HIT Consultant

OCTOBER 18, 2021

Capturing and combatting fraud in today’s healthcare landscape requires the convergence of innovation and experience to drive value beyond the margins. Organizations must take a multi-layered approach to identify, address, and prevent fraud. The second type, indirect fraud, involves several bad actors that coordinate their efforts.

Fraud 98

Fraud COVID-19 Public Health Medicare 98

Healthcare IT News - Telehealth

JANUARY 30, 2023

The Australian National Audit Office has conducted a review of the expansion of telehealth services across the country by the Department of Health and Aged Care in response to the COVID-19 pandemic. FINDINGS Based on the state audit , the department fell short in governance, risk management, and evaluation of the telehealth expansion.

COVID-19 156

COVID-19 Governance Medicare Medicare 156

Healthcare IT Today

SEPTEMBER 21, 2022

Since the COVID pandemic began, healthcare has never had further reach of accessibility. New types of fraud are continually emerging, and it’s also become harder to uncover with traditional approaches. The telehealth market is growing at a significant rate, and fraud is continuing to grow with it.

Fraud 69

Fraud COVID-19 Medicare Medicare 69

YouCompli

AUGUST 29, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. The audit also identified 1,714 providers whose billing for telehealth services for about a half million beneficiaries during the first year of the pandemic posed a high risk to Medicare.

Fraud 52

Fraud Medicare Medicare COVID-19 52

C&M Health Law

JANUARY 25, 2023

trillion spending package, which consists of all 12 fiscal year (FY) 2023 appropriations bills and funds the federal government through September 30, 2023, provides additional assistance to Ukraine, and makes numerous health care policy changes. 117-164 ) (the “Act”)—an approximately $1.7

Medicaid 104

Medicaid Medicaid Medicare Medicare 104

Healthcare IT Today

FEBRUARY 17, 2023

Amid swirling accusations that Medicare Advantage Organizations (MAOs) are overbilling the U.S. government and calls for better oversight , the Centers for Medicare & Medicaid Services announced in early February that it would investigate overbilling by those plans. They expect to recoup 4.7 But the needles pile up fast.

Overpayments 106

Overpayments Overpayment COVID-19 Medicare 106

Provider Trust

JANUARY 25, 2024

This report helps HHS fulfill its mission to improve the health and well-being of Americans while also providing suggestions for how healthcare organizations can stay ahead of the curve to avoid and combat fraud, waste, and abuse. With Medicaid, the challenges are equally formidable.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

Healthcare IT News - Telehealth

AUGUST 7, 2020

Governors Jay Inslee of Washington, Kate Brown of Oregon, Steve Sisolak of Nevada and Jared Polis of Colorado say their states, just as they have with other areas of the COVID-19 pandemic, will be collaborating on telehealth strategy. " Stewardship. Patient choice. " ON THE RECORD.

COVID-19 217

COVID-19 Informed Consent Governance Fraud 217

Provider Trust

AUGUST 9, 2023

Grimm, the OIG continues its tireless efforts to uncover instances of fraud, waste, and abuse within HHS programs. OIG continues to work tirelessly to identify instances of fraud, waste, and abuse and prosecute offenders. Led by acting Inspector General Christi A. A Message from Acting Inspector General Christi A.

Nursing Homes 52

Nursing Homes COVID-19 Fraud Medicaid 52

Healthcare Compliance Blog

FEBRUARY 7, 2022

A Michigan woman has pled guilty to stealing government funds that were designated to aid medical providers in the treatment of patients suffering from COVID-19 and acknowledged using the money for her own personal use. She is scheduled to be sentenced on May 19, and faces a maximum penalty of 10 years in prison.

COVID-19 59

COVID-19 Fraud Governance Compliance 59

Hall Render

SEPTEMBER 15, 2022

On September 2, 2022, the Office of the Inspector General (“OIG”) published a study assessing potential Medicare program integrity risks related to the proliferation of telehealth services during the first year of the COVID-19 pandemic. million in Medicare fee-for-service payments. Inspector General Christi A.

Telemedicine 40

Telemedicine Fraud Medicare Medicare 40

Healthcare IT News - Telehealth

JULY 16, 2020

The COVID-19 pandemic has made it clear that the "normal" healthcare landscape won't return for some time, if ever. Now, the question becomes : How many of those changes, particularly regarding temporary waivers issued by the Centers for Medicare and Medicaid Services, will become permanent? " asked Leary.

COVID-19 149

COVID-19 Medicare Medicare Governance 149

MedTrainer

JULY 28, 2023

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. Medicare/Medicaid Compliance Reviews. The OIG performs regular compliance reviews of Medicare and Medicaid providers.

Fraud 98

Fraud Compliance Medicaid Medicaid 98

YouCompli

JULY 26, 2023

Fraud, waste, and abuse (FWA) associated with telehealth services existed before COVID-19, but it significantly increased during the pandemic. The audit also identified 1,714 providers whose billing for telehealth services during the first year of the pandemic posed a high risk to Medicare. An audit by the U.S.

Fraud 52

Fraud Compliance Medicare Medicare 52

YouCompli

JULY 12, 2022

The COVID-19 pandemic opened the door to greater use of telehealth services, and healthcare providers and consumers walked through it. In fact, Medicare beneficiaries used telehealth to receive 12 percent of their services during the first year of the pandemic. This was more than two in five Medicare beneficiaries.

COVID-19 52

COVID-19 Medicare Medicare Telemedicine 52

Healthcare IT News - Telehealth

JUNE 8, 2022

While the nation seeks to reopen and put COVID-19 behind us, providers are still addressing new variants and recovering from the financial and emotional impact of the pandemic. State government executive orders. If Medicare coverage requirements for telehealth services (e.g., Agency enforcement discretion.

US Department of Health and Human Services 195

US Department of Health and Human Services Compliance Overpayments Overpayment 195

Health Law Advisor

FEBRUARY 10, 2023

The total recoveries in fraud cases brought with respect to the health care and life sciences industries fell to the lowest level since 2009. billion was recovered in qui tam cases in which the government declined to intervene. By contrast, $777 million was recovered in cases where the government intervened or otherwise pursued.

Fraud 52

Fraud COVID-19 Governance Medicaid 52

Healthcare IT News - Telehealth

NOVEMBER 2, 2021

During the COVID-19 pandemic, telehealth and remote monitoring have found their place in routine clinical practice like never before. During the pandemic, a health technology company provided IoT devices to people's homes that monitored COVID-19 symptoms, along with a platform for data collection.

COVID-19 215

COVID-19 Telemedicine Doctors Hospitals 215

Healthcare Law Blog

DECEMBER 12, 2022

The COVID-19 Public Health Emergency (“PHE”) led to a rapid expansion in the utilization of telehealth. Now, almost three years later, governmental entities have focused their attention on telehealth services and the potential for fraud and abuse. Mark Warner , and industry groups. Increased DOJ Activity.

COVID-19 52

COVID-19 Fraud Telemedicine Public Health 52

Kaiser Health News

NOVEMBER 11, 2021

Finding the best private Medicare drug or medical insurance plan among dozens of choices is tough enough without throwing misleading sales tactics into the mix. The problems are especially prevalent during Medicare’s open-enrollment period, which began Oct. “You’re not from Medicare,” Heimer told her.

Medicare 141

Medicare Medicare Doctors Fraud 141

Health Law Advisor

FEBRUARY 3, 2022

FY 2021 was also a record-shattering year for DOJ as it relates to health care fraud enforcement; over $5 billion (90% of the total) was obtained from cases pursued against individuals and entities in the health care and life sciences industries. With collections amounting to $5.6 billion received in FY 2020. KEY TAKEAWAYS.

Fraud 52

Fraud COVID-19 Governance Medicare 52

Health Law Advisor

APRIL 13, 2023

Department of Health and Human Services’ Office of Inspector General (“OIG”) updated its Frequently Asked Questions (“FAQs”), drafting 13 FAQs aimed at easing the transition from COVID-era flexibilities to the end of the Public Health Emergency (“PHE”) on May 11, 2023.

Public Health 52

Public Health Fraud COVID-19 Medicaid 52

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. Or an extension of the doctrine of public fraud? Do we have people thinking about how to sue Fox News, pundits, and political candidates for their lies?

Public Health 261

Public Health Health Care Reform ACA COVID-19 261

Health Care Law Brief

JUNE 2, 2022

The onset of the COVID-19 public health emergency (“PHE”) led to a surge in the use of telehealth by health care providers. Similarly, with respect to Medicare, Congress extended certain Medicare telehealth flexibilities for 151 days following the conclusion of the PHE, as part of the Fiscal Year 2022 Omnibus appropriations bill.

Public Health 52

Public Health Compliance COVID-19 Licensing 52

AIHC

SEPTEMBER 5, 2023

Compliance Considerations for Best Outcomes Written in collaboration with the AIHC Volunteer Education Committee Delivering mental health services via telehealth has increased since the COVID-19 pandemic. Higher rates of use of telehealth are now standard in many practices since the coronavirus disease 2019 (COVID-19) pandemic.

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

Hall Render

FEBRUARY 4, 2022

Of that, $5 billion relates to health care fraud involving drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories and physicians. Health Care Fraud Actions. ” Medicare Part C. ” Medicare Part C. Boynton of the DOJ Civil Division.

Fraud 40

Fraud Governance Medicare Medicare 40

Healthcare Law Blog

MARCH 3, 2023

The once-novel medium of telehealth surged onto the stage as a common sense solution to the COVID-19 pandemic. federal government. Department of Health and Human Services Office of Inspector General Special Fraud Alert issued in July 2022, which urged practitioners to exercise caution when entering telemedicine arrangements. [11]

Fraud 52

Fraud Nurses Telemedicine COVID-19 52

Healthcare Law Blog

MAY 16, 2022

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). With a few exceptions, the Final Rule is a wholesale codification of the proposed rule.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

AIHC

MARCH 28, 2022

The complex Medicare appeals process is used to demonstrate the importance of appealing claims denied in an audit. The learning objective of this lesson is to help you become familiar with the Medicare Claims Review Program (MCRP). Other payers mirror Medicare’s program. Audited by a payer? What is an “improper” payment?

Medicare 52

Medicare Medicare Compliance Governance 52

Hall Render

FEBRUARY 27, 2023

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. This has been a growing trend in health care enforcement, and health care fraud remained the leading source of all FCA cases in 2022. COVID-10 Related Fraud.

Nursing Homes 40

Nursing Homes Fraud Medicaid Medicaid 40

Hall Render

JANUARY 21, 2022

5 states facing highest, lowest weekly nursing home COVID-19 positivity rates. AMDA releases COVID-19 vaccine medical exemption request forms, guidance. CMS healthcare worker COVID-19 vaccination mandate enforceable nationwide after Texas suit dismissed. COVID-19 emergency could end this year, WHO says.

COVID-19 40

COVID-19 Nursing Homes COVID-19 Vaccine Nurses 40

Hall Render

JANUARY 14, 2022

Supreme Court blocks Biden Covid vaccine mandate for businesses, allows health-care worker rule. 19% of US hospitals critically understaffed, 21% anticipate shortages: Numbers by state. 5 states facing the worst nursing home COVID-19 outbreaks. CMS proposed rule seeks to lower Medicare Part D prescription drug costs.

COVID-19 40

COVID-19 Nursing Homes Nurses COVID-19 Vaccine 40

Hall Render

JANUARY 28, 2022

Biden administration withdraws Covid vaccine mandate for businesses after losing Supreme Court case. COVID-positive employees returning to work: 2 CEOs share their protocols. Medicare posts key nursing home staffing info for consumers. State health officer discusses Alabama’s COVID-19 peak.

Nursing Homes 40

Nursing Homes COVID-19 US Department of Health and Human Services Nurses 40

Hall Render

AUGUST 4, 2023

1 CMS final rule boosts Medicare hospice payments by 3.1% 1 CMS final rule boosts Medicare hospice payments by 3.1% News The 5 best hospitals in Florida for cardiac care Florida COVID-19 cases almost double since May GEORGIA 12 Metro ATL Hospitals Among Nation’s Best: U.S. To Address SDOH Needs U.S.

COVID-19 40

COVID-19 Hospitals Nursing Homes Nurses 40

Hall Render

FEBRUARY 25, 2022

40% of Nursing Home Residents Haven’t Received COVID-19 Boosters, Analysis Finds. Biden extends COVID-19 national emergency. No COVID-19 boosters for 70% of nursing home staffs, AARP says. The 55 hospitals penalized by Medicare 8 years straight over patient complications.

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40

Hall Render

FEBRUARY 4, 2022

CMS clarifies COVID-related LTC survey process. Medicare patients win the right to appeal gap in nursing home coverage. Alabama sees decrease in positive COVID-19 tests. Alabama hospitals react to COVID relief funds approval. Huntsville Hospital System reaches record number of Covid-19 inpatients.

COVID-19 40

COVID-19 US Department of Health and Human Services Nursing Homes Nurses 40

Hall Render

MARCH 25, 2022

OSHA accepting new comments on healthcare worker COVID-19 protection rule. OSHA will hold hearing on permanent COVID-19 standard for healthcare workers. Moderna wants the FDA to authorize its COVID-19 vaccine for kids under 6. Alabama COVID hospitalizations drop to lowest point since pandemic started.

COVID-19 40

COVID-19 US Department of Health and Human Services Nursing Homes Nurses 40