Wed.Nov 15, 2023

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UnitedHealth sued over use of algorithm to deny care for MA members

Healthcare Dive

The lawsuit alleges UnitedHealth used nH Predict to deny claims for Medicare Advantage seniors, despite the algorithm’s determinations being overturned in more than 90% of appeals.

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Where social work, tech and health equity intersect

Healthcare It News

Felisha Norrington, director of academic assistance at GSU's College of Nursing and Health Professions, says while there is movement on health equity, social work and technology investments help ensure care resources are accessible to all people.

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Senate subcommittee signals support for permanent telehealth flexibilities

Healthcare Dive

But witnesses noted Congress shouldn’t wait to enshrine pandemic-era accommodations for virtual care, arguing regulatory uncertainty is a danger to telehealth’s longevity.

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Using Automation to Improve Payer Collaboration: On Air Insights

MRO Compliance

Managing laborious payer processes is one of the most cumbersome operational challenges for hospitals and health systems. From initial claim submission to filling additional documentation requests, and responding to payer audits or denials, healthcare provider organizations dedicate significant time and resources to collaboration with payers. I recently had the pleasure of sitting down with Beth Friedman, Senior Partner of FINN Partners, on FINN Voices , part of Healthcare NOW Radio.

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Everything You Wanted to Know About FACIS, but Didn’t Know to Ask

Speaker: Amy Anderson

FACIS® helps organizations mitigate patient and organizational risk. Maintaining compliance and safeguarding against fraud and abuse in today’s changing healthcare landscape can be challenging. Most healthcare organizations screen and monitor providers against the OIG but that’s only ONE of FACIS®’ primary sources. FACIS® pulls data for every taxonomy from the lowest level employee to the highest level licensed professional.

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‘Finger-pointing and blame-shifting’: House subcommittee voices frustration over VA Oracle EHR rollout

Healthcare Dive

Witnesses at the hearing said system performance has improved, but lawmakers called the persistent outages “unacceptable.

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Five Opportunities to Use the Law to Address Persistent OUD Treatment Gaps 

Bill of Health

By Jon Larsen and Sterling Johnson People who need opioid use (OUD) treatment in the United States are often not receiving it — at least two million people with OUD are experiencing a treatment gap that prevents or hampers their ability to receive life-saving care and support. This reality reflects structural, policy, and legal misalignments common to the entire U.S. health care system, but that are especially present for behavioral health needs like substance use, and are exacerbated by other c

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Primary care player Forward unveils AI-based, self-serve CarePods backed by $100M investment

Fierce Healthcare

Primary care player Forward unveiled this week what it has been quietly working on the past two years—self-serve CarePods that use artificial intelligence to screen and diagnose health conditions.< | Primary care player Forward unveiled this week what it has been quietly working on the past two years—self-serve CarePods that use artificial intelligence to screen and diagnose health conditions.

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Centene names new COO following leadership turnover

Healthcare Dive

Current SVP Susan Smith will take the reins as the health insurer’s chief operating executive starting next year.

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UnitedHealthcare hit with class action over alleged use of AI to deny Medicare Advantage claims

Fierce Healthcare

UnitedHealthcare is facing a potential class action lawsuit following allegations that it used an algorithm to deny claims for post-acute care services in Medicare Advantage. | UnitedHealthcare is facing a potential class action lawsuit following allegations that it used an algorithm to deny claims for post-acute care services in Medicare Advantage.

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Amazon’s One Medical partners with employer group for primary care

Healthcare Dive

The primary care chain will serve as a virtual and in-person primary care provider for companies like Coca-Cola, Boeing and JPMorgan.

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Ensure Continuous Patient Care: How to Avoid Disruptions Due to Ransomware

The industry has seen an increasing pace of ransomware, zero-day, and remote-code execution attacks. Learn how to defend against these against these attacks in this eBook.

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Proposals on PBMs and medical devices advanced by House subcommittee

Fierce Healthcare

The House Committee on Energy and Commerce health subcommittee pushed forward 21 proposals on Tuesday, some of which will restrict the power of pharmacy benefit managers (PBMs). | PBMs were a source of bipartisan agreement during a House hearing on Tuesday, while Republicans and Democrats clashed over durable medical equipment legislation.

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Frontline digitisation funds at risk to cover industrial action costs

Digital Health News

A new guidance letter from NHSE to trusts on industrial action suggests investment for frontline digitisation may be pulled from more mature trusts

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Digital pharmacy startup Truepill confirms hackers accessed health data for 2.3M users

Fierce Healthcare

Postmeds, doing business as Truepill, confirmed that hackers accessed the personal data of more than 2.3 million patients. | Postmeds, doing business as Truepill, confirmed that hackers accessed the personal data of more than 2.3 million patients.

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7 Effective Ways To Market Your Medical Practice

Electronic Health Reporter

This article is copyrighted strictly for Electronic Health Reporter. Illegal copying is prohibited. Any doctor’s dream is to open a medical practice and to have patients line up the next day. Unfortunately, it’s a lot more difficult than this. A quick online search for marketing tips gives you […] The article 7 Effective Ways To Market Your Medical Practice appeared first on electronichealthreporter.com.

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Generative AI for Contracts Is Here: New Tools to Accelerate Drafting and Editing

The emergence of generative AI is reshaping the landscape of contract management, enabling businesses to generate and negotiate legal agreements with greater ease and speed. In this on-demand webinar, Hal Marcus, VP of Product Marketing at Evisort discusses how Evisort's generative AI transforms contract creation and negotiation, empowering legal teams to streamline processes while reducing risk.

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Pediatric telehealth startup Summer Health expands text-based service into primary care for kids

Fierce Healthcare

Summer Health launched a year ago as a text-based service for parents to get answers to urgent needs from pediatricians. | There is a growing shortage of pediatric clinicians. To meet the demand for primary care services, Summer Health rolled out a new on-demand text message service for parents to connect with pediatricians, sleep coaches and lactation experts.

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What Are Some of the Uses of AI You’ve Already Seen Implemented in Healthcare?

Healthcare IT Today

AI is a big field in the world of healthcare. It feels as though there is a new theory on the mass potential of AI in (insert field of choice here) every. single. day. But what is actively being done right now? What organizations and fields are using AI? What sort of tasks is it being asked to do and is it doing it well? In the search for answers, we pulled aside some of our most knowledgeable members of the Healthcare IT Today Community at the recent HLTH Conference to get their experiences wit

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NHS Confederation CEO: Innovation can help streamline NHS

Digital Health News

Ahead of the Digital Health Rewired conference in March 2024, Matthew Taylor explains why innovation and greater use of technology hold significant potential to improve the efficiency and effectiveness of the NHS.

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CIO Perspective: The Crucial Role of a Trustworthy Consultant in Building a Sustainable Program

HIT Consultant

Anis Trabelsi, CIO at Palomar Health As a CIO with experience working with various consultants, I understand the importance of finding the right partner, especially in the realm of cybersecurity. Many consultants prioritize financial gains over personalized solutions, making it crucial to seek out ethical, committed and knowledgeable experts. In this article, I will highlight the key factors that make a good consultant, emphasizing the need for trust, a personal touch and a focus on tailored sol

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Best Practices for Sharing Protected Health Information (PHI)

In this ebook, you will learn about the 18 PHI indicators, the legal requirements and penalties surrounding PHI, and how your healthcare teams should securely exchange this data. Key takeaways from this ebook: Gain confidence in identifying PHI. Acquire practical implementation strategies for exchanging PHI within your organization. Emphasize the importance of using compliant communication tools within healthcare teams.

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Zealous for Wellness: Deciding What Kind of Change You Want

Healthcare IT Today

The previous article in this series explained some of the ways payers, providers, and digital health companies demonstrate that they have made a positive difference in their patients’ lives. Jim Wallace, CEO of DecisionRx , writes to me that, “Payer incentives for wellness are largely stuck at the water’s edge, so to speak: few payers have gotten a lot of people to go in for a swim.” Their incentives (health club memberships, subsidies for over-the-counter healthcare products)

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Amazon's One Medical announces three new partnerships

Mobi Health News

Hackensack Meridian Health, CommonSpirit Health's Virginia Mason Franciscan Health, and the Health Transformation Alliance will utilize One Medical's primary care services.

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Surescripts Acquires ActiveRADAR to Offer Therapeutic Alternatives for Prescriptions

Healthcare IT Today

Surescripts , the nation’s leading health information network, acquired ActiveRADAR , a clinical intelligence company that identifies therapeutic alternatives for prescriptions. “We are always looking for ways to broaden our impact on patients and the people who care for them,” explained Frank Harvey, Chief Executive Officer at Surescripts. “Our acquisition of ActiveRADAR underscores our commitment to optimizing our network solutions with even more comprehensive clinical and cost data avai

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Mental health platform UpLift acquires women-focused company Minded

Healthcare IT News - Telehealth

The acquisition brings UpLift's offerings to Illinois, New York, Pennsylvania, Texas and California, helping to speed up its ability to expand nationally.

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Buyer's Guide: Evaluating and Selecting the Best CLM Solution for Your Organization

Evaluating and selecting the right contract lifecycle management (CLM) platform can be complicated. However, by getting the right people involved, prioritizing your business needs, and testing your technology options, you can make it easier.

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Six Compelling Reasons to Begin Your HIPAA Compliance Journey Before the Year Ends

Total HIPAA

As 2023 unfolds, the urgency for entities in the healthcare sector to initiate or reinforce their HIPAA compliance cannot be overstated. This isn’t just about ticking off a checklist; it’s about safeguarding the future of your organization, whether you’re a medical practice, a health insurance agent, a self-funded employer, or a business associate in the healthcare realm. 1.

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Digital Health Coffee Time Briefing ?

Digital Health News

This coffee briefing features a drug discovery partnership between Almirall and Absci, and a new rehabilitation hub for stroke survivors in Lanarkshire.

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Lee Health System Leverages KeyCare’s Epic Platform to Provide 24/7 Virtual Care Access

HIT Consultant

What You Should Know: – KeyCare , the nation’s first Epic-based virtual care company, has partnered with Lee Health , a leading provider of healthcare in Florida, to deliver high-quality virtual urgent care with licensed providers (known as Virtualists). – Lee Health patients can now get 24×7 care across all 50 states via a virtual visit through Lee Health’s MyChart patient portal.

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Digital Health Unplugged: AI and Data news team debrief

Digital Health News

The Digital Health News team return as news editor Andrea Chipman makes her debut alongside CEO Jon Hoeksma and news reporter and host Jordan Sollof.

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HIPAA: Why It Matters to Your Practice

85% of practices are not complying with the government’s HIPAA standards. The large majority of practices are likely trying to protect patients’ information, but they may not be doing all that they need to meet government requirements. Not complying with HIPAA has definite drawbacks, with one major one being massive fines. The government can fine up to 1.5 million dollars for a single HIPAA breach incident - an amount that would put most small practices out of business.

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Meet The Circular Smart Ring Slim, The Slimmest and Lightest Smart Ring in the World

HIT Consultant

What You Should Know: Following the success of the groundbreaking Circular Ring Pro, Circular, pioneers of smart ring technology, is excited to unveil the Circular Ring Slim , the thinnest, and lightest, most intuitive smart ring in the world and the first to incorporate haptic navigation and alerts. Paired with Kira+, Circular’s powerful AI wellness assistant, the sleek Circular Ring Slim assesses 7 biometrics and 142 derived markers 24/7 to help people sleep better and live healthier liv

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Koa Health external ethics audit shows 24% improvement

Digital Health News

Koa Health has announced that the results of its 2022-2023 external ethics audit show a 24% improvement in comparison to the year before.

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Ohio hospital reports 3rd party data breach

Becker's Health IT

Salem (Ohio) Regional Medical Center is the latest hospital to confirm being affected by a data breach that occurred at Perry Johnson & Associates, a medical transcription service, local news outlet, WFMJ reported Nov. 15.

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Mental health platform UpLift acquires women-focused company Minded

Mobi Health News

The acquisition brings UpLift's offerings to Illinois, New York, Pennsylvania, Texas and California, helping to speed up its ability to expand nationally.

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Forrester Wave™ Contract Lifecycle Management for 2023

In The Forrester Wave™ Contract Lifecycle Management, Q3 2023, Evisort has debuted as a Strong Performer.