Bill of Health

NOVEMBER 9, 2023

has some of the world’s leading medical facilities and research institutions, and the ability to deliver the highest available quality of care, it ranks last among rich nations in providing equitable, accessible, affordable, and high-quality health care. America is the only wealthy nation to lack universal health coverage.

COVID-19 157

COVID-19 Public Health ACA Health Insurance 157

Compliancy Group

MARCH 19, 2024

Hospitals and private practices aren’t the only enterprises with compliance obligations within this sector. Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. No other industry in the U.S.

Regulatory Compliance 52

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

Health Populi

AUGUST 2, 2021

This has raised the importance of price transparency, which is based on the hypothesis that if patients had access to personally-relevant price/cost information from doctors and hospitals for medical services, and pharmacies and PBMs for prescription drugs, the patient would behave as a consumer and shop around.

Doctors 130

Doctors COVID-19 Health Insurance ACA 130

Health Populi

MAY 15, 2019

With lower expectations of and satisfaction with health care, Millennials in America seek three things: available, accessible, and affordable services, research from the Transamerica Center for Health Studies has found. This generation has greater engagement with employers that offer health benefits.

Health Insurance 116

Health Insurance ACA Doctors Hospitals 116

Center for Health Insurance Reform

FEBRUARY 10, 2022

Continue reading → The post January Research Roundup: What We’re Reading appeared first on Center on Health Insurance Reforms.

Health Insurance 98

Health Insurance Medicare Medicare ACA 98

MedTrainer

JANUARY 12, 2024

The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. HIPAA (1996): The Health Insurance Portability and Accountability Act (HIPAA) established strict standards for patient data privacy and security.

Compliance 52

Compliance HIPAA Telemedicine ACA 52

Compliancy Group

JANUARY 3, 2024

This mistake resulted in millions of dollars in lost revenue for hospitals. Because many denied claims can be recovered, providers need to follow up within the window of appeal or before the deadline outlined in the insurance payer contract. Many medical bills are unpaid because providers do not promptly follow up on claim denials.

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 52

Healthcare Law Blog

JANUARY 26, 2023

The amendment defines healthcare entity to include any individual physician or other healthcare professional, a hospital, a provider-sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of healthcare facility, organization, or plan.

ACA 105

ACA Medicaid Medicaid Compliance 105

Healthcare IT Today

APRIL 10, 2023

By understanding the personalized motivation that each member needs to change behaviors—and by helping train these behaviors into lasting habits—we’ve been able to help people from all walks of life dramatically improve their health outcomes. This saved our customers over $24 million just on hospitalization costs alone.

Health Outcomes 103

Health Outcomes Hospitals ACA Doctors 103

Health Populi

JUNE 30, 2023

For this study, PwC conducted 21 surveys and 12 interviews in April through May 2023 among health plan actuaries covering about 100 million employer-sponsored lives and 10 million ACA marketplace members. More patients are coming back to health care, abandoning their personal health mitigation strategy of “medical distancing.”

Prescription Drug Pricing 83

Prescription Drug Pricing COVID-19 ACA Hospitals 83

Health Populi

NOVEMBER 19, 2019

In research from HealthPocket , 2 in 5 Americans said they needed to reduce other household expenses to be able to afford their monthly insurance premiums. Four in ten consumers said their monthly health insurance premiums were increasing. Health insurance costs increased a whopping 20.1%

Health Insurance 68

Health Insurance Hospitals Doctors Nurses 68

Health Populi

APRIL 24, 2018

consumers rank hospitals as the top-trusted segment in the U.S., Otherwise, the news is negative across the remaining four segments: consumer health is the second most-trusted segment, by 56% of Americans, but dropped by 7 percentage points from 2017. Hospitals ranked top in trust among U.S.

Health Insurance 74

Health Insurance Fraud Hospitals Doctors 74

Hall Render

SEPTEMBER 1, 2023

ALABAMA American Family Care opens new health care center in Northeast Birmingham doctors secure $13.9M

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

MedTrainer

JUNE 28, 2023

Health Insurance Portability and Accountability Act (HIPAA). The Affordable Care Act (ACA) also established the Health Care Fraud Prevention and Enforcement Action Team (HEAT) and increased resources for fraud investigations and prosecutions. In addition, the Federal False Statements Act (18 U.S.C.

Fraud 52

Fraud Compliance Governance Compliance Officers 52

YouCompli

AUGUST 9, 2023

From a compliance perspective, this means supporting care teams based on the principles of social determinants of health (SDOH), such as understanding how to access affordable health insurance or obtaining transportation for follow-up appointments.

Compliance 52

Compliance COVID-19 ACA Fraud 52

The Digital Health Corner

APRIL 28, 2017

In his testimony on healthcare market’s consolidation effects on quality, cost and access, Paul Ginsberg, Director of Public Policy at the USC Schaeffer Center for Health Policy and Economics cites some key drivers of consolidation. ACOs require scaling which small hospitals cannot provide.

Hospitals 60

Hospitals ACA Patient Satisfaction Payment Systems 60

Health Populi

SEPTEMBER 5, 2018

The largest patient experience workflows included shopping for health insurance, preparing to see a healthcare provider, connecting with that provider, managing a diagnosis, shopping for services, receiving treatment, and finally, paying for the services. At this moment in U.S.

Health Insurance 63

Health Insurance Medical Billing Medicaid Medicaid 63

Health Populi

JUNE 18, 2018

The bulk of medical costs comprise, Hospital inpatient care (30% of the total medical cost), Prescription medications to treat complications of diabetes (30%), Anti-diabetic agents and diabetes supplies (15%), and, Physician office visits (13%). In the current environment, one in two PwD is already avoiding some care due to costs.

Health Insurance 52

Health Insurance Hospitals ACA Public Health 52

C&M Health Law

NOVEMBER 23, 2020

On October 29, 2020, the Departments of Health and Human Services, Labor, and the Treasury (“the Departments”) issued a final rule requiring private-sector health insurers and self-insured health plans to disclose treatment prices and cost-sharing information with consumers.

Regulatory Compliance 40

Regulatory Compliance Hospitals Compliance Health Insurance 40

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. And, if you get a bill from a physician, clinic, or hospital that you think might qualify for no cost sharing, call your insurer to inquire or dispute the charge.

ACA 76

ACA Medicare Medicare Medicaid 76

Health Populi

MARCH 15, 2018

varied, with that 10% of health citizens lacking coverage for basic health care. had a higher avoidable hospitalization rate for diabetes and asthma compared with other countries. rated the lowest satisfaction with their health system, where only 19% said the health system orks well. On quality, the U.S.

Doctors 84

Doctors Hospitals Public Health ACA 84

Healthcare Law Blog

DECEMBER 15, 2022

CMS discusses providers’ concerns that excessive wait times for prior authorization decisions often cause delays to patient care, including transfers between hospitals and post-acute care facilities, treatment, medication, and supplies, and create medical risks in some cases. Timeframes for Decisions and Communications.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

MedTrainer

JANUARY 26, 2024

healthcare providers – health systems, hospitals and post-acute care facilities – must comply with 629 discrete regulatory requirements across nine domains. At the top of the list is the Health Insurance Portability and Accountability Act (HIPAA).

HIPAA 52

HIPAA Compliance ACA Health Insurance 52

Hall Render

AUGUST 19, 2022

Amazon to offer behavioral health services through Ginger partnership. Ambulatory surgery centers compete with hospitals for outpatient dollars. CDC, amid criticism for COVID-19 response, plans reorganization as public health threats grow. CDC to regain control of hospital pandemic data despite criticism. CALIFORNIA.

COVID-19 40

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

Health Populi

OCTOBER 8, 2019

health care. This challenge covers hospital-acquired conditions and adverse events, clinician-related inefficiency, and lack of adoption of preventive care practices like administering vaccines and addressing obesity and hypertension. That’s the Holy Grail and vision in my book, HealthConsuming: From Health Consumer to Health Citizen.

Prescription Drug Pricing 105

Prescription Drug Pricing Medicare Medicare ACA 105

Hall Render

OCTOBER 27, 2023

Ransomware attacks against hospitals put patients’ lives at risk, researchers say States, FTC continue to target noncompetes: 3 updates The best hospital in each state, per Newsweek What to know about Stark law’s $9.2M

US Department of Health and Human Services 40

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

Compliance Now

JANUARY 13, 2022

The Biden Administration recently announced the new out-of-pocket (OOP) limits that will apply to group and individual health plans during the 2023 plan year, as well as the Patient-Centered Outcomes Research Institute (PCORI) Fee for plan or policy years ending on or after October 1, 2021, and before October 1, 2022. This is a $.13

ACA 113

ACA Health Insurance Medicaid Medicaid 113

Health Populi

AUGUST 16, 2019

Examples of these in the current news cycle are Zolgensma, which is priced about $2 million to treat spinal muscular atrophy, and CAR-T therapy which can run as high as $1 million all-in for the treatment and hospital service costs for the patient. Much now depends on the U.S.

Governance 75

Governance Health Care Reform FDA ACA 75

Health Populi

MARCH 13, 2019

my alma mater) and colleagues track the growth of consumer-facing digital health tools and initiatives leading to consumers’ engagement with websites and apps. Furthermore, the difference in information seeking between more educated Americans versus less could exacerbate health disparities and the inequities of health literacy.

ACA 102

ACA Health Insurance Bioethics Prescription Drug Pricing 102

Hall Render

MAY 24, 2024

NATIONAL AHA, FAH request CMS to extend comment period for TEAM proposed rule CMS launches new option to file EMTALA complaints Cybersecurity execs share healthcare’s biggest vulnerabilities Here’s how much hospital prices are rising – and why Hospital groups seek more time to comment on proposed payment model How noncompete ban could shake (..)

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 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

Health Law Gurus

DECEMBER 19, 2018

The report drew immediate responses from different health care groups, and some reacted with criticism. To the contrary, the report’s urge to ease scope-of-practice state laws that limit services delivered by various types of health care professionals received a positive response by the American Nurses Association.

Nurses 52

Nurses Licensing Hospitals Health Insurance 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.

ACA 100

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.

ACA 100

ACA Health Insurance Hospitals 100

Hall Render

APRIL 7, 2023

NATIONAL AHA, AHCA warn CMS against unfunded nursing home staffing mandates AHA to Congress: Funding rural hospitals is critical for access AHA-supported bill to aid small rural hospitals reintroduced in Senate Biden won’t veto Republican-led bill ending COVID emergency CVS-branded hospitals?

US Department of Health and Human Services 40

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

Health Populi

MARCH 15, 2021

and more health citizens getting their first jabs, there’s growing optimism in America looking to the next-normal by, perhaps, July 4th holiday weekend as President Biden reads the pandemic tea leaves. But that won’t mean Americans will be ready to return to pre-pandemic health care visits to hospital and doctor’s offices.

COVID-19 113

COVID-19 Health Insurance ACA Medicaid 113

Kaiser Health News

OCTOBER 31, 2023

For millions of Americans who buy their own health insurance through the Affordable Care Act marketplace, the end of the year brings a day of reckoning: It’s time to compare benefits and prices and change to a new plan or enroll for the first time. 1 for the ACA’s federal and state exchanges.

ACA 105

ACA Health Insurance Medicaid Medicaid 105