Hall Render

JUNE 20, 2022

Is housing health care and should Medicaid pay the rent? States are using Medicaid programs to cover rent, security deposits and furniture per The New York Times. State and local governments are stepping up to save facilities on the brink of closure. The following states are leading the way: TX (8); WI (7); AZ (6); and FL (5).

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Hall Render

FEBRUARY 10, 2023

North Carolina legislators are considering a Medicaid expansion bill that includes a repeal of its CON law. Higher interest rates have resulted in fewer government and non-profit health care providers going to market to place debt. Hall Render blog posts and articles are intended for informational purposes only.

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Medicaid Medicaid Hospitals Governance 40

Health Care Law Brief

FEBRUARY 8, 2024

billion to fund Medicaid, $4.8 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. The Department of Health (“DOH”) would establish Medicaid reimbursement rates for such off-site services.

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Medicaid Medicaid Nurses Licensing 52

Hall Render

AUGUST 22, 2023

The Fourth Circuit recently held that providers may not defend a False Claims Act (“FCA”) lawsuit by arguing that eligibility requirements violate the Medicaid Act. the government alleged a clinical pharmacy manager for a Tennessee Walgreens falsified twelve different patients’ medical records between January 2015 and June 2016.

Medicaid 40

Medicaid Medicaid Governance Fraud 40

Medisys Compliance

FEBRUARY 27, 2024

In this article, we will explore the complex landscape of radiology billing compliance, exploring key regulations, audit processes, and strategies for ensuring adherence to guidelines. Understanding Regulatory Framework Radiology billing is governed by a multitude of regulations at the federal, state, and local levels.

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Compliance Medical Billing Outsourcing Medicare Medicare 59

HIT Consultant

AUGUST 6, 2023

Often, insurance or the government covers part of the healthcare costs, but if a patient doesn’t have healthcare coverage, they will be responsible to reimburse their providers for the entire cost of the care. They are no longer simply a place for aging Medicare and Medicaid patients to live out their final years.

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Nursing Homes Nurses Medicare Medicare 98

Bill of Health

MARCH 25, 2022

A full posting of abstracts/summaries of these articles may be found on our? A New Way to Contain Unaffordable Medication Costs – Exercising the Government’s Existing Rights. Medicaid Expenditures and Estimated Rebates on Line Extension Drugs, 2010-2018. Mayo Clin Proc. 2022 Feb;97(2):250-260. PMID: 35120693.

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FDA COVID-19 Medicaid Medicaid 205

Bill of Health

FEBRUARY 10, 2023

This replacement, “neoliberalism,” has as its central tenet that markets are, in all ways and at all times, superior to government in allocating societal resources. That is why the ACA’s Medicaid expansion doesn’t exist in 11 states , why the penalties for failing to have insurance under the “individual mandate” has been set to $0.00.

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Public Health Health Care Reform ACA COVID-19 261

Health Populi

FEBRUARY 15, 2022

While his friend did not win his race, William Weld did win the governor’s post and Abner joined State government under Weld. He ended up working in Massachusetts State government for about 15 years. Abner would talk about Medicaid, and the VC community didn’t understand what Medicaid was having little to no exposure to the payor.

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Medicaid Medicaid Telemedicine Governance 113

Healthcare IT Today

OCTOBER 20, 2023

This is the final article in a series about social determinants of health (SDoH). Previous articles covered the definition, collection, sharing, and use of SDoH. Food Aid Federal government food programs expanded significantly during the COVID-19 crisis. I’ll finish with a look at some specific areas of intervention.

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Medicaid Medicaid COVID-19 Doctors 119

Medisys Compliance

MARCH 5, 2024

This article explores into the details of cardiology billing, offering insights into payer audits and reimbursement challenges in cardiology billing. This complexity is reflected in the coding and billing requirements set forth by government payers such as Medicare, as well as private insurance companies.

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Medical Billing Outsourcing Medical Billing Compliance Governance 105

Healthcare IT Today

AUGUST 20, 2023

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. That said, 66% trust their health plan more that the government or non-traditional entities such as Amazon or Walmart to their health insurance.

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Health Insurance Medicaid Medicaid FDA 92

Healthcare Law Blog

JANUARY 26, 2023

In this article we provide a brief summary of the Proposed Rule, while also examining the statutory amendments and previous rulemakings that create its foundation. BACKGROUND The Proposed Rule is the latest in a long line of federal legislation and rulemakings governing the conscience rights of healthcare providers and entities.

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ACA Medicaid Medicaid Compliance 105

MedTrainer

DECEMBER 7, 2023

This article is your guide to the important aspects of healthcare compliance in New Mexico with strategic insights for effective management. Telehealth Policy For providers in New Mexico, telehealth services are governed by regulations that emphasize equitable access and reimbursement rates.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 27, 2023

This article outlines some of the key compliance aspects specific to Ohio, so you know what’s needed to establish a sufficient compliance program. This department focuses on ensuring access to quality healthcare services while managing the state’s Medicaid budget and policies. The license is valid for three years unless revoked.

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Compliance Licensing Medicaid Medicaid 52

Healthcare IT Today

OCTOBER 18, 2023

Previous articles in this series showed why social determinants of health (SDoH) are the hottest recent addition to data used by the medical industry. This article shows how organizations are collecting it. We’ve explored how SDoH data is defined and shared. The percentage is much higher in some areas.

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Doctors Public Health Medicare Medicare 119

Healthcare IT Today

OCTOBER 12, 2023

The Centers for Medicare & Medicaid Services (CMS) have taken a bold step by mandating a standard for prior authorization. The federal government has been haranguing vendors and clinicians to make interoperable systems since the HITECH act was passed in 2009. A CMS fact sheet offers more details on CMS’s thinking and plans.

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Electronic Medical Records Doctors Governance Medicaid 99

MedTrainer

DECEMBER 4, 2023

This article gives a clear and detailed look at the important things you need to know about following healthcare laws in Kentucky, especially for those who provide healthcare and manage compliance. Medicaid Telehealth Regulations In Kentucky, Medicaid telehealth regulations are crucial for healthcare providers and compliance professionals.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Hall Render

JANUARY 27, 2023

The main drivers of the increase in filings were increased labor and supply costs, interest rate increases, lack of government stimulus funds and lower investment returns. The Kaiser Family Foundation released a summary of all of the Medicaid Waivers (section 1115) that are pending or that have been approved by each state.

Medicaid 40

Medicaid Medicaid Hospitals Governance 40

Healthcare IT Today

NOVEMBER 15, 2023

The previous article in this series explained some of the ways payers, providers, and digital health companies demonstrate that they have made a positive difference in their patients’ lives. ” This article looks at the measurements and reporting strategies used by some specific companies.

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Medicare Medicare Hospitals Compliance 100

Hall Render

AUGUST 8, 2022

The web server contained ePHI, including patients’ names, Medicaid numbers, health care provider names, dates of service, dates of birth, addresses and treatment information. Further, data governance is key to proactively managing ePHI. Hall Render blog posts and articles are intended for informational purposes only.

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HIPAA Governance Medicaid Medicaid 73

MedTrainer

DECEMBER 4, 2023

Use the resources in this article to guide you through the complexities of Nebraska’s healthcare compliance regulations, so you don’t find yourself behind the game. The state’s policy allows for Medicaid coverage of real-time video, real-time audio only, and remote patient monitoring, however, excludes store-and-forward services.

Compliance 52

Compliance Licensing Nursing Homes Nurses 52

Compliancy Group

JANUARY 3, 2024

This article discusses the issues related to medical billing compliance policy and the steps for providers to maintain financial integrity and adherence to all requirements. One of the most common ways for providers and healthcare organizations to run afoul is to incorrectly or illegally bill and code for services or supplies.

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 52

AIHC

NOVEMBER 29, 2023

We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. The Centers for Medicare & Medicaid Services (CMS) HCC model was initiated in 2004 and is becoming increasingly prevalent as the environment shifts to value-based payment models. Why this Trend of Value-Based Care?

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Medicare Medicare Medicaid Medicaid 59

Healthcare IT Today

AUGUST 7, 2022

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Cybersecurity company Surfshark found the number of government requests for user data increased 4x from 2013 to 2020 among Apple, Google, Facebook, and Microsoft. Partnerships.

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Governance Telemedicine Medicaid Medicaid 88

Med Law Blog

MAY 1, 2023

This “fee obstacle” was what precipitated many of the bankruptcies in the 1990s physician practice management ventures, as mentioned in my prior article. In the article entitled “The Death of Hahnemann Hospital” published in the New Yorker magazine in May 2021.

Nursing Homes 52

Nursing Homes Malpractice Hospitals Nurses 52

Hall Render

FEBRUARY 27, 2023

Whistleblowers continue to be one of the federal government’s greatest assets in FCA cases, as whistleblowers filed 652 qui tam suits in 2022 with recovery totaling $1.9 The government initiated 296 FCA cases on its own last year without input of a relator, which is the highest volume of DOJ initiated cases since the 1986 FCA amendments.

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Nursing Homes Fraud Medicaid Medicaid 40

AIHC

OCTOBER 20, 2023

Part 1 in a Series of Leadership Articles on Value-Based Care Written by Joanne Byron, LPN, BS, CCA, CIFHA, CHA, COCAS, CORCM, CHCO, OHCC, CMDP, ICDCT-CM/PCS ​ Edited by Julie Rickman , MBA, CHC, CHPC, CHCO ​ This article is the first in a series sponsored by the American Institute of Healthcare Compliance (AIHC) Volunteer Education Committee.

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Health Outcomes Medicare Medicare Governance 59

Hall Render

DECEMBER 18, 2023

government with uncovering these crimes, but it will also help international efforts to expose individuals that defraud governments around the world. Special thanks to Becca Foerder, summer associate, for her assistance in this article. Hall Render blog posts and articles are intended for informational purposes only.

Governance 40

Governance Compliance Licensing Medicaid 40

MedTrainer

DECEMBER 7, 2023

State-specific governing bodies, such as the West Virginia Department of Health and Human Resources (DHHR) and the Bureau for Medical Services (BMS) , oversee and enforce these regulations. This article explores key elements you need to know to achieve compliance in West Virginia.

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Compliance Licensing Medicaid Medicaid 52

MedTrainer

DECEMBER 7, 2023

For example, the Office of Health Care Assurance (OHCA) is one governing body that healthcare professionals need to understand in order to manage organizational licensure and healthcare compliance in Hawaii effectively. This article offers a summary of essential aspects of healthcare compliance specific to Hawaii.

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Compliance Compliance Officers Licensing Medicaid 52

MedTrainer

DECEMBER 4, 2023

Additionally, the state’s approach to Medicaid expansion involves unique waivers, impacting eligibility criteria and cost-sharing provisions. In this article, you’ll learn more about creating a comprehensive approach to ensure compliance in North Dakota’s unique regulatory environment.

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Compliance Licensing Health Outcomes Medicaid 52

AIHC

NOVEMBER 29, 2023

We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. The Centers for Medicare & Medicaid Services (CMS) HCC model was initiated in 2004 and is becoming increasingly prevalent as the environment shifts to value-based payment models. Why this Trend of Value-Based Care?

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Medicare Medicare Medicaid Medicaid 52

Healthcare IT Today

JUNE 2, 2023

Bill Charnetski, EVP, Health System Solutions & Government Affairs at PointClickCare Traditionally, long-term and post-acute care (LTPAC) facilities have not benefited from the same health IT investments or funding as other care sectors. Thank you to everyone that left a quote for us and thank you to everyone reading this article!

Governance 93

Governance Nursing Homes Medicaid Medicaid 93

MedTrainer

SEPTEMBER 8, 2023

From ensuring proper infection control to safeguarding patient privacy and data, the healthcare compliance examples provided in this article demonstrate how compliance plays a pivotal role in maintaining high-quality industry standards. Many healthcare facilities rely on reimbursements from government programs such as Medicare and Medicaid.

Compliance 52

Compliance HIPAA Medicaid Medicaid 52

Healthcare IT Today

OCTOBER 18, 2022

The following is a guest article by Jay Nakashima, Executive Director at eHealth Exchange. By selecting a national HIE (and potential future QHIN) today that is structured and governed in a way that provides flexibility, state and regional exchanges can access the benefits of broad exchange.

Electronic Medical Records 62

Electronic Medical Records Governance Public Health Medicaid 62

Medisys Compliance

MAY 19, 2022

The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. In this article, we shared revised Medicare billing and coding guidelines which will help in billing Medicare telehealth during COVID-19 PHE. Changed Telehealth Policies. Eligible services.

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COVID-19 Medicare Medicare Medical Billing 52