Healthcare IT Today

DECEMBER 30, 2024

The challenge is that access to quality care isn’t always easy to come by, with appointments often booked out for months. This API-first approach will be driven by health plans needing to perform with Medicare Advantage and managed Medicaid. Government-funded capitation has to ensure care is adequate.

US Department of Health and Human Services 88

US Department of Health and Human Services Nurses Medicare Medicare 88

Health Populi

JUNE 3, 2020

McKinsey’s report models outpatient and office visits that can be virtually enabled for patients covered by both commercial and public sector health plans (Medicare and Medicaid). This graphic comes out of my book, HealthConsuming: From Health Consumer to Health Citizen. 35% of home health services, and.

COVID-19 153

COVID-19 Hospitals Medicaid Medicaid 153

Compliancy Group

JANUARY 31, 2025

Last year was truly one for the books, with 13 breaches affecting more than one million patients. Centers for Medicare & Medicaid Services In May 2023, the Clop group exploited a zero-day vulnerability to gain unauthorized access to the networks of 2,500 companies. Not so shocking? 3,998,163 patients PHI exposed.

Ransomware 52

Ransomware HIPAA Medicare Medicare 52

Healthcare IT News - Telehealth

JUNE 12, 2020

The good news for telehealth is that the reimbursement environment has improved, with the Center for Medicare and Medicaid Services bringing telehealth and eVisits on par with in-person visits for the duration of the pandemic, along with a relaxing of rules for virtual consults across state lines.

COVID-19 218

COVID-19 Hospitals Medicaid Medicaid 218

Health Populi

FEBRUARY 6, 2020

isn’t repealing or replacing the Affordable Care Act or moving to a Medicare-for-All government-provided plan. Improving Medicare. Improving Medicaid. modernizing the Stark Law and Anti-Kickback Statute, modifying Medicare Part D drug benefits to cap out-of-pocket spending, and other items), and to improve Medicaid.

Health Insurance 79

Health Insurance Medicare Medicare Medicaid 79

Provider Trust

APRIL 30, 2024

This year, as always, the Medicaid Fraud Control Units (MFCUs) released an annual report dissecting the exclusions, enforcements, and overall takeaways from their work throughout the previous fiscal year (FY). for every $1 spent How ProviderTrust Can Help With nearly 80 million individuals covered by Medicaid, every data point counts.

Fraud 52

Fraud Medicaid Medicaid Licensing 52

HIT Consultant

MARCH 15, 2023

Clinicians can manage appointments, write prescriptions, chart notes and handle booking and payments all in one place. Their API-driven platform can be aligned to meet brand needs and securely houses patient PII with its built-in HIPAA compliance software.

Medicaid 98

Medicaid Medicaid Compliance Medicare 98

Healthcare IT News - Telehealth

DECEMBER 13, 2024

Called PfizerForAll, the DTP space allows patients to use their existing health insurance and pharmacy programs to talk to a doctor at UpScript or book an appointment on Zocdoc and get support on prior authorizations for medications. Senate Majority Whip Dick Durbin, D-Ill.,

Doctors 148

Doctors Health Analytics FDA Health Insurance 148

Healthcare IT Today

MARCH 27, 2023

Clinicians can manage appointments, write prescriptions, chart notes and handle booking and payments all in one place. Their API-driven platform can be aligned to meet brand needs and securely houses patient PII with its built in HIPAA compliance software.

Licensing 111

Licensing Health Outcomes Medicaid Medicaid 111

Healthcare IT Today

APRIL 29, 2024

A Congressional bill would promote behavioral therapy for obesity and extend Medicare coverage for drugs treating obesity. A recently released book that explores Flegal’s impact, as well as many other psychological, historical, and sociological themes, is Unshrinking: How to Face Fatphobia by philosopher and social activist Kate Manne.

Medicare 120

Medicare Medicare Medicaid Medicaid 120

HIT Consultant

DECEMBER 15, 2022

Think Uber’s ride-sharing data ecosystem, which connects customers seeking to book an on-demand ride with thousands of drivers as partners, or Airbnb’s data ecosystem, which enables hosts with extra rooms or space to connect with guests seeking a place to stay. Data-sharing is common in some industries but less so in healthcare.

Governance 98

Governance Medicaid Medicaid Public Health 98

Jane Sarashon

FEBRUARY 27, 2024

In addition to highlighting the Patient’s Bill of Rights, NABIP’s keynotes and general sessions will speak to similar topics being brainstormed at VIVE this week — including mental health, maternal health, pharmacy and prescription drugs (pricing, PBMs), population health, and Medicare and Medicaid innovations.

ACA 118

ACA Prescription Drug Pricing Health Insurance Hospitals 118

HIT Consultant

APRIL 20, 2022

Since the passage of the Medicare Improvements for Patients & Providers Act in 2008, the U.S. Hospitals report the data to the Centers for Medicare & Medicaid Services (CMS), which uses that data to create the Overall Hospital Quality Star rating for each hospital. Tom Zaubler, MD, Chief Medical Officer of NeuroFlow.

Medicare 98

Medicare Medicare Telemedicine Medicaid 98

HIT Consultant

JULY 24, 2022

For example, while Medicare only accounts for approximately 20% of the country’s population, data from the Centers for Medicare and Medicaid Services (CMS) detailing utilization for this small segment of Americans have not only served as the foundation for regulatory decisions but has also become the industry proxy for other population segments. .

COVID-19 98

COVID-19 Medicare Medicare Telemedicine 98

Health Populi

MAY 14, 2019

Respondents were both uninsured and insured through individual coverage, Medicare, Medicaid, and dual enrollees. In my book, HealthConsuming: From Health Consumer to Health Citizen , I discuss “Zip Codes, Genetic Codes, Food and Health” in Chapter 7. McKinsey conducted the survey among over 12,500 U.S.

Health Insurance 103

Health Insurance Public Health Hospitals Medicaid 103

HIT Consultant

NOVEMBER 10, 2021

Although many companies had plans on the books to advance telemedicine, the crisis revealed that virtual care is not only possible but in many cases is also preferred by patients. Larry English, President & cofounder of Centric Consulting. – Finally, estimates say U.S. The insurance side is jumping on board, too.

COVID-19 105

COVID-19 Telemedicine Medicaid Medicaid 105

HIT Consultant

FEBRUARY 5, 2024

Although the surgeon falsely claimed in his application that he had privileges at nearby hospitals, the hospital’s urgency to book cases and its failure to verify credentialing led to accepting responsibility for the majority of damages. Mistake No. 4: Not updating and verifying information. 8: Failing to take peer review activity seriously.

Malpractice 96

Malpractice Licensing Due Diligence Hospitals 96

Healthcare Law Blog

JANUARY 11, 2023

Morgan Healthcare Conference, you would know that all three are waiting to see what the upcoming final rule on Medicare Advantage risk adjustment data validation (known as RADV) audits will mean for the industry when it drops in February. That’s worth a look in my book. Well, if you were at the 41st annual J.P. range, with a 1.3 – 1.4

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Medisys Compliance

JANUARY 29, 2024

Utilize coding manuals and reference books: Comprehensive references like the Medicare Claims Processing Manual and CPT Assistant offer detailed guidance on specific procedures. Subscribe to coding updates: The American Medical Association regularly updates CPT codes. Stay informed through their website or professional organizations.

Medical Billing Outsourcing 64

Medical Billing Outsourcing Medical Billing Medicare Medicare 64

Healthcare Law Blog

JANUARY 12, 2023

Using it in a sentence: “Amazon transrupted how books are sold.” That’s reminiscent of the well-known Medicare Advantage statistic that about 4% of Medicare Advantage members drive 40% of Medicare Advantage total expenses. Sticks and Stones will break my [budget?]”. Thinking Outside the Box. The Game of Risk.

Medicare 52

Medicare Medicare Doctors Hospitals 52

Jane Sarashon

DECEMBER 13, 2021

In early December, FarmBoxRx was the first online grocer to be approved to channel food to SNAP/EBT recipients as payment from Medicare and Medicaid. enabling enrollees in Medicare and Medicaid to order fresh produce online. I reported out this trend in my 2019 book, Health Citizenship , which looked at U.S.

COVID-19 64

COVID-19 Public Health Governance Medicaid 64

Verisys

JULY 20, 2023

In one of the earliest negligent credentialing cases , a Wisconsin hospital was eager to book surgical cases and failed to properly verify a surgeon’s credentials. Mistake No.

Due Diligence 52

Due Diligence Malpractice Licensing Hospitals 52

Verisys

NOVEMBER 30, 2023

Although the surgeon falsely claimed in his application that he had privileges at nearby hospitals, the hospital’s urgency to book cases and its failure to verify credentialing led to accepting responsibility for the majority of damages. Mistake No. 4: Not updating and verifying information. 8: Failing to take peer review activity seriously.

Malpractice 52

Malpractice Licensing Due Diligence Hospitals 52

Verisys

FEBRUARY 4, 2022

Although the surgeon falsely claimed in his application that he had privileges at nearby hospitals, the hospital’s urgency to book cases and its failure to verify credentialing led to accepting responsibility for the majority of damages. Mistake No. 4: Not updating and verifying information. Other adjudicated actions or decisions.

Malpractice 52

Malpractice Licensing Due Diligence Hospitals 52

Medisys Compliance

JANUARY 16, 2024

Resources and Support Coding Manuals: CPT and HCPCS code books provide guidance on specific codes and modifiers. Package Deals: Consider offering discounted packages for group therapy participants to incentivize commitment and continuity.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medical Billing Services 59

Medisys Compliance

JULY 25, 2023

The typical times outlined in the Current Procedural Terminology (CPT) books are used to determine the corresponding code level. Billing for staff services by a physician is referred to as “incident-to” billing in Medicare regulations, indicating that the services provided are part of the overall service rendered by the physician.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Nurses Compliance 52

AIHC

FEBRUARY 17, 2025

There are also self-reporting mechanisms in place to report overpayments on the OIG website ( Self-Disclosure ) and Self-Referral Disclosure for voluntary self-reporting of overpayments on the Centers for Medicare and Medicaid Services (CMS) website. Tons of information can be found on the Internet, books, articles, etc.

Fraud 52

Fraud Compliance Overpayments Overpayment 52

Healthcare It News

APRIL 28, 2023

"We serve the same families in our Administration for Children and Families that we serve with Medicare and Medicaid, that we serve in our Substance Abuse and Mental Health Services Administration," said Palm. How are we thinking about the way Medicare and Social Security work together?" " asked Palm.

US Department of Health and Human Services 318

US Department of Health and Human Services Medicaid Medicaid Governance 318

Healthcare IT News - Telehealth

OCTOBER 25, 2022

She has written four books, including The Patient as CEO: How Technology Empowers the Healthcare Consumer and, most recently, How AI Can Democratize Healthcare: The Rise in Digital Care. The Centers for Medicare and Medicaid Services is one of the organizations that sets the standard of care in the U.S.

FDA 218

FDA Hospitals Doctors Medicare 218

HIT Consultant

JUNE 12, 2022

With the passage of the No Surprises Act, a large book of new regulations and requirements for healthcare providers and payers was handed down in an effort to protect patients. In fact, when CMS reviewed Medicare Advantage directories, they found 52% had at least one error. .

Medical Billing 98

Medical Billing Medicare Medicare Health Insurance 98

Healthcare IT Today

JANUARY 8, 2023

The biggest news for healthcare IT was the extension of telehealth expansion under Medicare through the end of 2024. NextGen announced that clients using NextGen Population Health achieved an average of $9 million in savings in 2021 in the Medicare Shared Savings Program MSSP. 29, 2022, President Biden signed the omnibus spending bill.

Medicare 79

Medicare Medicare Hospitals FDA 79

Healthcare IT Today

FEBRUARY 14, 2023

Health policy wonks logging onto Twitter to check #HealthPolicyValentines this morning pic.twitter.com/X0gsFT1wau — Dania Palanker (@DaniaPal) February 14, 2023 Unlike Medicaid, I don’t need to redetermine my love for you. We hope you enjoy and get a good laugh.

Medicaid 82

Medicaid Medicaid Medicare Medicare 82

Health Populi

NOVEMBER 19, 2019

My cousin Arlene got married in Detroit at the classic Book Cadillac Hotel on July 23, 1967, a Sunday afternoon wedding. To address this challenge, Medicare Advantage programs from Aetna and Humana are working with Papa which connects “grandchildren on demand” with older people to bolster social connections.

Medicare 59

Medicare Medicare Health Care Access Health Insurance 59

AIHC

AUGUST 30, 2023

Medical practices can provide patients with educational materials such as brochures, pamphlets, or books that provide information about their medical condition, treatment options, and preventive care. These companies will follow policies and procedures for the Accrediting organization along with all Medicare rules and regulations for DME.

Compliance 52

Compliance Fraud Medicare Medicare 52

Health Populi

OCTOBER 2, 2023

could save at least $13 billion a year through deploying medically-tailored meals for people enrolled in Medicare, Medicaid, and private insurance programs, according to the True Cost of Food , research published by the Tufts School of Nutrition Science and Policy collaborating with The Rockefeller Foundation.

Governance 77

Governance Public Health Medicaid Medicaid 77

Healthcare IT News - Telehealth

NOVEMBER 27, 2019

Many want to target drug costs and the Centers for Medicare and Medicaid Services has mandated hospitals to post a list of their standard charges by diagnostic-related group, in an effort for consumers to have transparent cost options. And providers need to collect every penny owed them and combat revenue leakage. needs a plan.

Telemedicine 97

Telemedicine Health Analytics Governance Hospitals 97

Healthcare IT Today

JANUARY 9, 2023

Policymakers say they want to lower health care costs, yet the Centers for Medicare & Medicaid Services (CMS) is once again pursuing policies that will exacerbate consolidation pressures, and oncology has one of the highest rates of consolidation, largely driven by payment disparities across different sites of service.

Pharmaceutical Industry 82

Pharmaceutical Industry Medicare Medicare FDA 82