT News - Telehealth

JULY 11, 2019

However, the challenge lies in how government institutions such as the Ministry of Public Health (MOPH) can meaningfully engage the private healthcare sector in moving towards VBHC. In healthcare, it is often easy to ‘cut and paste’ solutions from other health systems but sometimes the answers or successful models may lie within.

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Telemedicine Governance Hospitals Health Outcomes 106

Compliancy Group

MAY 30, 2023

However, this law won’t take effect until January 1, 2026, more than two and a half years after it was signed. For instance, healthcare providers are governed by HIPAA, enacted long before any other state-level privacy laws were even considered. This move was long overdue, as privacy concerns have been a hot topic for years.

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HIPAA Compliance Health Insurance Governance 52

HIT Consultant

AUGUST 21, 2023

The rise of high-deductible health plans means more financial responsibility has fallen directly on patients, as out-of-pocket costs have skyrocketed by 111% since 2010 and are projected to increase by 10% each year through 2026. But there’s good news.

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Medical Device Industry Patient Satisfaction Hospitals Governance 98

HIT Consultant

AUGUST 14, 2023

According to government reports, 23% of hospitals are experiencing a significant staff shortage. Furthermore, it predicts that 900,000 nurses will permanently leave the industry by 2026. These critical staffing talent shortages could jeopardize communities’ access to care and result in dire consequences.

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Nurses Hospitals Doctors Governance 98

Verisys

DECEMBER 23, 2022

If a provider fails to obtain a postgraduate training license on or before January 31, 2023, or the governing licensing agency denies the application, all privileges and exemptions under Business and Professions Code section 2064.5 shall automatically cease. Postgraduate Training License Deadlines.

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Licensing Governance Hospitals Doctors 52

Hall Render

FEBRUARY 10, 2023

CVS plans to grow the Oak Street business to 300 locations by 2026. Higher interest rates have resulted in fewer government and non-profit health care providers going to market to place debt. CVS Health announced plans to buy Oak Street Health for $9.5 billion in cash. The sale is designed to improve Tower’s financials.

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Medicaid Medicaid Hospitals Governance 40

Kaiser Health News

JULY 14, 2023

The proposal would have moved more than 200 people off waiting lists for government-supported care and saved the state money by accessing more federal Medicaid money to cover their costs and the cost of those already in assisted living. But Republican Gov. Greg Gianforte vetoed the measure May 18, two weeks after the legislature adjourned.

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Medicaid Medicaid Nursing Homes Nurses 72

Redox

NOVEMBER 21, 2023

The California Health and Human Services Data Exchange Framework (CA DxF) is a novel statewide data-sharing agreement between healthcare providers, health plans, laboratories, government agencies, and social service programs. It was established through CA Assembly Bill 133 in 2021.

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Hospitals Nurses Public Health HIPAA 59

C&M Health Law

MARCH 15, 2022

With a stronger emphasis on provider-led organizations as model participants, participating providers or their proxies must hold at least 75% control of each ACO’s governing body, compared to only 25% in the GPDC. The GPDC model will transition to the ACO REACH model at the end of this calendar year and will run through 2026.

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Medicare Medicare Governance Compliance 52

Medisys Compliance

DECEMBER 1, 2022

These laws governing secrecy are, however, constantly changing, and if not followed correctly, can result in heavy fines. By 2026, the medical billing outsourcing market will be worth $8 million. First, let’s glance through the challenges faced by the New York physicians when it comes to medical billing, shall we? Wrapping Up.

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Medical Billing Medical Billing Outsourcing US Department of Health and Human Services Doctors 52

Health Care Law Brief

MARCH 8, 2022

Under both options, the Direct Contracting Entity’s (DCE) Participating Providers must have held at least 25% of the governing board voting rights. Performance in the ACO REACH Model will span five years through 2026.

Medicare 52

Medicare Medicare Fraud Compliance 52

Healthcare IT Today

MAY 5, 2023

billion by 2026 , driven in part by direct-to-consumer testing for health risks such as breast cancer and physician orders for prenatal testing, tumor molecular profiling and sequencing to diagnose rare disease. The surge in genetic testing claims comes with a rise in fraud, waste and abuse across government and commercial payers.

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Fraud Medicare Medicare Overpayments 62

Healthcare IT Today

JANUARY 27, 2023

Further fueling telehealth’s momentum, the federal government and many states have taken action to require that healthcare providers be reimbursed the same amount for telehealth visits as those in person. billion by 2026 from $16.2 The global wearable devices market is projected to grow to $30.1

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Doctors COVID-19 Telemedicine Governance 69

Provider Trust

OCTOBER 12, 2021

government estimates that >200,000 new RN positions will be created each year from 2016 to 2026. And according to the American Association of Colleges of Nursing , nursing is the largest healthcare profession in the U.S. with more than 3.8 million RNs nationwide. Additionally, of all licensed RNs, 84.5% are employed in nursing.

Licensing 52

Licensing Nurses COVID-19 Public Health 52

C&M Health Law

JANUARY 25, 2023

trillion spending package, which consists of all 12 fiscal year (FY) 2023 appropriations bills and funds the federal government through September 30, 2023, provides additional assistance to Ukraine, and makes numerous health care policy changes. 117-164 ) (the “Act”)—an approximately $1.7

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Medicaid Medicaid Medicare Medicare 104

CMS.gov

OCTOBER 2, 2018

economy, and by 2026 the CMS Office of the Actuary projects that one in every five dollars spent in America will be spent on healthcare. It’s no secret that the government often moves more slowly than private industry — some of our payment policies haven’t been updated in decades.

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Medicare Medicare Payment Systems FDA 44

Health Care Law Brief

FEBRUARY 8, 2024

In addition to those provisions that look to extend current government programs, the HMH Bill proposes the following new initiatives: Provider Specific Provisions : Transforming Safety Net Hospitals. billion to fund Medicaid, $4.8 billion to address serious mental illness and $6 billion in federal funding through the 1115 Waiver.

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Medicaid Medicaid Nurses Licensing 52

Healthcare IT Today

JANUARY 11, 2023

Even though initiatives such as the 988 Suicide and Crisis Lifeline – the behavioral health lifeline akin to 911 – demonstrate the renewed focus on behavioral health from communities and the government, far too many at-risk individuals fall through the cracks because of incomplete, outdated encounters, referrals and prescription data.

Hospitals 108

Hospitals Health Outcomes Public Health Governance 108

C&M Health Law

JANUARY 4, 2024

The United States Core Data for Interoperability Version 3 (USCDI v3): ONC established the USCDI v3 as the new baseline standard of data classes and constituent data elements for certified health IT, effective January 1, 2026.

Public Health 52

Public Health Licensing HIPAA Governance 52

HIPAA Journal

MARCH 17, 2023

A Brief History of HIPAA Enforcement The HIPAA Enforcement Rule – Final Rule was issued on February 16, 2006, and took effect on March 16, 2026. The Enforcement Rule gave the U.S.

HIPAA 87

HIPAA Compliance Health Insurance Governance 87

Bill of Health

SEPTEMBER 9, 2022

Consider, for example, the Coronavirus State and Local Fiscal Recovery Funds Program (SLFRF) — enacted as part of the American Rescue Plan Act — which provided $350 billion in flexible aid to state, local, tribal, and territorial governments. This precludes rebuilding the decimated public health workforce.

Public Health 362

Public Health COVID-19 Public Health Professionals Governance 362

Hall Render

JULY 14, 2023

Under PDGM, CMS must “annually determine the impact of differences between assumed behavior changes … and actual behavior changes on estimated aggregate expenditures” every year from 2020 to 2026. The proposed regulation does not provide any criteria to govern the administrator’s decision.

Medicare 52

Medicare Medicare Payment Systems Governance 52

Hall Render

OCTOBER 13, 2023

Luke’s receives $1.5 Luke’s receives $1.5 David’s forges ahead with new behavioral health hospital after rezoning vote Texas rehab hospital settles ADA case UTAH Fire spurs evacuation at Intermountain hospital Intermountain, Ortho Montana break ground on new ASC U of Utah Health adds new C-suite role $17.5

Nurses 40

Nurses Hospitals Nursing Homes Doctors 40

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

SQA

FEBRUARY 15, 2023

Finalization of the document is planned for 2026. ACT EU features ten priority action areas that are the basis for the ACT EU 2022-2026 workplan. There were seven (7) observations with respect to the following: Quality Control Department: The establishment and/or the maintenance of a data governance plan was inadequate.

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US Department of Health and Human Services FDA COVID-19 World Health 40

SQA

MAY 24, 2023

Having analyzed over 2000 responses received, the government will now take forward legislation to reform of the UK clinical trials regulatory framework that will: Ensure patients and their safety are at the focus of all clinical trials and bring the benefits of clinical trials to everyone.

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FDA Licensing Governance Compliance 40

Hall Render

MAY 10, 2024

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ ranks second nationwide in hospital patient safety, with 7 Central Va. hospitals highly-ranked WASHINGTON DOJ resolves allegations Tacoma spine surgeon billed for unnecessary surgeries WA hospitals lose $1.74

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Nursing Homes Nurses Hospitals Medicaid 40

HIT Consultant

JUNE 7, 2023

About Karen Iapoce RN-BC, MS, CPHQ, CMAC, CAPA, LSSBB Karen Iapoce is the Senior Director of Government Solutions at ZeOmega and has 30+ years of experience in strategic healthcare. Over the years, her titles have ranged from RN to Senior VP of Clinical Operations and Director of Government Solutions.

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Medicaid Medicaid Medicare Medicare 52

HIPAA Journal

APRIL 23, 2024

“This final rule balances the interests of society in obtaining Member Login Username: Password: for non-healthcare purposes with the interests of the individual, the Federal Government, and society in protecting individual privacy, thereby improving the effectiveness of the health care system by ensuring that persons are not deterred from seeking, (..)

HIPAA 89

HIPAA Compliance Doctors Health Insurance 89

Hall Render

MARCH 3, 2023

Clair Health partners with Duquesne University College of Osteopathic Medicine UPMC sees lower operating income in 2022 as economic headwinds persist UPMC settles lawsuit with federal government for $8.5 What does it mean for you?

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

JUNE 3, 2022

Maryland Department of Health releases the 2022-2026 State Plan to Address Alzheimer’s Disease and Related Dementias. Most Oregon hospitals owe federal government for early pandemic loans. Maryland Hospital All-Payer Model: Can It Be Emulated? COVID Infection Data In Maryland Could Be Skewed By At-Home Test Kits, Expert Says.

COVID-19 40

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

Hall Render

JANUARY 27, 2023

NATIONAL Amazon launches $5-a-month unlimited prescription plan CMS begins publicizing disputed nursing home deficiencies CMS Readies Nursing Home Staffing Mandate Proposal, Reviews Study Recommendations Healthcare workers are unhappy with their pay Kroger Health launches clinical trial site network Local anesthetic drug supply: 132 in shortage, 13 (..)

US Department of Health and Human Services 40

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

Healthcare Law Blog

MARCH 2, 2022

The REACH Model will encourage doctors and other health care providers to continue playing a primary role in accountable care, including by requiring that 75 percent control of the ACO’s governing body be held by participant providers or their designated representatives (an increase from the 25 percent control requirement under the GPDC Model).

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Medicare Medicare Governance Medicaid 52

Healthcare Law Blog

JANUARY 5, 2023

The HEI for the 2027 Star Ratings would be calculated using data collected or used for the 2026 and 2027 Star Ratings, and would replace the current reward factor that has been in place since the 2009 Star Ratings. That is, the HEI is specifically designed to create an incentive to reduce disparities in care. lump sum, premium reduction, etc.)

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