Fri.Apr 29, 2022

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Medicare Advantage plans denied some members needed care, OIG finds

Healthcare Dive

The report calls for improved oversight of MA and urges the CMS to update audit protocols and issue new guidance on medical necessity reviews performed by the plans.

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Mobilizing Long COVID Awareness to Better Support People with Acquired Disabilities

Bill of Health

By Marissa Wagner Mery. Long COVID exposes an often-unacknowledged facet of disability: that one is far more likely to develop a disability than be born with one. Estimates suggest that, at present, approximately 10 – 20 million Americans are now afflicted with the array of debilitating symptoms we now call Long COVID , which include fatigue, shortness of breath, and cognitive dysfunction or “brain fog.”.

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Bristol Myers wins FDA approval for first drug to treat inherited heart condition

Healthcare Dive

Bristol Myers paid $13 billion to acquire the drug's maker, MyoKardia, and expects it to become a blockbuster. But a tricky dosing regimen, as well as safety concerns, could challenge the pharmaceutical giant's lofty forecast.

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Follow the (Medical) Record: Elliott Noble-Holt and MediCopy

MRO Compliance

Follow the (Medical) Record: Elliott Noble-Holt and MediCopy. Host Don Hardwick interviews Elliott Noble-Holt, founder and CEO of MediCopy, now an MRO Company. Elliot talks about his journey to becoming an entrepreneur and founding MediCopy, as well as summarizing his new book, Bald Bearded Boss. HealthcareNOW Radio Podcast Network · Follow the (Medical) Record: Elliott Noble-Holt, founder and CEO of MediCopy.

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Optimizing Medical Waste Management: A Guide to Best Practices

Feeling overwhelmed by medical waste regulations? This comprehensive guide unravels the complexities of medical waste disposal, ensuring you stay compliant and prioritize safety. Inside you'll find: Clear categorization: Learn to precisely classify medical waste for proper handling and disposal. Labeling & Storage: Discover best practices for clear labeling and secure storage of medical waste.

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'Very false and misleading' criticisms over direct contracting stoked model controversy, stakeholders say

Healthcare Dive

Political ire around direct contracting that came to a head earlier this year was rooted in a "real lack of understanding," one CEO of a physician group said Friday at NAACOS' spring conference.

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Study of 40.7M adults finds telehealth comparable for chronic conditions

Healthcare IT News - Telehealth

A study of 40.7 million commercially insured adults in the United States who sought care via telehealth found contrasting patterns of follow-up care between those with chronic conditions and those with acute clinical conditions. The research, which was published this week in JAMA Network Open , assessed outcomes of care two weeks after patients' initial ambulatory encounters.

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Providence spins off DexCare, which orchestrates capacity and digital health demand

Healthcare IT News - Telehealth

Renton, Washington-based Providence knew healthcare was becoming more consumer-driven and believed that meant digital needed to play a role in how care was accessed and delivered. THE PROBLEM. But, like many health systems, Providence needed to dramatically evolve its digital capabilities to not just meet but exceed customers' expectations of accessing care where and when they needed it.

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CommonSpirit names new CEO, Wright Lassiter of Henry Ford Health

Healthcare Dive

Wright Lassiter will succeed Lloyd Dean, who announced his intent to retire last year, setting off a nationwide executive search.

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Health Tech VC Firm Flare Capital Partners Closes $350M Fund

HIT Consultant

What You Should Know: – Flare Capital Partners , a Boston-based healthcare technology venture capital firm closes its third fund with $350M, which follows up on its prior two funds raised in July 2019 and the inaugural fund raised in April 2015, respectively. – The most recent fund, establishes Flare Capital Partners as one of the largest, independent, early-stage venture capital firms dedicated to healthcare technology.

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Former Cerebral VP alleges unsafe prescribing practices in lawsuit

Mobi Health News

Former vice president Matthew Truebe said he was fired after raising concerns about the company's prescribing practices, alleging Cerebral aimed to prescribe stimulants to all its ADHD patients to increase retention.

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HIPAA Compliance: Can Your Organization Avoid Costly Government Penalties and Fines?

Colington Consulting was established in 2013 and helps organizations achieve HIPAA compliance and ensures clients stay current with the latest enforcement trends. We provide a full range of HIPAA compliance services and consulting. What separates us from our competitors is our knowledge of HIPAA compliance regulations and their application to each of our client’s particular scenarios and requirements.

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Driving Effective Patient Onboarding in Remote Patient Monitoring Programs

Healthcare IT Today

The following is a guest article by Ryan Clark, VP of Client Solutions at Optimize Health. Remote patient monitoring (RPM) has the power to fundamentally change how healthcare providers care for and engage with patients. RPM provides a unique opportunity to collect, monitor, and trend data on a daily basis, so you are no longer limited […].

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Mobile app-based health studies hampered by low participant engagement, retention rates

Mobi Health News

In one large-scale study, mean engagement with the app lasted only 4.1 days.

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A Look at the Behavioral Health Network, TPN.health

Healthcare IT Today

Behavioral Health is in an interesting space since it’s suffered through many stigmas and missed out on many reimbursement and stimulus efforts that have been available to medical care. That seems like it’s starting to change as many realize the importance of treating mental health and overcoming the past stigmas. However, behavioral health still suffers […].

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Racial split on COVID-19 endures as restrictions ease in US

Modern Healthcare

Despite majority favorability among U.S. adults overall for measures like mask mandates, public health experts said divided opinions among racial groups reflect not only the unequal impact of the pandemic on people of color but also apathy among some white Americans.

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The Big Payoff of Application Analytics

Outdated or absent analytics won’t cut it in today’s data-driven applications – not for your end users, your development team, or your business. That’s what drove the five companies in this e-book to change their approach to analytics. Download this e-book to learn about the unique problems each company faced and how they achieved huge returns beyond expectation by embedding analytics into applications.

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WEDI Makes Healthcare-Specific Recommendations for Improving the NIST Cybersecurity Framework

HIPAA Journal

The Workgroup for Electronic Data Interchange (WEDI) has responded to the request for information from the National Institute of Standards and Technology (NIST) and has made several recommendations for improving the NIST cybersecurity framework and supply chain risk management guidance to help healthcare organizations deal with some of the most pressing threats facing the sector.

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Mobile app-based health studies hampered by low participant engagement, retention rates

Healthcare IT News - Telehealth

Enterprise Taxonomy: Node settings: Exclude from Accelerate RSS feed

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15 Most Exploited Vulnerabilities in 2021

HIPAA Journal

The Five Eyes security agencies, an alliance of intelligence agencies from Australia, Canada, New Zealand, the United Kingdom, and the United States, have issued a joint advisory about the 15 vulnerabilities in software and operating systems that were most commonly targeted by nation-state hackers and cybercriminal organizations in 2021. Throughout 2021, malicious cyber actors targeted newly disclosed critical software vulnerabilities in attacks against a wide range of industry sectors, includin

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Contributed: The opportunities and challenges for remote patient monitoring

Mobi Health News

Dr. Liz Kwo outlines the landscape of the RPM space.

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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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Mitigating Coverage Loss When the Public Health Emergency Ends: The Role of the Affordable Care Act Marketplaces

Center for Health Insurance Reform

As many as 16 million people are expected to lose Medicaid once the COVID-19 public health emergency ends. One-third of these could be eligible for ACA marketplace plans. In their latest To the Point blog for the Commonwealth Fund, Sabrina Corlette and Maanasa Kona discuss strategies that marketplaces can deploy to help reduce the potential coverage loss and help consumers make a smooth transition.

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Texas Adult Day Care Owner Sentenced for Healthcare Fraud Scheme

Healthcare Compliance Blog

On April 25, 2022, a former owner of multiple Texas adult day care centers was sentenced to 60 months in prison and ordered to pay $1,784,817.96 in restitution for her role in healthcare fraud, wire fraud, and theft of government funds. The money judgment represents the proceeds that she obtained as part of her scheme. Court documents show that between 2008 and 2016 the former owner defrauded the Texas Medicaid program by billing for items and services that had not been provided to the clients o

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Featured Health IT Job: IT Infrastructure Administrator

Healthcare IT Today

We like to regularly feature a healthcare IT job that might be of interest to readers. Today, we’re featuring the IT Infrastructure Administrator position that was recently posted on Healthcare IT Central. This position was posted by Colorado Access and is in Colorado. Here’s a description of the position: Colorado Access is looking for an […].

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CY 2022 Program Audit Protocols Changes

Innovaare Compliance

The Centers for Medicare & Medicaid Services (CMS) launched a new cycle of program audits in February 2022. Multiple Medicare Advantage Prescription Drug Plans (MAPDs) have already received notification of their selection. CMS anticipates a total of 25 plan organizations to be audited in this cycle. Plan sponsors that have gone through program audits previously are well advised to review the new features in this year’s audit protocols (CMS 10717; OMB 0938 NEW) and incorporate them into pract

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Monetizing Analytics Features

Think your customers will pay more for data visualizations in your application? Five years ago, they may have. But today, dashboards and visualizations have become table stakes. Turning analytics into a source of revenue means integrating advanced features in unique, hard-to-steal ways. Download this white paper to discover which features will differentiate your application and maximize the ROI of your analytics.

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HIPAA Compliant Environment or a Culture of Compliance?

Compliancy Group

One of the trendy marketing terms being used by equipment and service providers in the security space is “HIPAA Compliant Environment.” It’s usually used to describe items like highly secure protocols, including operational environment controls, workload (VM and application) hardening, data at rest and in transit protection, identity, and access management.

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HSBlox Releases Enhanced VBC Contract Builder

HIT Consultant

What You Should Know: – HSBlox , a technology company empowering healthcare organizations with the tools and support to deliver value-based care (VBC) successfully and sustainably, today announced Release 3.5 of its CureAlign platform. – CureAlign enables healthcare organizations to administer value-based programs, including network build-out, contract administration, permissioned data exchange and payment.

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HANYS, members advocate in Washington, D.C.

Hanys

New York hospital and health system leaders joined HANYS at AHA's annual meeting this week and met with Senate Majority Leader Charles Schumer and Sen. Kirsten Gillibrand. We discussed our federal priorities , including supporting and strengthening the healthcare workforce, fiscal relief and supportive funding for healthcare providers, and funding care transformation.

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Report: Advancing Tech-Enabled Health & Home Care

HIT Consultant

What You Should Know: The Milken Institute Center for the Future of Aging today released a report to identify actionable recommendations to better integrate health and home care through technology. These recommendations were gathered from a convening of stakeholders representing health care, technology, government and policy, research and academia, philanthropy, advocacy, and community-based organizations.

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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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MedSpa Business Can Be Quicksand for Physicians

Florida Health Care Law Firm

Many physicians have come to realize the synergy and profitability of establishing a medspa business for their patients. Done right, it can be the perfect compliment. And being “off insurance” is a nice pivot for many physicians, especially those in the cosmetic space (or even many OB/GYNs). While most physicians starting a medspa already understand about the scope of practice and physician supervision issues for mid-level practitioners, most don’t seriously consider the issue of

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CMS issues guidance on Transparency in Coverage regulations

Hanys

The guidance addresses frequently asked questions on the regulations, which go into effect July 1, that require health plans to release machine-readable files of their in-network negotiated rates and out-of-network allowed amounts.

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Avoiding Common Documentation Pitfalls

Medisys Compliance

Its quite common to receive a request for medical records from insurance carrier who is going to conduct an audit on your claims. Sometimes, in such external/payer audits, practices receive audit results like, medical necessity not supported; records include conflicting data; or notes are cloned. Audit report also says practice owes them huge amount of money due to ‘overpaid claims’ and they are putting on pre-payment review until things improve.

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CDC updates treatment, information for high-risk COVID-19 outpatients

Hanys

The CDC Health Alert highlighted widely available and accessible treatment options for non-hospitalized COVID-19 patients and recommended against certain uses. Among those, systemic corticosteroids are not recommended to treat patients with mild to moderate COVID-19 who do not require supplemental oxygen; patients who are receiving dexamethasone or another corticosteroid for other indications should continue therapy for their underlying conditions as directed by their healthcare providers.

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How To Package & Price Embedded Analytics

Just by embedding analytics, app owners can charge 24% more for their product. How much value could you add? This framework from Software Pricing Partners explains how application enhancements can extend your product offerings. You’ll learn: How to take a disciplined approach to pricing The three elements of the Packaging Decision Framework Ways to structure your new embedded analytics offering Download the White Paper to learn about How To Package & Price Embedded Analytics.