Healthcare IT News - Telehealth

SEPTEMBER 3, 2020

Centers for Medicare and Medicaid Services to extend administrative flexibility around greater portability of licensure for telehealth service providers. "States and the federal government should work to harmonize definitions and regulations (e.g., Kat Jercich is senior editor of Healthcare IT News.

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Licensing Medicare Medicare Governance 157

Healthcare IT News - Telehealth

APRIL 30, 2021

Questions about the future of telehealth regulations have endured ever since the federal government opted to relax some of them during the COVID-19 pandemic. Access for Medicare beneficiaries. A years-long effort.

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COVID-19 Medicare Medicare Public Health 214

Healthcare Law Blog

JANUARY 26, 2023

BACKGROUND The Proposed Rule is the latest in a long line of federal legislation and rulemakings governing the conscience rights of healthcare providers and entities. The Church Amendments In the 1970s, the federal government enacted the Church Amendments, 42 U.S.C.

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ACA Medicaid Medicaid Compliance 105

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”). Enrollee Participation in Dual Eligible Special Needs Plan (“D-SNP”) Governance (§ 422.107).

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American Medical Compliance

MARCH 15, 2024

Furthermore, it prohibits knowingly submitting false or false claims to Medicare, Medicaid, or other federally funded healthcare programs. HIPAA regulations govern the use, disclosure, and safeguarding of protected health information (PHI) by covered entities and their business associates.

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Compliance Fraud HIPAA Health Insurance 105

Healthcare IT Today

OCTOBER 20, 2023

Previous articles covered the definition, collection, sharing, and use of SDoH. Food Aid Federal government food programs expanded significantly during the COVID-19 crisis. Recently, though, Medicaid has imposed tight restrictions on its food programs , leaving more people food-insecure.

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Medicaid Medicaid COVID-19 Doctors 114

Compliancy Group

JANUARY 3, 2024

When auditing claims, medical records, and financial documentation, it is essential to incorporate guidance based on the following questions: Are all codes for services and supplies correct?

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 52

MedTrainer

DECEMBER 7, 2023

State-specific governing bodies, such as the Bureau of Facility Standards , provide oversight with certain standards, adding a layer of complexity to successfully managing healthcare compliance in Idaho. Similar to other states, Idaho has its own unique regulations and requirements that healthcare providers and organizations must adhere to.

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Compliance Licensing Compliance Officers Informed Consent 52

HIPAA Journal

NOVEMBER 4, 2022

Warner suggests the only way to improve healthcare cybersecurity rapidly is through a collaborative effort involving the public and private sectors, with the federal government providing overall leadership. The program would standardize coverage elements and provide incentives for insurance companies to adopt them.

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HIPAA Governance FDA Medicaid 113

Provider Trust

MAY 17, 2022

In this post, we’ll break down the definition of healthcare vendors and summarize the most important and impactful laws and regulations that apply to vendors and the healthcare organizations that contract with them. Which regulations govern vendor compliance? So what does that mean for your healthcare organization’s compliance program?

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Compliance Medicare Medicare Due Diligence 52

Healthcare IT News - Telehealth

MARCH 18, 2022

Norden is particularly passionate about funding companies focused on the Medicaid population – a traditionally tricky and often ignored area. Fortunately, government, investors and startups are working together to close some of these care gaps. What's happening in this area of digital health?

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Medicaid Medicaid COVID-19 Telemedicine 198

Health Law Advisor

AUGUST 14, 2023

Similarly, the Stark Law carveout from the definition of “referral” – for services that are personally performed by a physician – rarely will apply with respect to DME. 3] As indicated above, the temporary waiver that allowed mailing or home delivery of DME during the COVID-19 PHE expired May 11, 2023 and is no longer available. 2, 2023). [2]

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COVID-19 Medicare Medicare Public Health 52

Healthcare IT Today

FEBRUARY 15, 2024

Sarah Carroll, Senior Vice President, Center for Care Transformation at AVIA Health Medicaid and Medicare have become one of the biggest quiet crises in health systems today. US hospitals regularly lose $100B annually on Medicaid and Medicare patients but continue to chase higher-margin commercial patients to drive toward profitability.

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Medical Device Industry Medicaid Medicaid Nurses 105

Healthcare Law Today

JANUARY 2, 2023

As written, the proposed rule would remove the existing “reasonable diligence” standard for identification of overpayments, and add the “knowing” and “knowingly” FCA definition. For example, in a 2015 case, DOJ attorneys stated in a court conference, “[T]his is not a question. Healthfirst, Inc. ,

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Overpayments Overpayment ACA Medicare 52

MedTrainer

MARCH 28, 2024

The answer has as many layers as the definition of compliance itself. Establishes a governance structure, reviews compliance reports, and ensures the organization operates ethically and within legal boundaries. But that’s only one aspect of this complex – and sometimes confusing – process.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

AIHC

SEPTEMBER 5, 2023

Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs. This is also called “store-and-forward telemedicine.”

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COVID-19 Telemedicine Compliance Informed Consent 59

Healthcare IT Today

OCTOBER 18, 2023

Data can be spotty, according to Eye, who says for instance that data from Centers for Medicare & Medicaid Services (CMS) often lacks racial identifications. The service pulls together the profiles maintained by facilities and local governments and combines relevant information to display to providers.

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Doctors Public Health Medicare Medicare 114

Hall Render

NOVEMBER 18, 2022

On November 2, 2022, CMS announced revisions to the Calendar Year 2023 Payment Policies that impact Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; and Medicare and Medicaid Provider Enrollment Policies (“CY 2023 PFS Final Rule”). New Definitions.

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Nurses Nursing Homes Medicare Medicare 40

Hall Render

NOVEMBER 15, 2023

Billing for Advanced Practice Professionals (“APPs”) has been a challenging area for providers and practitioners because of different and changing Medicare, Medicaid and state law requirements. APPs should be enrolled in the Medicare and Medicaid programs and credentialed with commercial payors.

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Medicare Medicare Medicaid Medicaid 40

Health Law Advisor

NOVEMBER 23, 2021

On November 12, 2021, the Centers for Medicare and Medicaid Services (“CMS”) released final guidance confirming that hospitals can be co-located with other hospitals or healthcare providers. The allowableness of shared-space arrangements in such circumstances may hinge on compliance with the provider-based regulation, 42 C.F.R.

Hospitals 40

Hospitals Compliance Medicare Medicare 40

AIHC

APRIL 10, 2024

HIPAA and HITECH is for all health care organizations falling under the definition as a Covered Entity, from solo practices to larger clinics and hospital medical networks to health plans and clearinghouses. There is a lot of information available.

Compliance 99

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 99

Healthcare Law Today

JANUARY 20, 2022

The entity is also prohibited from billing Medicare or, possibly, Medicaid for such referrals. It is noteworthy that requirements of the IOAS, including compliance with the definition of “group practice” are well beyond the scope of this discussion, but should be reviewed, in depth, with counsel knowledgeable with them.

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Compliance Medicare Medicare COVID-19 52

HIT Consultant

NOVEMBER 22, 2021

July 1, 2021 was the enforcement date for the Centers for Medicare and Medicaid Services (CMS) Interoperability and Patient Access final rule. John Kelly, Principal Business Advisor, Edifecs. The healthcare industry is now closer than ever to its quest for true interoperable data exchange. Compliance Challenges.

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Compliance Medicaid Medicaid Medicare 52

C&M Health Law

FEBRUARY 16, 2021

On November 13, 2020, the Centers for Medicare & Medicaid Services (“CMS”) published a final rule , demonstrating long-awaited efforts to streamline the regulatory framework governing the Medicaid and Children’s Health Insurance Program (“CHIP”) managed care programs. Standard Contract Requirements/Coordination of Benefits.

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Medicaid Medicaid Medicare Medicare 40

Health Populi

MAY 6, 2018

government (which offers several flavors of plans through the VA, Tricare for active military, Medicare for aging people and Medicaid for people with low-incomes) or private sector employers, unions, and other insurance-conveners. .” At the time, this was one of the world’s biggest public-sector financed health plan.

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Medicaid Medicaid Medicare Medicare 54

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. "If you've seen one Medicaid program, you've seen one Medicaid program.

US Department of Health and Human Services 230

US Department of Health and Human Services Medicaid Medicaid Governance 230

AIHC

APRIL 10, 2024

HIPAA and HITECH is for all health care organizations falling under the definition as a Covered Entity, from solo practices to larger clinics and hospital medical networks to health plans and clearinghouses. There is a lot of information available.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 52

Healthcare Law Blog

NOVEMBER 21, 2022

Pharmaceutical manufacturers are challenging the breadth of the Federal Anti-Kickback Statute (“AKS”) in federal court, arguing that the government is harming the very vulnerable patients it aims to serve by prohibiting cost-sharing subsidies for life-saving oncology drugs. OIG appears to want to have its cake and eat it, too.

Medicare 52

Medicare Medicare Governance Medicaid 52

Healthcare Law Blog

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). Enrollee Participation in Plan Governance (§ 422.107). and 422.107).

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

Hall Render

FEBRUARY 21, 2023

For NFs, the data would be reported via means prescribed by the particular state Medicaid agency. The post Proposed Ownership Disclosure Requirements for Medicare Skilled Nursing Facilities and Medicaid Nursing Facilities appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

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Nurses Medicaid Medicaid Medicare 40

Healthcare Law Blog

NOVEMBER 16, 2023

Department of Health and Human Services’ Centers for Medicare and Medicaid Services (“CMS”) will publish a final rule requiring Medicare skilled nursing facilities (“SNFs”) and Medicaid nursing facilities (“Facilities”) to provide more detailed ownership, managerial and other information on Form CMS-855A (the “Final Rule”). [1]

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Nurses Medicaid Medicaid Medicare 52

Total Medical Compliance Resources

APRIL 14, 2023

FACT SHEET: Biden-Harris Administration Makes Progress in the Whole-of-Government Response to Long COVID U.S. Diagnosis code education: The Centers for Medicare and Medicaid developed educational materials for providers so they can use the new ICD-10 code for Long COVID. Agencies across the U.S.

Governance 59

Governance COVID-19 Department of Veterans Affairs COVID-19 Vaccine 59

AIHC

NOVEMBER 3, 2021

This definition applies to “access” as used in this subpart, not as used in subpart E of this part [the HIPAA Privacy Rule]).” The government HIPAA privacy/security enforcement agency is the Office for Civil Rights (OCR). Information Access Management and Access Control are two HIPAA Security Rule standards that govern access to ePHI.

HIPAA 52

HIPAA Compliance Electronic Medical Records Governance 52

Healthcare Law Blog

FEBRUARY 27, 2023

On February 15, 2023, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule that would require nursing homes enrolled in Medicare and Medicaid to disclose new information about their ownership and management structures. Finally, CMS proposed a number of other definitions (e.g.,

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Nursing Homes Nurses Medicaid Medicaid 52

Healthcare Law Blog

AUGUST 3, 2022

is a reminder that the government will use the FCA to target medical device manufacturers for off-label use of medical devices, even where healthcare providers have decided the use is safe and effective. The government is attempting to prove materiality using Medicare’s coverage requirement that procedures must be “reasonable and necessary.”

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Governance FDA Medicare Medicare 52

Hall Render

JULY 14, 2023

On Friday, June 20, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update (“PPS Rule”), which has since been published in the Federal Register and is currently open for comment.

Medicare 52

Medicare Medicare Payment Systems Governance 52

Hall Render

APRIL 6, 2022

Turning to the present case, in Safeway , the relator alleged that the defendant engaged in the submission of false claims to the government when it “reported its ‘retail’ price for certain drugs as its ‘usual and customary’ price.” Guidance Must Be Truly Authoritative and Must Come from An Actual Authority. Practical Takeaways.

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Medicare Medicare Medicaid Medicaid 72