Medisys Compliance

NOVEMBER 6, 2023

Introduction Orthopedic billing compliance is essential for healthcare providers to avoid costly audits and penalties. By following a comprehensive orthopedic billing compliance checklist, providers can ensure that their claims are accurate, complete, and supported by proper documentation.

Compliance 59

Compliance Medical Billing Outsourcing Medical Billing ACA 59

MedTrainer

MAY 10, 2024

This process is vital for enhancing the accessibility and affordability of mental health services, aligning with the comprehensive healthcare coverage expansions under the Affordable Care Act ( ACA ). It can also be a prerequisite for enrolling with an insurance network or Medicare for the first time. Effective Jan.

Licensing 52

Licensing ACA Medicare Medicare 52

Healthcare Law Blog

JANUARY 26, 2023

Medicaid and Medicare The Balanced Budget Act of 1997, Public Law 105–33, 111 Stat. The Medicaid and Medicare statutes also contain conscience provisions related to the performance of advanced directives, religious nonmedical healthcare providers and their patients.

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ACA Medicaid Medicaid Compliance 105

MedTrainer

JUNE 28, 2023

Benefits of the CFE in Healthcare Compliance Working with a CFE gives providers access to specialized skills, knowledge, and resources for effectively managing fraud risks. They can also help strengthen compliance programs and protect against financial losses due to fraudulent activities. Compliance Program Enhancement.

Fraud 52

Fraud Compliance Governance Compliance Officers 52

Medisys Compliance

APRIL 25, 2023

Need of Choosing Oncology Billing Company As an oncology practice, selecting the right billing company is a crucial decision that can significantly impact your financial success and regulatory compliance. On the other hand, a wrong choice can lead to delayed payments, billing mistakes, and even regulatory non-compliance issues.

Regulatory Compliance 52

Regulatory Compliance Compliance ACA Medical Billing Outsourcing 52

Medisys Compliance

JULY 27, 2022

For dates of service on or after calendar year 2030, Medicare waives the coinsurance. In addition, the ACA amended Section 1833(b)(1) of the Act to waive the Part B deductible for screening colonoscopies, which includes moderate sedation services as an inherent part of the screening colonoscopy procedural service.

Medical Billing 52

Medical Billing Medical Billing Outsourcing ACA Medicare 52

Bill of Health

APRIL 13, 2022

After the PHE, states can facilitate smooth transitions for those no longer eligible for Medicaid by taking advantage of the full 12- to 14- month period that the Centers for Medicare & Medicaid Services (CMS) has established for redetermining eligibility.

Medicaid 144

Medicaid Medicaid COVID-19 Public Health 144

Med-Net Compliance

NOVEMBER 8, 2022

The inspection objective was to determine whether the direct care licensed nursing hours recorded at the nursing home supported the hours submitted to the US Centers for Medicare & Medicaid Services (CMS) in compliance with federal requirements.

Nursing Homes 59

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

Verisys

MARCH 24, 2022

We’ll explore what the OFAC Sanctions List means for healthcare organizations, how maintaining compliance with OFAC rules reduces reputational, financial, and patient risk, and the steps individual providers and entities can take to be removed from the OFAC list. businesses and individuals. However, the U.S.

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ACA Compliance Governance Medicaid 52

Healthcare Law Blog

MARCH 25, 2022

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger insurers. United States Dep’t of Health & Hum. 20-50963, 2022 WL 807554, at *1 (5th Cir. The Risk-Adjustment Program.

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ACA US Department of Health and Human Services Health Insurance Medicaid 52

MedTrainer

NOVEMBER 15, 2023

In the United States, there are several compliance frameworks and entities that govern requirements for the healthcare industry. Each governing body oversees a different aspect of regulatory compliance. To understand which compliance frameworks govern which requirements, we need to break it down entity by entity.

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Compliance Framework Governance Compliance Medicaid 52

Healthcare Law Blog

DECEMBER 15, 2022

The Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule , “Advancing Interoperability and Improving Prior Authorization Processes” (the “Proposed Rule”), that is intended to improve patient and provider access to health information and streamline processes related to prior authorization for medical items and services.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Hall Render

SEPTEMBER 1, 2023

Louis hospital ‘You can’t do this to people’: Patients say they waited 12 hours to be treated at hospital Missouri health system names CEO Petitions seek to add rape, incest exceptions to Missouri abortion law Cigna exiting ACA exchanges in Kansas, Missouri for 2024 ‘It’s a win-win for everybody’: Gov.

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

MedTrainer

AUGUST 2, 2023

Auditing helps healthcare organizations maintain accurate and appropriate documentation, optimize revenue, minimize compliance risks, and improve overall operational efficiency. The Importance of Medical Auditing From a compliance standpoint, medical auditing serves several important purposes within healthcare organizations.

Compliance 52

Compliance ACA Medicaid Medicaid 52

Compliance Now

JANUARY 13, 2022

To comply with the ACA, non-grandfathered health plans cannot require a participant to pay more out-of-pocket during the plan year than the amounts listed below. Under the ACA, the out-of-pocket limitation requirement directly applies to essential health benefits. This is a $.13

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ACA Health Insurance Medicaid Medicaid 113

Hall Render

AUGUST 19, 2022

UnitedHealth Group buys Medicare insurer in Texas. Cleveland Clinic, UH, other area hospitals earn five stars in Centers for Medicare and Medicaid ratings. UnitedHealth Group buys Medicare insurer in Texas. Hospitals, patient group dispute Virginia price transparency compliance. CVS Health makes $18.9M Twenty states, D.C.

COVID-19 40

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

US Department of Health and Human Services 40

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

Healthcare Law Blog

AUGUST 25, 2022

The expansive legislation includes key health care provisions, including drug pricing reforms, inflationary rebates, Medicare Part D benefit redesign, as well as myriad other updates. Medicare Drug Price Negotiation Program. Program Compliance. Penalties under the Program are severe.

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Medicare Medicare Medicaid Medicaid 52

Healthcare Law Blog

MAY 17, 2022

On January 5, 2022, we discussed the Notice of Benefit and Payment Parameters for 2023 proposed rule released by the Centers for Medicare & Medicaid Services (CMS). On April 28, 2022, CMS issued the NBPP 2023 Final Rule. CMS published a Fact Sheet and other resources on April 28, 2022.

ACA 52

ACA Health Insurance Medicaid Medicaid 52

Hall Render

JULY 1, 2022

Medicare’s physician pay system is ‘unsustainable,’ trustees say. Supreme Court backs HHS approach to Medicare payments for hospitals serving low-income patients. Supreme Court rules in favor of HHS in Medicare disproportionate share payments case. GV hospital moves closer to possible closure. CONNECTICUT.

US Department of Health and Human Services 40

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

HIT Consultant

OCTOBER 10, 2023

Section 1557, known as the “Health Care Rights Law,” is the main nondiscrimination provision of the Affordable Care Act (ACA). For healthcare providers, compliance with these regulations is not only a legal obligation but also critical to addressing health disparities and improving patient outcomes.

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Compliance ADA Informed Consent ACA 111