Healthcare IT News - Telehealth

JUNE 8, 2020

"Regrettably, minority groups are being left behind by the telehealth revolution," said David Smith, executive director for the Medicaid Transformation Project, in an interview with Healthcare IT News. " David Smith, Medicaid Transformation Project Executive Director. Since the pandemic began its spread across the U.S.

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COVID-19 Medicaid Medicaid Telemedicine 181

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., But the details of telehealth reimbursement are still unknown.

Licensing 158

Licensing Medicare Medicare Governance 158

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.

Medicaid 122

Medicaid Medicaid COVID-19 Doctors 122

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

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

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.

Compliance 105

Compliance Fraud HIPAA Health Insurance 105

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?

Compliance 52

Compliance Medicare Medicare Due Diligence 52

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. ,

Overpayments 52

Overpayments Overpayment ACA Medicare 52

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. This standard was interpreted and applied differently by various Medicare contractors and was difficult to review/audit.

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Medicare Medicare Medicaid Medicaid 40

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.

Compliance 52

Compliance Licensing Compliance Officers Informed Consent 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. As artificial intelligence becomes increasingly integral to healthcare, the urgency to integrate ethical governance cannot be overstated.

Medical Device Industry 117

Medical Device Industry Medicaid Medicaid Nurses 117

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.

HIPAA 115

HIPAA Governance FDA Medicaid 115

AIHC

SEPTEMBER 5, 2023

Medicare covers many telebehavioral and telemental health services including audio-only services. 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.

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

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

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

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.

Doctors 122

Doctors Public Health Medicare Medicare 122

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).

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

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

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 199

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.

Compliance 52

Compliance Medicare Medicare COVID-19 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. and $500.39. [4].

Medicare 52

Medicare Medicare Governance Medicaid 52

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

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

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.

Compliance 52

Compliance Medicaid Medicaid Medicare 52

Hall Render

FEBRUARY 21, 2023

For SNFs, the data would be reported by completing the Form CMS-855A Medicare enrollment application (“CMS-855A” or “Form”). For NFs, the data would be reported via means prescribed by the particular state Medicaid agency.

Nurses 40

Nurses Medicaid Medicaid Medicare 40

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. How are we thinking about the way Medicare and Social Security work together?" " asked Palm.

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US Department of Health and Human Services Medicaid Medicaid Governance 228

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.

Medicaid 54

Medicaid Medicaid Medicare Medicare 54

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

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. Actuarial Soundness. Actuarial Soundness.

Medicaid 40

Medicaid Medicaid Medicare 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]

Nurses 52

Nurses Medicaid Medicaid Medicare 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.,

Nursing Homes 52

Nursing Homes Nurses Medicaid Medicaid 52

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

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.”

Governance 52

Governance FDA Medicare Medicare 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.

Medicare 72

Medicare Medicare Medicaid Medicaid 72

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

HIPAA Journal

MAY 12, 2023

The term “continuity of care” has various definitions. Some definitions imply care is continuous within the same healthcare organization (or Organized Health Care Arrangement), while others extend the definition to multiple healthcare settings. 42 CFR Part 2).

HIPAA 64

HIPAA Compliance Health Services Administration Medicare 64

AIHC

FEBRUARY 16, 2024

The “Cobra” - In the late 1800s-early 1900s when India was ruled by the British government, there was a problem with venomous cobras invading major cities. The British government decided to take action and offered citizens a bounty to redeem for dead cobras. The government eventually found out and stopped the financial incentives.

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52