Compliancy Group

JANUARY 3, 2024

Medical billing compliance ensures that providers and administrators engage in ethical and accurate billing practices. It pays to know the law and avoid temptations to cut corners.

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 52

MedTrainer

JUNE 28, 2023

The primary goal of a Certified Fraud Examiner in healthcare is to safeguard the integrity of healthcare systems and protect patients, insurance providers, and government programs from financial losses due to fraudulent activities. Health Insurance Portability and Accountability Act (HIPAA). Anti-Kickback Statute (AKS).

Fraud 52

Fraud Compliance Governance Compliance Officers 52

Healthcare Law Blog

MARCH 20, 2023

1] In addition to the challenges presented by provider shortages, even when patients are able to locate an available mental health provider, many are hesitant to engage in treatment due to cost uncertainties, which often arise due to limited availability for in-network care and the subsequent need to seek out-of-network care. [2]

Medicaid 52

Medicaid Medicaid Licensing ACA 52

MedTrainer

MARCH 28, 2024

Establishes a governance structure, reviews compliance reports, and ensures the organization operates ethically and within legal boundaries. Law by law, regulations were added, increasing the complexity of maintaining compliance for healthcare organizations. Cons: Limited focus on other aspects of compliance beyond their specific areas.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

Medisys Compliance

APRIL 25, 2023

It is crucial to verify that the billing company is adhering to industry standards, such as HIPAA (Health Insurance Portability and Accountability Act) regulations, which protect patients’ medical information.

Regulatory Compliance 52

Regulatory Compliance Compliance ACA Medical Billing Outsourcing 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.

Compliance Framework 52

Compliance Framework Governance Compliance Medicaid 52

Healthcare Law Blog

APRIL 6, 2022

On April 1, 2022 , the Centers for Medicare & Medicaid Services (“CMS”) announced states may seek to extend Medicaid postpartum coverage from 60 days to one year through a new state plan option offered by the American Rescue Plan Act (“ARPA”). In states that have not expanded Medicaid, however, many postpartum women lose coverage.

Medicaid 52

Medicaid Medicaid ACA Public Health 52

Kaiser Health News

JULY 6, 2022

. “There are still some gaps that need to be filled,” said Katie Keith, a researcher at the Center on Health Insurance Reforms at Georgetown University. Your insurance matters. The ACA does set parameters. As the ACA went into effect, trouble spots emerged. Here are five other things to know: 1.

ACA 80

ACA Medicare Medicare Medicaid 80

Center for Health Insurance Reform

JANUARY 20, 2022

The federal government has taken a series of actions to strengthen the Affordable Care Act (ACA) and Medicaid, and the Biden administration has announced its intent to do more in this arena.

ACA 98

ACA Federal Policy Health Insurance Medicaid 98

Health Populi

MAY 6, 2018

.” At the time, this was one of the world’s biggest public-sector financed health plan. Over time, America’s approach to health care provision fragmented by plan sponsor, whether U.S.

Medicaid 54

Medicaid Medicaid Medicare Medicare 54

MedTrainer

AUGUST 2, 2023

Federal Government Audits These audits are performed by government agencies such as the Centers for Medicare and Medicaid Services (CMS). They aim to ensure compliance with federal healthcare programs like Medicare and Medicaid, reviewing claims, billing practices, and overall adherence to program requirements.

Compliance 52

Compliance ACA Medicaid Medicaid 52

Hall Render

AUGUST 19, 2022

Connecticut ditches $20M health information exchange software. Two Health Insurers Grilled for Proposing Rate Increases of 20 and 25 Percent. HCA Florida Fort Walton-Destin Hospital, Okaloosa school district to build health academy. Two Georgia health systems to receive $300M in federal funds. From CIO to CEO?

COVID-19 40

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

Hall Render

MAY 2, 2023

Importantly, when the NE ends, the HHS projects that an estimated 15 million individuals will lose Medicaid or CHIP coverage and will be entitled to a special enrollment period to enroll in an employer-sponsored group health plan. With the expiration of the PHE, these requirements will also end.

Public Health 40

Public Health COVID-19 COVID-19 Vaccine ACA 40

Hall Render

OCTOBER 27, 2023

Here’s why Grady Health System recognized as health care I.T. Million Health Care Fraud Conspiracy in Idaho Orthopedic activity in the 5 most underserved states St. Louis-based health system to form Michigan joint venture Mercy opens ‘high-tech’ multispecialty center, ASC in St.

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

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). The 2023 NBPP final rule makes regulatory changes in the individual and small group health insurance markets and establishes requirements for the 2023 benefit year.

ACA 52

ACA Health Insurance Medicaid Medicaid 52

Hall Render

JANUARY 27, 2023

to revisit whether to set limits for numbers of patients assigned to a nurse Tufts spent $70M on EHR install Wait times for long-term psychiatric care span months for some patients Health care leaders applaud appointment of Kate Walsh as Massachusetts health secretary As ER waits stretch for days, Mass.

US Department of Health and Human Services 40

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

Health Populi

MAY 14, 2018

Seniors and government programs over-paying for drugs. High and rising out-of-pocket costs for health consumers. Foreign governments’ “free-riding” Americans’ investment in innovation. health consumers/voters want to see, shown in the second graph.

Prescription Drug Pricing 48

Prescription Drug Pricing Governance ACA Medicare 48

Health Populi

MARCH 15, 2021

household budgets have been particularly hard-hit in paying off credit cards and bills (23%), paying for food (17%), falling behind paying rent or mortgage (16%), affording health insurance coverage (16%), and paying for medical bills (16%). State Governors to expand Medicaid. electorate is in favor.

COVID-19 112

COVID-19 Health Insurance ACA Medicaid 112

Health Populi

MARCH 27, 2019

Health insurance was on the collective minds of American voters in the 2018 midterm elections. Health care, broadly defined, drove many people to the polls voting with feet and ballots to protect their access to a health plan covering a pre-existing condition or to protest the cost of expensive prescription drugs.

Health Insurance 93

Health Insurance ACA Governance Medicare 93

Health Populi

OCTOBER 19, 2020

Women were surveyed on perspectives for health care in America in the wake of the COVID-19 pandemic, the prospects for the Affordable Care Act and health insurance security, and views on health, well-being, and health care. Women identified the top five personal health issues they face as: Mental health.

COVID-19 105

COVID-19 Health Insurance Prescription Drug Pricing ACA 105

Health Populi

APRIL 3, 2023

public does not want politicians to “up-end” government-funded health programs, according to the Kaiser Family Foundation’s March 2023 Health Tracking Poll. Suddenly, the role of Federal and State governments takes on a very personal role — and value. A majority of the U.S. voters ages 18 and over.

Medicaid 62

Medicaid Medicaid Medicare Medicare 62

Hall Render

MAY 12, 2023

Connecticut is weighing several changes to Medicaid. Cloud Hospital names Chief Quality Officer Tampa’s Lions Eye Institute adopts new name Troubled Cano Health records $60.6M Here’s what it means.

COVID-19 40

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

Kaiser Health News

DECEMBER 23, 2021

President Joe Biden’s top health advisers credited the increased government subsidies, which lowered out-of-pocket costs, for the surge in enrollment. They also said enhanced personal assistance and outreach helped connect more people to health insurance plans. ” The 13.6

Health Insurance 96

Health Insurance ACA Medicaid Medicaid 96

Health Populi

FEBRUARY 6, 2020

Among all Americans, the most popular approach for improving the health care in the U.S. isn’t repealing or replacing the Affordable Care Act or moving to a Medicare-for-All government-provided plan. Addressing employer-sponsored health insurance. Reducing system-wide health care costs. Improving Medicaid.

Health Insurance 76

Health Insurance Medicare Medicare Medicaid 76

Health Populi

JUNE 27, 2019

.” Moving from the macro economy, Lester Holt segued the debate into health care, recognizing that “many at home have coverage with employers.” ” He asked the ten debaters to raise their hands to answer the question: “Who would abolish and do a government-run plan?”

Medicare 85

Medicare Medicare Health Insurance Public Health 85

Health Populi

JUNE 25, 2020

” As health insurance for working-age people is tied to employment, COVID-19 led to disproportionate loss of health plan coverage especially among people earning lower incomes, as well as non-white workers, explained in the Commonwealth Fund Health Care Poll: COVID-19, May-June 2020. .” 23% were Hispanic.

Health Insurance 68

Health Insurance COVID-19 ACA Medicaid 68

Health Populi

JANUARY 24, 2019

.'” I note that note all national health plan designs would need to be tied to Medicare. There are many ways to deliver universal health care to citizens beyond this concept. Paying more in taxes and eliminating private insurance companies would be opposed by most people. from a low of 10.9

ACA 62

ACA Medicare Medicare Health Insurance 62

Health Populi

NOVEMBER 7, 2018

While we have a divided government via split legislature, one winner in the 2018 midterm outcome is Medicaid. As I wrote about yesterday (about learning from Governor Kasich), people keen on healthcare should pay attention to the states, which are laboratories for health reform. pharma costs on reference pricing].

Prescription Drug Pricing 39

Prescription Drug Pricing Medicaid Medicaid Medicare 39

Kaiser Health News

MARCH 24, 2022

health care system, including expanding private insurance coverage and Medicaid coverage to millions of people, banning restrictions based on preexisting medical conditions, providing no-cost preventive care, and adding restrictions on health insurers’ profits. And subscribe to KHN’s What the Health?

ACA 59

ACA Health Insurance Governance Doctors 59

Health Populi

MAY 3, 2019

.” I note that, by the time Americans voted in the 2018 mid-term elections, it was no surprise that lower-income Americans were highly concerned about paying higher premiums, most people earning over $75,000 a year were also very worried about covering the costs of health insurance. health care system , Gallup learned.

ACA 72

ACA Doctors Health Care Reform Health Insurance 72

Kaiser Health News

JANUARY 12, 2023

Indeed, one of the first orders of business in the new Congress was the re-establishment of a committee on the covid pandemic with a new focus on investigating the origins of the virus and the government’s response to it. But also, for the first time, Medicare, or the federal government is starting to take on drug prices directly.

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

Biden’s calls for bipartisanship to extend health programs like pandemic-era subsidies for Affordable Care Act health plans are expected to clash with conservative demands to slash federal government spending. But first, this week’s health news. So that really jumped out at me in the speech as well.

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare FDA 52

Health Populi

JUNE 28, 2019

Harris and VP Biden on race, busing, and segregation — which in the larger public health context continue to have a direct impact on health equity, health disparities, and socio-economic status. Senator Harris, too, mentioned government benefits like free college and Medicare for All as her health plan preference.

Medicare 70

Medicare Medicare Health Insurance Governance 70