Compliancy Group

JANUARY 3, 2024

This is why a regular review of these contracts is essential so that providers and administrators can clear up uncertainties in the terms or conditions, remain compliant, and ensure the payer is engaging in fair practices.

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 52

Healthcare Law Today

JANUARY 2, 2023

As written, the proposed rule would remove the existing “reasonable diligence” standard for identification of overpayments, and add the “knowing” and “knowingly” FCA definition.

Overpayments 52

Overpayments Overpayment ACA Medicare 52

MedTrainer

MARCH 28, 2024

The answer has as many layers as the definition of compliance itself. But that’s only one aspect of this complex – and sometimes confusing – process. Just as perplexing is who is responsible for compliance in healthcare organizations.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

Health Populi

FEBRUARY 5, 2020

The American Academy of Family Physicians offers several definitions , which I’ve mashed up here. In the U.S., more health plans are attending to SDoH, and physicians at the front-end challenged with this coordination work-flow. So what is primary care, anyway?

Patient Advocacy 143

Patient Advocacy Health Insurance HIPAA Doctors 143

Health Populi

MAY 6, 2018

For poorer citizens, that under-insured definition falls to spending 5% of household income on healthcare payments. banks’ definition of “prime” customers, and 53 mm people are “credit invisibles” without sufficient financial history to build a FICO score.

Medicaid 54

Medicaid Medicaid Medicare Medicare 54

Health Populi

OCTOBER 22, 2019

In the 2019 dictionary next to the word “stress,” we would find variations of a definition all deriving from Americans’ current worries about their money, the economy, and health care costs…then, family responsibilities and jobs. The 7th Annual U.S.

Prescription Drug Pricing 52

Prescription Drug Pricing Health Insurance Doctors Governance 52

Health Populi

JUNE 18, 2018

People with diabetes have, by definition, a pre-existing condition when they seek health insurance. The session was sponsored by the Center for Health Journalism at the Annenberg School. Jost and Armour discussed the ramifications of the U.S. Department of Justice effort to erode the Affordable Care Act.

Health Insurance 52

Health Insurance Hospitals ACA Public Health 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

Hall Render

FEBRUARY 21, 2023

Proposed Revision to Form CMS-855A The proposed rule seeks to provide definitions of private equity company and real estate investment trust, whereby SNFs would disclose whether each direct and indirect owning or managing entity is a private equity company or real estate investment trust through a CMS-855A.

Nurses 40

Nurses Medicaid Medicaid Medicare 40

Healthcare Law Blog

MAY 11, 2023

Broad Implications for Preventative Health Care Section 2713 of the ACA , requires health plans and health insurers to provide coverage for a range of “preventative care services” without patient cost-sharing. The ACA’s definition of “preventative care services” includes certain services recommended by the USPSTF, the U.S.

ACA 52

ACA Health Insurance Patient Advocacy 52

Bill of Health

MAY 12, 2023

Fifteen states require insurers to cover some infertility care, though these mandates are riddled with holes: caps on total benefits, lack of express inclusion of IVF, marriage requirements, definitions of infertility that exclude same-sex couples, and other lurking exceptions.

ACA 241

ACA Medicaid Medicaid Health Insurance 241

CMS.gov

OCTOBER 22, 2018

After the Affordable Care Act’s (ACA) regulations took effect, we have witnessed a serious deterioration of the individual market across the country because of skyrocketing costs and the withdrawal of insurance plans. As the ACA regulations took effect, choice plummeted and premiums soared.

Health Insurance 55

Health Insurance ACA Medicaid Medicaid 55

Hall Render

OCTOBER 27, 2023

Louis-based health system to form Michigan joint venture Mercy opens ‘high-tech’ multispecialty center, ASC in St. finds new C-suite exec at a subsidiary MONTANA COVID Map Shows Five States With ‘Substantial Increase’ in Hospital Admissions St. RHODE ISLAND Lifespan, largest hospital owner in R.I.,

US Department of Health and Human Services 40

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

Healthcare Law Blog

MAY 17, 2022

Here, the final rule provides no definitions of “clinically based” or “clinically indicated.”. The final rule declined to finalize any changes, however, because HHS’s Office of Civil Rights (OCR) is developing a rule that also will address prohibited discrimination based on sex in health coverage under ACA Section 1557.

ACA 52

ACA Health Insurance Medicaid Medicaid 52

Compliance Now

OCTOBER 13, 2022

The Biden Administration issued a final regulation and a new IRS notice on October 11, 2022, which eliminate the Affordable Care Act’s (ACA) “family glitch” beginning on January 1, 2023. The preamble to the final rule also explicitly states that the policy change will not impact ACA reporting for either ALEs or health insurance issuers.

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ACA Health Insurance Hospitals 100

Compliance Now

OCTOBER 13, 2022

The Biden Administration issued a final regulation and a new IRS notice on October 11, 2022, which eliminate the Affordable Care Act’s (ACA) “family glitch” beginning on January 1, 2023. The preamble to the final rule also explicitly states that the policy change will not impact ACA reporting for either ALEs or health insurance issuers.

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ACA Health Insurance Hospitals 100

Health Populi

NOVEMBER 2, 2020

Health is translating across all definitions for U.S. In this pandemic time, we vote not just for health care , with concerns about the potential for an ACA repeal from the bench of the newly-re-formed U.S. In 2020, as voting commences in-person tomorrow on 3 rd November, U.S. voters have lives and livelihoods on their minds.

COVID-19 17

COVID-19 ACA Nurses Public Health 17

Hall Render

MAY 12, 2023

has gotten worse over last two years Massachusetts hospitals ‘pummeled’ by workforce shortage, driving $1.52 billion in temporary labor costs UMass Chan ranked 13 for primary care education in US News & World Report One hospital in central Mass.

COVID-19 40

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

Kaiser Health News

JANUARY 12, 2023

But I agree that there’s definitely more to look at. In the meantime, though, my colleagues over the firewall at KFF report that some 5 million more uninsured Americans are actually eligible for free health care coverage under the ACA. But the Republicans definitely have moved on to other targets.

US Department of Health and Human Services 52

US Department of Health and Human Services FDA Medicare Medicare 52

Kaiser Health News

FEBRUARY 9, 2023

So it’s definitely not a good indication for a lot of these things. And, you know, the ACA, or Obamacare, actually made a lot of headway in covering big swaths of the uninsured population. I’m old enough to remember fights over the ACA, death panels, and the independent Medicare advisory board that never happened.

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare FDA 52