Tue.Jul 25, 2023

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Cigna sued over algorithm allegedly used to deny claims

Healthcare Dive

The lawsuit filed in a California district court alleges the health insurer used the technology to “deny payment in batches of hundreds or thousands at a time,” violating state law.

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NZ clinicians hope for a patient-centred future, but hindrances abound: report

Healthcare It News

Like many healthcare systems around the world, New Zealand’s healthcare system is also under immense pressure, plagued by clinician burnout, patient dissatisfaction, and rising costs. To reimagine the future of healthcare and build a sustainable system that can meet the challenges of the post-pandemic era, patients' and clinicians’ voices (and frustrations) must be heard.

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Biden administration cracks down on payers over mental health coverage

Healthcare Dive

The HHS and Treasury and Labor departments announced a new proposed rule on Tuesday that requires health insurers to analyze patient outcomes to ensure their benefits are administered equally.

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MRO Addition to the Peer Review Program

MRO Compliance

MRO Addition to the Peer Review Program AAOE Adds the MRO Clinics Disability & FMLA Forms and MRO Clinics Release of Information by MRO to the Peer Review Program™ for Orthopedic and Musculoskeletal Vendors. AAOE’s Peer Review Process creates a unique opportunity for vendors to enhance their reputation and foster deeper, more meaningful relationships with prospective clients.

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Navigating the Future: Generative AI, Application Analytics, and Data

Generative AI is upending the way product developers & end-users alike are interacting with data. Despite the potential of AI, many are left with questions about the future of product development: How will AI impact my business and contribute to its success? What can product managers and developers expect in the future with the widespread adoption of AI?

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Average cost of healthcare data breach reaches $11M, report finds

Healthcare Dive

Healthcare continues to be the most expensive industry for data breaches, with costs increasing 53% since 2020.

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Educating for Disability and Climate Change

Bill of Health

By David Liebmann Children starting kindergarten in 2023 will be 32 years old in 2050, the year the Paris Climate Accord signatories agreed to reach net zero carbon emissions. Those 32-year-olds will have grown up with signs of climate change appearing everywhere around them. They must learn enough in school about the changing global environment to lead themselves and the next generation into a livable future.

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Vendor notebook: Virtual care options on Google Cloud, AR surgical imaging and more

Healthcare IT News - Telehealth

New healthcare technology innovations developed outside the box offer clinicians more tools, including cloud-based telehealth, remote lab testing for infections and enhanced imaging for surgical precision. Google Cloud adds Pager's virtual care platform Pager announced Monday that its 23 million-member-strong virtual care navigation and collaboration platform is available on Google Cloud Marketplace, which means its customers can now access cloud-based tools like artificial intelligence and

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Cigna hit with class action alleging it used an algorithm to reject claims

Fierce Healthcare

Two Cigna members have hit the insurer with a class action lawsuit, accusing the company of using an algorithm to improperly deny scores of patient claims. | Two Cigna members have hit the insurer with a class action lawsuit, accusing the company of using an algorithm to improperly deny scores of patient claims.

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Community Health Systems improves chronic condition outcomes with RPM

Healthcare IT News - Telehealth

Community Health Systems operates more than 80 affiliated hospitals and more than 1,000 outpatient sites of care in 16 states. THE PROBLEM The massive health system recently set three goals: Improve patient outcomes by monitoring and actively managing patients with chronic diseases, with a specific focus on remote medication titration to get more patients to guidelines.

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Hospitals are seeing higher acuity patients, struggling to discharge to post-acute care settings, report finds

Fierce Healthcare

Hospitals are finding it harder to place patients into post-acute care settings, a new report finds. | The number of referrals to nursing homes and home health agencies per patient has increased over the last year, as has patient acuity. At the same time, referral rejection rates are also on the rise.

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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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K4Connect Raises $8.9M to Expand Tech Accessibility for Senior Living

HIT Consultant

What You Should Know: K4Connect , a Raleigh, NC-based mission-centered healthtech company and provider of enterprise operations tech for the senior living communities raises $8.9M in funding co-led by Bryce Catalyst and AXA Venture Partners , with continued support from existing investors, including Intel Capital , Forté Ventures , Topmark Partners , and the Ziegler-Linkage Fund.

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GLP-1 drugs are still in demand. Insurers are cutting back coverage in response, Found study shows

Fierce Healthcare

As demand surges for GLP-1 therapies, insurers are pulling back on coverage, according to new data from obesity care provider Found. | Sarah Jones Simmer, CEO of Found, said that the trends are likely the result of irresponsible prescribing for recreational reasons causing the pendulum to swing "all the way in the other direction," and it's leading to patients who have genuine medical need struggling to access these therapies.

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24,400 Rite Aid Customers Had Personal Informatiion Compromised in May Cyberattack

HIPAA Journal

Rite Aid has confirmed that the protected health information of up to 24,400 of its customers has been stolen in a cyberattack. The stolen files contained names, birth dates, addresses, prescription information, and limited insurance information. Social Security numbers and financial information were not exposed or stolen in the attack. Rite Aid said a vulnerability was exploited by the attackers to gain access to sensitive data.

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Biden admin proposes new mental health parity regulations

Fierce Healthcare

Amid a worsening mental health crisis, the Biden administration is proposing a slew of regulatory changes aimed at improving access to critical care. | Amid a worsening mental health crisis, the Biden administration is proposing a slew of regulatory changes aimed at improving access to critical care.

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How Embedded Analytics Gets You to Market Faster with a SAAS Offering

Start-ups & SMBs launching products quickly must bundle dashboards, reports, & self-service analytics into apps. Customers expect rapid value from your product (time-to-value), data security, and access to advanced capabilities. Traditional Business Intelligence (BI) tools can provide valuable data analysis capabilities, but they have a barrier to entry that can stop small and midsize businesses from capitalizing on them.

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What does OSHA Regulate?

HIPAA Journal

The Occupational Safety and Health Administration (OSHA) is responsible for the regulation and enforcement of safety and health standards in most private and public workplaces in the United States. Key areas that OSHA regulates include: Safety Standards Hazard Communications Recordkeeping and Reporting Training and Education Inspections and Enforcement Emergency Preparedness and Response Whistleblower Protections Overview of OSHA Regulation OSHA is best known for setting and enforcing workplace

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AHIP, AMA, NAACOs team on playbook for value-based care

Fierce Healthcare

AHIP, the American Medical Association and the National Association of ACOs have teamed up to release a playbook that aims to arm stakeholders with best practices for value-based care. | Three major national organizations released a playbook to help payers and providers adapt to value-based care.

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Public Health Transparency Leads to Better Outcomes at San Bernardino County

Healthcare IT Today

Maps are important tools in infectious disease surveillance. They depict where cases are occurring and where treatment resources are needed. San Bernardino County uses geographic information system (GIS) technology to accurately track the prevalence of specific infectious diseases in their communities. That information is used to raise awareness and to marshal resources to limit the spread.

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CHS selling 3 Florida hospitals to Tampa General Hospital for $290M

Fierce Healthcare

Community Health Systems (CHS) announced that it has signed a deal to sell three Florida hospitals to Tampa General Hospital for roughly $290 million. | The divestiture of Bravera Health Brooksville, Bravera Health Seven Rivers and Bravera Health Spring Hill is slated to close later this year pending regulatory approval and other customary closing conditions.

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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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Greenwich Health chooses Cleo Systems’ urgent care solution

Digital Health News

Cleo Systems' Cleo Core UTC solution has been deployed at Greenwich Health to help streamline operations at its urgent treatment centre.

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Teladoc reports higher Q2 revenue, bullish on opportunities for virtual weight management, mental health

Fierce Healthcare

Editor's Note: The article has been updated with information from Teladoc's earnings call with investors late Tuesday afternoon. | Teladoc is doubling down on its strategy to focus on "whole person care" through its virtual care platform. The telehealth provider is seeing strong growth across its chronic care programs and virtual mental health and is eyeing opportunities in the booming weight management market.

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VUMC Faces Lawsuit Over Disclosure of Medical Records of Transgender Patients to State AG

HIPAA Journal

Vanderbilt University Medical Center (VUMC) in Nashville, TN, has confirmed that the medical records of transgender patients have been provided to Tennessee Attorney General, Jonathan Skrmetti, in connection with an investigation of medical billing fraud. According to AG Skrmetti’s Chief of Staff, Brandon Smith, the medical records were requested as part of an investigation into medical billing fraud focused on VUMC and related healthcare providers, rather than patients.

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Healthcare tops all industries when it comes to money lost in data breaches: report

Fierce Healthcare

Data breaches hurt all industries, but this is especially true for healthcare, which has lost the most financially to these incidents, according to a new report. | Healthcare seems particularly vulnerable to data breaches, and the problem’s gotten worse since COVID-19, according to a report published by IBM Security. The average cost of a data breach in healthcare grew 53.3% since 2020.

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Embedding BI: Architectural Considerations and Technical Requirements

While data platforms, artificial intelligence (AI), machine learning (ML), and programming platforms have evolved to leverage big data and streaming data, the front-end user experience has not kept up. Holding onto old BI technology while everything else moves forward is holding back organizations. Traditional Business Intelligence (BI) aren’t built for modern data platforms and don’t work on modern architectures.

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The U.S. Government and Global Health Security

KFF

This brief examines the U.S. government's efforts in global health security—that is, activities to help countries prepare for and develop capacities to address epidemic and pandemic diseases. The brief provides history and background, outlines the U.S. agencies carrying out these efforts, describes funding, and highlights key policy issues going forward.

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Universal Health Services revises guidance after Q2's $171.3M profit, higher volumes

Fierce Healthcare

King of Prussia, Pennsylvania-based Universal Health Services (UHS) reported a $171.3 million net gain ($2.42 per diluted share) for the second quarter of 2023, up slightly from the $164.1 million | The for-profit chain logged a 6.8% rise in net revenues over Q2 2022, with gains split across both of its acute and behavioral health businesses.

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EPR frontline digitisation target declared “unachievable”

Digital Health News

The target of getting all trusts to have an EPR by March 2025, has been called "unachievable" by the government's Infrastructure and Projects Authority.

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Nonprofit hospitals, health systems still another year away from 'normal,' Fitch predicts

Fierce Healthcare

Nonprofit hospitals and health systems are likely still a year away from “normal” finances, volumes and in particular labor availability as the sector claws its way back from “what will likely be d | The ratings agency's latest sector report outlines "across-the-board" margin deterioration and other signs that nonprofit hospitals' financial pressures are lingering longer than expected.

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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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KareInn gains complete end-to-end medication management

Digital Health News

KareInn has integrated with Camascope, delivering end-to-end medication management that syncs automatically with both systems.

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Biden administration proposes rules to boost mental health coverage

Modern Healthcare

The rules would force health insurance companies to study patient outcomes to ensure mental health benefits are administered equally.

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Hippocratic AI raises $15M and more digital health fundings

Mobi Health News

GenHealth AI, maker of what it calls a large medical model, and senior-focused startup K4Connnect also secured investment.

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Healthy Blue Kansas backs training course for docs on treating patients intellectual disabilities

Fierce Healthcare

Kansas physicians and clinicians will have free access to a course that aims to teach the fundamentals of providing care to patients with intellectual disabilities. | Kansas physicians and clinicians will now have access to a free course that teaches the fundamentals of providing healthcare to people with intellectual disability.

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How to Leverage AI for Actionable Insights in BI, Data, and Analytics

In the rapidly-evolving world of embedded analytics and business intelligence, one important question has emerged at the forefront: How can you leverage artificial intelligence (AI) to enhance your application’s analytics capabilities? Imagine having an AI tool that answers your user’s questions with a deep understanding of the context in their business and applications, nuances of their industry, and unique challenges they face.