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Fraudsters Prey on Factors Influencing Health Outcomes

AIHC

This article addresses various forms of fraud and how criminals’ prey on compromised citizens. There are many factors which can influence our health, and in turn, there are just as many schemes which are actually considered health care fraud. SNAP Fraud Food assistance is generally referred to as SNAP or food stamps.

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CMS Program Integrity’s Role in Combatting FWA While Maintaining Health Equity

HIT Consultant

Program integrity staff from every state Medicaid program, and federal program staff working on Medicare, must consider the roles of both program integrity and analytics when combatting fraud, waste, and abuse (FWA)in the healthcare system. Health outcomes and Medicaid program integrity Health outcomes are a function of the quality of care.

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Navigating the Intersection of Payment Integrity and Provider Relations in Healthcare

Innovaare Compliance

The Importance of Payment Integrity Payment integrity is crucial for health plans to control costs, reduce fraud, waste, and abuse (FWA), and ensure the accuracy of healthcare payments. billion in healthcare fraud judgments and settlements. billion in healthcare fraud judgments and settlements.

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URAC CEO talks virtual care access, tele-mental health, post-COVID regs

Healthcare IT News - Telehealth

Advances in telehealth have allowed both populations to receive more convenient, high-quality care, thus leading to better health outcomes. Further, telehealth providers can help reduce the chance for fraud, waste and abuse by implementing risk-management policies and mechanisms.

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How health IT's leading innovators are using AI now, and where they see it going

Healthcare IT News - Telehealth

By Mike Miliard | September 19, 2023 News Guardrails, data governance key to solid generative AI outcomes IT leaders need to take a step back and ensure they are truly prepared to use large language models.

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OIG Advisory Opinion Alert: Yet Another Favorable Decision for Medical Device Manufacturers

Healthcare Law Blog

Like these other AOs, OIG found that while the Proposed Arrangement could generate fraud and abuse risks under both the Federal anti-kickback statute (i.e., Section 1128A(a)(5) of the Act), the Proposed Arrangement nevertheless presented a minimal risk of fraud and abuse under the law on the facts presented.

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Why Data Analytics are Critical in a Value-Based Care (VBC) Environment

AIHC

Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. percent of the gross domestic product (GDP) on healthcare, which was almost two times the average of other high-income countries, while the health outcomes in the U.S.