Kaiser Health News

APRIL 16, 2024

Such private sector platforms, which must be approved by the Centers for Medicare & Medicaid Services, streamline enrollment by integrating with the federal ACA marketplace, called healthcare.gov. She ended up with a higher-deductible plan along with medical bills for her now-uninsured son, the lawsuit alleges.

ACA 138

ACA Health Insurance Governance Medical Billing 138

AIHC

MAY 31, 2022

health care system relies heavily on third-party payers to pay the majority of medical bills on behalf of patients. Health care insurance fraud is a pressing problem, causing substantial and increasing costs in medical insurance programs. First, remember that anyone can commit health care fraud.

Fraud 52

Fraud Compliance Officers Compliance Medicare 52

Healthcare Law Blog

NOVEMBER 9, 2023

Thereafter, OIG said it planned to update existing industry-specific compliance program guidance (ICPG), which would include tailoring each to address fraud and abuse risk areas specific to a particular industry and describing the compliance measures that industry could take to reduce these risks [2].

Compliance 52

Compliance Compliance Officers Fraud Medicare 52

Medisys Compliance

NOVEMBER 6, 2023

Compliance with Regulatory Guidelines Ensure that all claims are submitted per all applicable laws and regulations, including the Health Insurance Portability and Accountability Act (HIPAA), the Affordable Care Act (ACA), and the Medicare Fraud, Waste, and Abuse (FWA) laws. Stay up-to-date on all changes to regulatory requirements.

Compliance 59

Compliance Medical Billing Outsourcing Medical Billing ACA 59

Healthcare IT Today

JUNE 29, 2023

However, ASC billing practices must be followed to ensure proper reimbursement and regulatory compliance. Medicare Certification ASCs must sign a contract with Medicare and meet its Conditions for Coverage (CFC) to be paid. ASCs must also meet Medicare’s Conditions for Coverage.

Compliance 52

Compliance Medicare Medicare Medical Billing 52

MedTrainer

JANUARY 26, 2024

Non-compliance in this area includes unauthorized access to patient records, inadequate data encryption, and improper disposal of medical records. Significant fines also can be levied by the Office of Inspector General (OIG) for overbilling Medicare and Medicaid. These actions can lead to financial losses for patients and payers.

Compliance 52

Compliance Informed Consent HIPAA Medical Billing 52

MedTrainer

NOVEMBER 2, 2023

Their duties span across several areas, from ensuring adherence to laws to navigating the complexities of medical billing protocols. Centers for Medicare & Medicaid Services (CMS) Regulations CMS regulations govern healthcare programs like Medicare and Medicaid.

Compliance Officers 52

Compliance Officers Compliance HIPAA Regulatory Compliance 52

AIHC

MARCH 2, 2023

My task was to educate providers and staff through seminars on rules and regulations with Medicare. The most challenging aspect of having my own medical billing and consulting company was working with people. I have also added the CFE, Certified Fraud Examiner through the Association of Certified Fraud Examiners.

Compliance Officers 52

Compliance Officers Compliance Fraud Medical Billing 52

Medisys Compliance

APRIL 27, 2022

Another goal was to prevent healthcare fraud. The post Tips to Keep Your Practice HIPAA Compliant appeared first on Leading Medical Billing Outsourcing Services Company in the USA. Healthcare providers, health plans, and healthcare clearinghouses are primarily covered under HIPAA.

HIPAA 52

HIPAA Medical Billing Outsourcing Medical Billing Ransomware 52

Hall Render

APRIL 19, 2024

George’s hospital nears groundbreaking on new tower after landing millions from state Maryland program for specialist physicians reports initial Medicare savings Why private equity is investing in Maryland’s emergency departments Why the long wait? health system seeking $150M from state to jumpstart hospital project Pr.

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Med Law Blog

MAY 1, 2023

We saw that issue up close last year as the committee considered the role of PE firms in the increase of patients receiving surprise medical bills.” Howell, Constantine Yannelis and Abhinav Gupta positing that their research shows that “PE ownership increases short term mortality of Medicare patients by 10%, in nursing homes”.

Nursing Homes 52

Nursing Homes Malpractice Hospitals Nurses 52

Florida Health Care Law Firm

DECEMBER 9, 2021

Balance billing came as a surprise to many patients because they did not realize that they had gotten services from an OON provider even though they may had selected an in-network facility. Bans balance billing for emergency services. Cost sharing for emergency services must be determine an in-network basis.

Medical Billing 40

Medical Billing Medicare Medicare Compliance 40

MedTrainer

AUGUST 8, 2022

The Office of Inspector General for the Department of Health and Human Services is basically like the FBI of the HHS and they have a list of thousands of individuals and entities excluded from federally funded health care programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud.

US Department of Health and Human Services 40

US Department of Health and Human Services Medical Billing Hospitals Compliance 40

Medisys Compliance

APRIL 19, 2023

Providers must also comply with the AHCA Provider General Requirements and the Practitioner Services Handbook, which provide specific guidance on billing, documentation, and quality assurance requirements. Providers must also comply with Medicaid program integrity initiatives designed to prevent fraud, waste, and abuse.

Medicaid 52

Medicaid Medicaid Medical Billing Outsourcing Licensing 52

MedTrainer

FEBRUARY 13, 2022

The Office of Inspector General for the Department of Health and Human Services is basically like the FBI of the HHS and they have a list of thousands of individuals and entities excluded from federally funded health care programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud.

US Department of Health and Human Services 40

US Department of Health and Human Services Medical Billing Hospitals Compliance 40

Hall Render

MAY 10, 2024

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ million expansion ‘Very, very unusual.’

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Medisys Compliance

OCTOBER 31, 2023

Medical billing and coding are critical components of the healthcare industry, ensuring that healthcare providers are reimbursed for their services accurately and efficiently. For those specializing in internal medicine, understanding the basics of internal medicine billing is essential.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicaid 59

Hall Render

APRIL 22, 2022

San Francisco’s Laguna Honda Hospital Loses Medicaid, Medicare Funding. Colorado Springs health clinic to pay settlement in fraud lawsuit. Maryland Doctor Among 18 Indicted In COVID-19 Healthcare Fraud Scheme, Allegedly Overbilled For COVID-19 Tests. Maryland’s medical cannabis industry hit $600M in revenue.

COVID-19 40

COVID-19 Nursing Homes US Department of Health and Human Services Nurses 40

Healthcare IT Today

SEPTEMBER 19, 2023

I would continue to advance CMS’ directive that by 2030 all Medicare and the bulk of Medicaid beneficiaries be in care engagements governed under a value-based contract. A National Patient Identifier (NPI) would help get all patient documentation into one location vs. spread out among multiple providers and healthcare systems.

Hospitals 126

Hospitals HIPAA Nurses Governance 126

Hall Render

AUGUST 19, 2022

Stockton Doctor and Medical Practice Agree to Pay Nearly $2 Million to Resolve Allegations of Health Care Fraud. New Colorado Mountain Medical program helps employees grow into health care industry. UnitedHealth Group buys Medicare insurer in Texas. Medical billing vendor data breach affects more than 942,000 patients.

COVID-19 40

COVID-19 Nursing Homes US Department of Health and Human Services Nurses 40

Hall Render

MAY 19, 2023

SOUTH CAROLINA Grand Strand hospitals hope to see positive impact from Certificate of Need repeal McMaster signs South Carolina’s certificate of need repeal Newly-passed bill allows MUSC to move forward with delayed Nexton Hospital build Prisma Health records $31.7M

Nurses 40

Nurses COVID-19 Hospitals Nursing Homes 40

Hall Render

NOVEMBER 27, 2023

face growing challenges to stay open KENTUCKY BehaVR merges with New York City-based Fern Health For years, a powerful Louisville hospital sued people for unpaid bills. 11 Plan To Slash $1.5B 11 Plan To Slash $1.5B cash Tenet’s $2.4B cash Tenet’s $2.4B

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Nursing Homes Hospitals 40

Hall Render

DECEMBER 22, 2023

fraud scheme UConn Health is in financial trouble. health care spending hits $4.5 approval for obstetrics services in Prince George’s County Maryland health system gets state OK for $300M labor, delivery unit Maryland hospitals must pay back millions to poor patients.

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

FEBRUARY 18, 2022

13-year Medicare payment dispute will return to HHS, court rules. Florida physician convicted of $110M fraud. Lawmaker: Revisions coming to Georgia mental health bill. Local hospitals begin enforcing medical worker vaccine mandates. Family shocked after receiving medical bill that cost more than double what they expected.

COVID-19 40

COVID-19 Nursing Homes Nurses COVID-19 Vaccine 40

Hall Render

APRIL 12, 2024

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 s health, hospital chief says Raising Ky.’s

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Hall Render

MARCH 3, 2023

million for youth mental health care KENTUCKY Pike County nursing home officials release statement following loss of Medicare agreement Three Humana executives drop $11.2M

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

FEBRUARY 25, 2022

The 55 hospitals penalized by Medicare 8 years straight over patient complications. Medicare penalizes 40 hospitals in Florida for patient safety. Florida bill extending COVID-19 liability protections for health workers on its way to Gov. New report shows Tampa Bay hospitals not following medical bill transparency law.

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40

Hall Render

APRIL 28, 2023

merger International audience hails UPMC’s new vision and rehab complex Kaiser, Geisinger launch nonprofit to buy hospitals Kaiser Permanente to acquire Geisinger, form company to operate other nonprofit systems Lannett delisted from New York Stock Exchange PA-based medical equipment company to pay $5.3M

Nurses 40

Nurses Nursing Homes COVID-19 Hospitals 40

Hall Render

OCTOBER 14, 2022

Health policy researcher says Colorado has opportunity to reduce unwarranted Medicare Advantage prior authorization denials. Indianapolis health care giant must face federal lawsuit alleging Medicare fraud. Low-income New Mexicans may not know about law protecting them from medical bill collections. CONNECTICUT.

US Department of Health and Human Services 40

US Department of Health and Human Services COVID-19 Nursing Homes Nurses 40

Hall Render

MARCH 8, 2024

Charles Cavallo warns that private practices have three major threats These are Louisville’s Health Care Heroes Senate bill would lift conditions for Ky. NATIONAL 34.5% NATIONAL 34.5% NATIONAL 34.5%

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

JANUARY 7, 2022

HHS: Protections against surprise medical bills implemented at dawn of new year. More Military Medical Personnel Are Assisting Hospitals With Covid-19 Treatment As Staff Shortages Mount. More Military Medical Personnel Are Assisting Hospitals With Covid-19 Treatment As Staff Shortages Mount. fraud case in Arkansas.

COVID-19 40

COVID-19 Nursing Homes US Department of Health and Human Services Nurses 40

Hall Render

OCTOBER 20, 2023

Peter’s Health clinic nurses vote to join Montana Nurses Association NEBRASKA Nebraska hospitals warn seniors that Medicare Advantage isn’t for everyone Hospitals say Nebraska patients denied care under Medicare Advantage Cardinal Health to reduce operations at Nebraska plant NEVADA E. We want to know.

COVID-19 Vaccine 40

COVID-19 Vaccine Nursing Homes COVID-19 Nurses 40

Hall Render

JANUARY 14, 2022

CMS proposed rule seeks to lower Medicare Part D prescription drug costs. HHS secretary orders Medicare to ‘reassess’ premium increase driven by Alzheimer’s drug. Medicaid, Medicare won’t pay Denver-area elder care provider for new clients after finding staffing issues, other problems. NEW MEXICO.

COVID-19 40

COVID-19 Nursing Homes Nurses COVID-19 Vaccine 40

Jane Sarashon

MAY 7, 2024

The first chart from the study arrays the top 10 concerns for the 50+ health citizen, with over 50% concerned about costs and financial scams/fraud — with just under one-half worried about the cost of dental care. AARP sponsors this study, which is published nearly every month of the year on the Michigan Medicine portal.

Medicare 103

Medicare Medicare Health Insurance Fraud 103

Hall Render

APRIL 7, 2023

CareTrust CIO: After Entering Kansas with Latest Deal, We Are Keen for Other New Markets KENTUCKY 2 Louisville developments among biggest U.S. claims 4th-, 5th-largest U.S. on revenue of $2.1B claims 4th-, 5th-largest U.S. on revenue of $2.1B

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes COVID-19 Nurses 40

Hall Render

FEBRUARY 3, 2023

Daytona Beach medical office building/surgery center HCA Healthcare breaks ground on new freestanding ER in Orlando Lee Health’s new state-of-the-art bloodmobile hits the road Naples physician charged with Medicare fraud gives up license; enters guilty plea Nemours opens full-time office for children in Panama City with St.

US Department of Health and Human Services 40

US Department of Health and Human Services COVID-19 Nursing Homes Nurses 40

Hall Render

JANUARY 12, 2024

area to watch in 2024 DELAWARE Bayhealth now requires masks at hospitals, healthcare practices ChristianaCare drops top rated Medicare Advantage insurer. to settle improper billing allegations COVID-19 variant JN.1 region hard Development projects in the D.C. What options do members have? 1 ‘more transmissible’?

Nursing Homes 40

Nursing Homes US Department of Health and Human Services COVID-19 Nurses 40