Healthcare IT Today

MARCH 19, 2020

One of the biggest health IT related news items to come out was the announcement by Vice President Mike Pence that HHS was issuing a regulation to permit doctors to practice across state lines. State Medical Licensure is something that has baffled many of us that have worked in healthcare.

Doctors 77

Doctors Medicaid Medicaid Medicare 77

The Health Law Firm Blog

MAY 8, 2023

Board Certified by The Florida Bar in Health Law Recently it has come to our attention that there may be a nationwide effort by the Centers for Medicare and Medicaid Services (CMS) Medicare Administrative Contractors (MACs) to squelch physicians who prescribe opioids [.] Indest III, J.D.,

Medicare 52

Medicare Medicare Doctors Medicaid 52

The Health Law Firm Blog

MARCH 16, 2022

Board Certified by The Florida Bar in Health Law On November 2, 2021, a doctor and his wife who had been indicted for their roles in a $1.3 million Medicare fraud scheme asked a New Jersey court to eliminate a bail condition. The doctor argued that the. Indest III, J.D.,

Fraud 52

Fraud Medicare Medicare Doctors 52

Med-Net Compliance

JULY 20, 2022

A federal jury convicted a New York ENT doctor for defrauding Medicare and Medicaid by causing the submission of false and fraudulent claims for surgical procedures that were not performed. Medicare and Medicaid data demonstrated that he was identified as an outlier and the highest biller for this procedure in New York State.

Fraud 59

Fraud Doctors Medicare Medicare 59

Bill of Health

SEPTEMBER 9, 2022

And we know that our prisons, jails, and detention centers employ doctors with suspended and limited licenses as the exclusive source for health care for incarcerated people. health law and policy is the exclusion of people in custody in prisons, jails, and detention centers from Medicaid. These voluntary standards, within the U.S.

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COVID-19 COVID-19 Vaccine Medicaid Medicaid 349

The Health Law Firm Blog

MAY 8, 2023

Board Certified by The Florida Bar in Health Law Recently it has come to our attention that there may be a nationwide effort by the Centers for Medicare and Medicaid Services (CMS) Medicare Administrative Contractors (MACs) to squelch physicians who prescribe opioids and other narcotic medications. Indest III, J.D.,

Medicare 40

Medicare Medicare Doctors Medicaid 40

The Health Law Firm Blog

MAY 8, 2023

Board Certified by The Florida Bar in Health Law Recently it has come to our attention that there may be a nationwide effort by the Centers for Medicare and Medicaid Services (CMS) Medicare Administrative Contractors (MACs) to squelch physicians who prescribe opioids and other narcotic medications. Indest III, J.D.,

Medicare 40

Medicare Medicare Doctors Medicaid 40

The Health Law Firm Blog

MAY 8, 2023

Board Certified by The Florida Bar in Health Law Recently it has come to our attention that there may be a nationwide effort by the Centers for Medicare and Medicaid Services (CMS) Medicare Administrative Contractors (MACs) to squelch physicians who prescribe opioids [.] Indest III, J.D.,

Medicare 40

Medicare Medicare Doctors Medicaid 40

Medisys Compliance

DECEMBER 23, 2022

The internet is ringing with the news of the CMS Updates Final rule for the 2023 Medicare Physician Fee Schedule. The finalized 2023 Medicare Physician Fee Schedule was announced by the Centers for Medicare & Medicaid Services (CMS) on November 1 2022. Medicare reimbursement for telehealth services.

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Medicare Medicare Medical Billing Medical Billing Outsourcing 98

HIT Consultant

FEBRUARY 21, 2024

Don Rucker, MD – Chief Strategy Officer, 1upHealth CMS and Medicare are trying to change the dynamics of American healthcare. For the last 20 years, Medicare Fee for Service has been the hotspot of spending and value. Now fast forward to today and Medicare Advantage has more beneficiaries.

Medicare 52

Medicare Medicare Doctors Medicaid 52

Med-Net Compliance

JUNE 15, 2022

California Attorney General Rob Bonta announced a settlement against a Southern California doctor for submitting false claims to Medicare and Medi-Cal between the years of 2011 and 2018 for drugs, procedures, services, and tests that were never administered to patients. The doctor?is?an The case was ? in October 2017?under

Fraud 59

Fraud Doctors Elder Abuse Medicare 59

Kaiser Health News

JUNE 29, 2022

Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars every year, government watchdogs told a House panel Tuesday. Medicare Advantage plans accept a set fee from the government for covering a person’s health care.

Medicare 105

Medicare Medicare Governance Overpayments 105

The Health Law Firm Blog

FEBRUARY 11, 2022

Board Certified by The Florida Bar in Health Law Recently it has come to our attention that there may be a nationwide effort by the Centers for Medicare and Medicaid Services (CMS) Medicare Administrative Contractors (MACs) to squelch physicians who prescribe opioids and other narcotic medications. Indest III, J.D.,

Medicare 40

Medicare Medicare Doctors Medicaid 40

The Health Law Firm Blog

FEBRUARY 11, 2022

Board Certified by The Florida Bar in Health Law Recently it has come to our attention that there may be a nationwide effort by the Centers for Medicare and Medicaid Services (CMS) Medicare Administrative Contractors (MACs) to squelch physicians who prescribe opioids and other narcotic medications. Indest III, J.D.,

Medicare 40

Medicare Medicare Doctors Medicaid 40

The Health Law Firm Blog

FEBRUARY 11, 2022

Board Certified by The Florida Bar in Health Law Recently it has come to our attention that there may be a nationwide effort by the Centers for Medicare and Medicaid Services (CMS) Medicare Administrative Contractors (MACs) to squelch physicians who prescribe opioids and other narcotic medications. Indest III, J.D.,

Medicare 40

Medicare Medicare Doctors Medicaid 40

The Health Law Firm Blog

FEBRUARY 11, 2022

Board Certified by The Florida Bar in Health Law Recently it has come to our attention that there may be a nationwide effort by the Centers for Medicare and Medicaid Services (CMS) Medicare Administrative Contractors (MACs) to squelch physicians who prescribe opioids and other narcotic medications. Indest III, J.D.,

Medicare 40

Medicare Medicare Doctors Medicaid 40

Medisys Compliance

MARCH 21, 2023

What is Credentialing Doctors? Credentialing of doctors is a process that involves the evaluation of a doctor’s qualifications, education, training, licensure, and experience to determine if they meet the requirements set by the insurance company.

Doctors 52

Doctors Malpractice Licensing Medical Billing Outsourcing 52

Foster Swift

APRIL 16, 2024

In recent years, Michigan has been home to two of the largest sexual abuse scandals involving doctors in history: the sexual abuse committed by Larry Nassar while employed by Michigan State University and the sexual abuse committed by Robert Anderson while employed by the University of Michigan.

Informed Consent 52

Informed Consent Health Care Reform Doctors Medicaid 52

Kaiser Health News

AUGUST 12, 2022

First, it would give the federal government the ability to negotiate prices of some drugs purchased by Medicare beneficiaries, a tool that has long been opposed by the drug industry. Department of Health and Human Services to identify Medicare’s 100 most expensive drugs and then pick 10 for price negotiations starting in 2023.

Medicare 88

Medicare Medicare Prescription Drug Pricing Governance 88

Medisys Compliance

APRIL 11, 2024

Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) can now directly bill Medicare for services they furnish and diagnose. This milestone represents a major victory for the mental health professions, expanding access to much-needed care for Medicare beneficiaries and offering exciting new possibilities for MFTs and MHCs.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

The Health Law Firm

OCTOBER 31, 2019

Board Certified by The Florida Bar in Health Law On October 1, 2019, a Florida doctor was implicated in what federal investigators say is one of the largest health care fraud schemes ever charged. billion worth of false Medicare and Medicaid claims between July 2018 and January 2019. Indest III, J.D.,

Fraud 40

Fraud Medicare Medicare Doctors 40

Med-Net Compliance

JULY 1, 2022

Fifteen Texas doctors have agreed to pay a total of $2,831,280 to resolve False Claims Act allegations involving illegal kickbacks in violation of the Anti-Kickback Statute and Stark Law, and to cooperate with the Department of Justice’s investigations of and litigation against other parties.

Doctors 59

Doctors Medicare Medicare Hospitals 59

The Health Law Firm

OCTOBER 3, 2019

Board Certified by The Florida Bar in Health Law On October 1, 2019, a Florida doctor was implicated in what federal investigators say is one of the largest health care fraud schemes ever charged. billion worth of false Medicare and Medicaid claims between July 2018 and January 2019. Indest III, J.D.,

Fraud 40

Fraud Doctors Medicare Medicare 40

Health Populi

MAY 21, 2020

Doctors maintain their top status as U.S. However, as patients continue to be concerned about exposure to COVID-19, 3 in 5 are concerned about being at-risk to the virus in their doctor’s office, according to research from the Alliance of Community Health Plans (ACHP) and AMCP , the Academy of Managed Care Pharmacy.

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COVID-19 Doctors Health Insurance Medicare 159

Healthcare Law Blog

SEPTEMBER 28, 2023

The Centers for Medicare & Medicaid Services (“CMS”) released the final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”) on January 30, 2023. MAOs will be required to remit improper payments identified during RADV audits in a manner specified by CMS.

Medicare 52

Medicare Medicare Overpayments Overpayment 52

Verisys

MARCH 8, 2024

Million Medicare and Medicaid Fraud Full Story Pharmacist Fraud Pharmacy Owner and Operations Manager Convicted of $2.3M Peters Physician Pleads Guilty to False Statements, Resulting in $1.4 Million Full Story Protect your organization from bad actors with Verisys.

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Fraud Medicaid Medicaid Medicare 52

MedTrainer

SEPTEMBER 20, 2023

Examples of covered entities include health plans, clearinghouses, and certain health care providers including but not limited to: doctors, clinics, psychologists, dentists, chiropractors, nursing homes, and pharmacies. There are several accrediting organizations that require facilities to meet or exceed Medicaid and Medicare guidelines.

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Medicaid Medicaid Medicare Medicare 97

Verisys

FEBRUARY 9, 2024

Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Million Civil Judgment and Drug Treatment Center Enters Settlement to Pay $2.2

Fraud 52

Fraud Medicaid Medicaid Medicare 52

MedTrainer

JUNE 15, 2022

This is the case for proposed changes to the Medicare Shared Savings Program, as they’ll impact ACOs in more ways than one if they’re enacted. Before we discuss the proposed changes to the Medicare Shared Savings Program, let’s take a moment to review ACOs. What Are the Changes to the Medicare Shared Savings Program?

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Health Care Law Brief

FEBRUARY 2, 2023

Evident potential implications include: Traditional Medicare and Medicare Advantage beneficiaries may lose their ability to obtain free at-home COVID-19 testing and treatments and may have to begin paying certain cost-sharing amounts relating to these and other testing and treatments.

COVID-19 98

COVID-19 Medicare Medicare Medicaid 98

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 144

Medicare Medicare Doctors Fraud 144

Healthcare IT News - Telehealth

MARCH 2, 2023

WHY IT MATTERS The dual team study published by Epic found that 60% of the time, the virtual primary care telehealth appointments held between March 1, 2020, and October 15, 2022, did not result in subsequent doctors visits. "Americans are having a harder time securing an appointment with a doctor than 10 years ago," he pointed out.

Doctors 148

Doctors Telemedicine Medicaid Medicaid 148

Health Populi

AUGUST 28, 2019

These two surveys are: The Morning Consult’s poll published today finding growing support among Democratic voters for Medicare for All as the centerpiece for health reform in America; and, A recent study from Eligibility.com on “Medicare Myths Explained,” with the tagline, “How much do you know about Medicare?”

Medicare 94

Medicare Medicare ACA Prescription Drug Pricing 94

Provider Trust

JANUARY 25, 2024

Ensuring the Financial Integrity of HHS Programs In fiscal year (FY) 2022, improper payments within healthcare programs like Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) were estimated at a staggering $131.6 With Medicaid, the challenges are equally formidable.

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Fraud Medicaid Medicaid Medicare 52

Healthcare IT News - Telehealth

APRIL 10, 2020

The Centers for Medicare and Medicaid Services has temporarily suspended several regulations to enable hospitals, clinics and other providers to boost their front-line medical staff during the coronavirus pandemic.

Nurses 211

Nurses Medicare Medicare Licensing 211

Verisys

NOVEMBER 20, 2022

Pain management doctor gave patients steroid injections even after patients complained of negative side effects. A psychiatrist caught improperly billing over $1.36M to Medicare over the course of seven years. The group steered members to bill Medicaid rather than going through the NICA. Pharma Fraud . Pharma Fraud.

Fraud 52

Fraud Medicaid Medicaid Nursing Homes 52

Health Populi

JUNE 6, 2018

Doctors have a complicated relationship with electronic health records (EHRs): two-thirds of primary care providers (PCPs) see value in digital records (EHRs), but at the same time believe the technology has weakened relationships with patients, detracted from clinical effectiveness, and lack streamlined user experience.

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Doctors Medicaid Medicaid Electronic Medical Records 87