MedTrainer

JANUARY 12, 2024

At its core, healthcare compliance ensures the quality of care, patient safety, and integrity of healthcare systems. Over the years, healthcare compliance has evolved significantly, driven by changing regulations, advances in technology, and a growing emphasis on patient-centric care. What is Healthcare Compliance?

Compliance 52

Compliance HIPAA Telemedicine ACA 52

Health Care Law Brief

JULY 25, 2023

5] Rules Concerning Provider “Disincentives” are Forthcoming Of note, the Final Rule does not apply to health care providers. Unlike developers, exchanges, and networks, the Act does not empower OIG to directly assess penalties for non-compliance against health care providers. [6]

HIPAA 52

HIPAA Payment Systems Compliance Licensing 52

AIHC

NOVEMBER 29, 2023

Prior to this time, commercial carriers were already pushing HMOs (health maintenance organizations) and capitation contracts with physician networks or instituting “reasonable and customary charges” requiring physicians to collect data to negotiate reasonable contracts. Hospital reimbursement also changed.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Healthcare Law Blog

JANUARY 26, 2024

The payers impacted by the Final Rule include Medicare Advantage (“MA”) organizations, state Medicaid and Children’s Health Insurance Program (“CHIP”) agencies, Medicaid and CHIP managed care plans, and plans on the Affordable Care Act exchanges (collectively, “Impacted Payers”).

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Medicaid 52

AIHC

NOVEMBER 29, 2023

Prior to this time, commercial carriers were already pushing HMOs (health maintenance organizations) and capitation contracts with physician networks or instituting "reasonable and customary charges" requiring physicians to collect data to negotiate reasonable contracts. It's important for compliance and historical trend analysis.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

C&M Health Law

DECEMBER 23, 2022

The regulations impact CMS-regulated payers and provide incentives for providers and hospitals that participate in the Medicare Promoting Interoperability Program and the Merit-based Incentive Payment System (MIPS). Most of the Proposed Rule’s provisions will be effective on January 1, 2026. Our initial takeaways are summarized below.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

C&M Health Law

AUGUST 3, 2023

OIG’s lookback period is 6 years for information blocking, but OIG recommended maintaining information for additional time, noting that the ONC Health IT Certification Program requires participants to maintain records to demonstrate initial and ongoing compliance for 10 years.

Fraud 52

Fraud HIPAA Governance Compliance 52