Redox

JANUARY 24, 2024

Two and a half years ago I wrote my first blog at Redox. My debut focused on how the CMS proposed Interoperability and Prior Authorization rule would dramatically improve prior authorization processes with electronic processing via APIs. That rule was never finalized. ICYMI: It didn’t. But: There is still hope.

HIPAA 59

HIPAA Compliance Payment Systems 59

Healthcare Law Blog

JANUARY 26, 2024

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Medicaid 52

Hall Render

MARCH 20, 2024

CMS recently issued a final rule to require health care payers to improve communications between the payers, providers and patients and to improve the prior authorization processes (“Final Rule”). This process can lead to delays in necessary care, as well as immense frustration among providers and patients.

Medicare 40

Medicare Medicare Health Insurance Medicaid 40

Healthcare IT Today

FEBRUARY 25, 2024

The news isn’t all good, as ONC noted in a blog post , as 68% of vendors are also using some form of proprietary APIs as well. A report from Hospital for Special Surgery found ChatGPT provided responses to patients’ questions that were easier to understand that medical literature – but also less comprehensive.

Telemedicine 85

Telemedicine Compliance FDA Hospitals 85

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

Health Law RX

JULY 18, 2023

On June 27, 2023, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued its long-anticipated final rule amending the OIG’s civil monetary penalty (CMP) regulations as they relate to information blocking (CMP Final Rule or Rule).

Fraud 52

Fraud Compliance Medicaid Medicaid 52

Healthcare Law Blog

FEBRUARY 26, 2024

The Centers for Medicare and Medicaid Services is also assessing whether algorithms used by plans and providers to identify high risk patients and manage costs can introduce bias and restrictions. From a clinical perspective, payers and providers are integrating AI into daily operations and patient care.

Medicaid 52

Medicaid Medicaid Governance Medicare 52