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These are the compliance issues providers should be preparing for, post-PHE

Healthcare IT News - Telehealth

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. Additionally, any reimbursement resulting from these claims could be considered an overpayment. Healthcare IT News is a HIMSS publication.

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Clinical Trial Payments: Optimizing the Path Forward for Site Payments

HIT Consultant

This is in stark contrast to just 14% before the Covid-19 pandemic and 47% at the pandemic’s peak. They can reduce the burden on clinical and financial staff for payments, disputes, reporting and reconciliations, all while minimizing site and study overall costs and overpayments.

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Retrieving Billions in Overpayments by CMS

Healthcare IT Today

Challenges of Investigating Overpayments Undeserved payments are needles lurking in the haystack of 135 million Americans enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). Currently, Pults told me, CMS is focusing on overbillings during the height of the COVID-19 pandemic.

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Medicare Advantage 2024 Rate Announcement – Further Impacts to Risk Adjustment

Health Care Law Brief

The 2024 EGR also accounts for effects from COVID-19 and other changes, such as lower morbidity from excess COVID-19-related deaths, lower total spending due to shifts in care from inpatient to outpatient settings (e.g., hip and knee replacements), and to reflect an increase in dual-eligible beneficiaries enrolling in MA.

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Introduction to Telebehavioral Health

AIHC

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.

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2023 Non-Monetary Compensation to Physicians (and Chance to Review 2022)

Hall Render

As part of the final regulations released by the Centers for Medicare & Medicaid Services (“CMS”) effective January 19, 2021, CMS finalized a new exception for arrangements where an entity pays a physician less than $5,000 over the course of a calendar year in exchange for items or services. New Exception for Limited Remuneration.

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Preventing Genetic Testing Fraud: 5 Actions for Health Plans

Healthcare IT Today

So are scenarios where individuals who seek COVID-19 testing are also persuaded to submit to a cheek swab for genetic tests related to Parkinson’s disease, Alzheimer’s disease, diabetes, obesity, dementia and more. A “catchall” code used to bypass claim edits.

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