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Ghost Networks and Mental Healthcare

Bill of Health

by Rebekah Ninan A recent lawsuit in the Southern District of New York has alleged that the health insurance company Anthem Blue and Cross Blue Shield violated state laws and committed fraud by maintaining “ghost networks” of mental health providers. Rebekah Ninan’s (J.D.

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What is HIPAA?

HIPAA Journal

HIPAA is an acronym for the Health Insurance Portability and Accountability Act. When the Health Insurance Portability and Accountability Act was passed by Congress in 1996, the establishment of federal standards for safeguarding PHI was not one of the primary objectives. What is HIPAA Title II?

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How to Deliver Patient-Centered Care in a Post-Covid World

YouCompli

Compliance professionals should conduct routine facility audits to evaluate for areas of potential harm, such as loose stair railings or spaces where patient information can be easily overheard by others.     Regrouping on patient billing. We deliver model procedures and expert tools that can be used to fulfill your business requirements.

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2024 Final Rule: CMS Announces More Changes to Medicare Advantage but Declines to Reform the “60 Day Rule”

Health Care Law Brief

The Final Rule adopts a host of reforms aimed at improving health care access, quality, and equity for Medicare beneficiaries that receive coverage through Part C (“Medicare Advantage” or “MA”) and prescription drug benefits through Part D. 405.986) or “reliable evidence” of fraud or “similar fault” (as defined in 42 C.F.R.

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Health Provider News

Hall Render

for patient experience Emory Hospital Midtown will ‘move to normal operations’ after water pressure returned overnight Marietta’s Wellstar medical center now one of three Level I trauma centers in metro Atlanta Northside Hospital programs prioritize mental health in the workplace Rural U.S. health care is in a crisis.

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Health Provider News

Hall Render

in billing fraud Arizona system names new CEO Banner Health CEO Peter Fine to retire after 24 years, handing the reins to health system president Four UArizona bioscience startups selected for Flinn Foundation program Gov. s health, hospital chief says Raising Ky.’s

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Health Provider News

Hall Render

Some Health Providers Still Await Back Pay New innovative cancer treatment helps Montana woman beat cervical cancer NEBRASKA Nearly 60% of Nebraska’s smaller rural hospitals operate at a loss, hospital association says. continues crackdown on nursing homes, 2 more cited for poor care and ‘massive fraud’ Wow!