Bill of Health

DECEMBER 6, 2023

While many insurers attempt to comply with this requirement, systemic problems like a lack of staff to communicate with providers and providers being overwhelmed with other administrative burdens prevent full compliance. Insurers should also work to decrease the shortage of mental health care providers in their networks.

Governance 144

Governance Medicaid Medicaid Medicare 144

YouCompli

AUGUST 9, 2023

An opportunity to reframe, regroup, and refocus  Now that the COVID-19 Public Health Emergency (PHE) is well behind us, we have an opportunity to reframe patient expectations – and regroup and refocus on compliance-related patient care needs. These materials also should be easily accessible in print and online.  

Compliance 52

Compliance COVID-19 ACA Fraud 52

HIPAA Journal

FEBRUARY 23, 2022

HIPAA consisted of five Titles addressing the primary objectives of the Act: Title I: Health care access, portability, and renewability. Title II: Preventing health care fraud and abuse; administration simplification; medical liability reform. Further Rules have reinforced the importance of HIPAA compliance.

HIPAA 88

HIPAA Fraud Health Insurance Medicaid 88

Bill of Health

SEPTEMBER 9, 2022

And we know that our prisons, jails, and detention centers employ doctors with suspended and limited licenses as the exclusive source for health care for incarcerated people. Carceral health care occurs within a regulatory vacuum. These voluntary standards, within the U.S. One of the largest failures of U.S.

COVID-19 349

COVID-19 COVID-19 Vaccine Medicaid Medicaid 349

Health Care Law Brief

APRIL 12, 2023

On April 5, the Centers for Medicare & Medicaid Services (“CMS”) released the 2024 Medicare Advantage and Prescription Drug Benefit Programs Final Rule (“Final Rule”), which will be codified at 42 C.F.R. The SRFs include low-income subsidy, dual eligibility (meaning eligible for Medicare and Medicaid) and disability.

Medicare 52

Medicare Medicare Overpayments Overpayment 52

Innovaare Compliance

JANUARY 19, 2021

It has become evident by changes to the Centers for Medicare & Medicaid Services (CMS) Star Rating formulas over the past several years—and especially with changes implemented for the 2021 Plan Year—that member experience and medication adherence is of utmost importance to the CMS. Medicare Star Ratings 2021 Changes.

Medicare 52

Medicare Medicare COVID-19 Compliance 52

Hall Render

JUNE 30, 2023

for physician referral scheme In Los Angeles, hospital CEO pay could be capped Kaiser Permanente ratings affirmed amid healthy financial profile Nurses vote ‘no confidence’ in California hospital administration, board Nursing facility, management company settle physician kickback allegations for $3.8M

US Department of Health and Human Services 40

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