Healthcare IT News - Telehealth

JUNE 8, 2022

based attorney in the health law practice of Baker, Donelson, Bearman, Caldwell & Berkowitz about what providers should be doing to ensure compliance when the PHE finally sunsets. Additionally, any reimbursement resulting from these claims could be considered an overpayment. We spoke recently with Allison M.

US Department of Health and Human Services 182

US Department of Health and Human Services Compliance Overpayments Overpayment 182

HIT Consultant

JANUARY 9, 2024

Varying levels of economic development and legal systems lead to potential fraud and currency control complications as well. They can reduce the burden on clinical and financial staff for payments, disputes, reporting and reconciliations, all while minimizing site and study overall costs and overpayments.

Overpayments 95

Overpayments Overpayment COVID-19 Fraud 95

Compliancy Group

FEBRUARY 2, 2024

The DOJ will also determine if there is sufficient communication to employees informing them about the compliance program and garnering commitment to its mission. Tangible indicators of sufficient resources and effort include adequate staff assigned to conduct audits and document and analyze the results of the program’s efforts.

Compliance 52

Compliance Overpayments Overpayment Compliance Officers 52

Med-Net Compliance

OCTOBER 21, 2022

The government’s primary civil tool for addressing healthcare fraud is the FCA. The risk categories are described as follows: Highest Risk—Exclusion: Parties that the OIG determines present the highest risk of fraud will be excluded from Federal healthcare programs to protect those programs and their beneficiaries.

Fraud 59

Fraud Compliance Medicare Medicare 59

AIHC

APRIL 5, 2022

Due to the huge volume of claims payers receive to process, deny and pay, they have implemented various methods to track providers to detect potential waste, fraud and/or abuse. If the payer, such as Medicare, performs an extrapolation, reducing each overpayment dollar through appeal can mean thousands less to pay back.

Fraud 52

Fraud Compliance Medicare Medicare 52

The Health Law Firm

JULY 17, 2015

The unfortunate truth is that Florida has become synonymous with health care fraud. As a result, auditing and subsequent overpayment demands are very real possibilities. Facts You Should Know About the Medicaid Audit Process.

Medicaid 40

Medicaid Medicaid Overpayments Overpayment 40

Healthcare Law Blog

FEBRUARY 9, 2024

Global billing or collaborative care arrangements are not per se violations of the Anti-Kickback Statute, however, there is greater fraud and abuse risk in these types of arrangements unless there is active, ongoing monitoring for compliance. Million To Resolve Health Care Fraud Allegations | United States Department of Justice [3] See Defs.

Hospitals 52

Hospitals Compliance Officers Compliance Overpayments 52

Healthcare IT Today

FEBRUARY 2, 2023

It has given every indication that it intends to investigate fraud, waste, and abuse more robustly in the foreseeable future. The Justice Department has joined the fraud case against one large national insurer. One last note about conducting quality assurance audits: Remember to close the loop.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Hall Render

APRIL 19, 2024

Can lawmakers do anything about it? to Study Treatments for Vascular Abnormalities Federal Appeals Court Hears Arguments on Nation’s First Ban on Gender-affirming Care for Minors Jason Demke Hired as COO at Mercy Hospital Fort Smit Pulaski Tech Awarded $5.7M healthcare? MAINE St.

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

AIHC

SEPTEMBER 5, 2023

Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations. This includes understanding various fraud and abuse laws.

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

C&M Health Law

DECEMBER 18, 2023

OIG also specifically calls out the growing presence of private equity and other forms of private investment in health care and recommends that such investors scrutinize their operations and oversight to ensure compliance with fraud and abuse laws and the delivery of high-quality care for patients.

Compliance 52

Compliance Compliance Officers Governance Overpayments 52

Hall Render

DECEMBER 6, 2022

Specific detail about the exception is outlined below. Further, entities should review non-monetary compensation provided in 2022 to ensure that such compensation did not exceed the 2022 limit of $452 and take any necessary corrective action to recover excess amounts within the earlier of 180 days of the overpayment or by December 31, 2022.

COVID-19 40

COVID-19 Hospitals Overpayments Overpayment 40

Hall Render

MAY 10, 2024

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ Health Policy Commission still missing key document in Steward sale to Optum Local obesity drug developer lands deal worth up to $600M with Novo Nordisk Mass.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

CMS.gov

NOVEMBER 16, 2018

Fraud, waste, & abuse. Improper payments are not necessarily measures of fraud, but instead are payments that did not meet statutory, regulatory, administrative, or other legally applicable requirements. To view CMS’s fact sheet with more information about Improper Payment Reductions, please visit: [link]. ###. Jeremy.Booth@c….

Medicare 20

Medicare Medicare Overpayments Overpayment 20

Hall Render

JUNE 30, 2023

for physician referral scheme In Los Angeles, hospital CEO pay could be capped Kaiser Permanente ratings affirmed amid healthy financial profile Nurses vote ‘no confidence’ in California hospital administration, board Nursing facility, management company settle physician kickback allegations for $3.8M

US Department of Health and Human Services 40

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

Medisys Compliance

MARCH 7, 2022

An EHR system provides accurate, up-to-date information about the patient. These are usually just innocuous mistakes that do not represent any intent to commit billing fraud. In the unfortunate event when you receive such overpayment demand letters, don’t acquiesce without conducting an analysis first. Interval HPI.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Overpayments Overpayment 52

AIHC

MARCH 28, 2022

But first, learn more about how a complex payer audit system works. For example, the GAO states that they identified about $77.6 billion in financial benefits in fiscal year 2020— a return of about $114 for every $1 invested. Make sure to read Part 1: Managing Denials is Important to Good A/R Hygiene. Audited by a payer?

Medicare 52

Medicare Medicare Compliance Governance 52

Hall Render

JANUARY 19, 2024

PPP Loan Travel nurse speaks out about assault at MU Psychiatric Center, subsequent treatment MONTANA Montana boosts pay, adds bonuses for health facility employees Negotiations between St. Bipartisan Ky.

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

APRIL 26, 2024

New California rule aims to limit health care cost increases to 3% annually UC San Diego Health operations deal with California hospital slows to crawl Kaiser reports data breach affecting 13.4M health dept. processed 1.5 health dept. processed 1.5

Nursing Homes 40

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

HIPAA Journal

MARCH 30, 2022

Had the level of abuse and fraud in the healthcare industry been allowed to continue, tens of billions of dollars would have been lost to unscrupulous actors. the Transactions and Code Sets Rule) and address abuse and fraud in the health care industry to reduce costs to health insurance providers. 7 Billion Lost Each Year to Fraud.

HIPAA 119

HIPAA Fraud Health Insurance Health Care Reform 119

Hall Render

AUGUST 26, 2022

Oklahoma doctor raises concerns about life-threatening virus, polio. Charles workers launch petition, refuse to repay overpayments without outside audit; union files BOLI complaint. CHS faces class-action fraud suit. Project to bring about 216 senior housing units to McKinney. 124 years since it opened, St. PENNSYLVANIA.

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

OCTOBER 7, 2022

Judge orders Anthem to face lawsuit over alleged Medicare overpayments. Concerns about kids’ safety at Grand Junction psych hospital prompt state actions. Local Jax health care provider settles fraud allegations by paying $700,000. Million Health Care Fraud. About 5% of N.J. residents have updated COVID boosters.

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

NOVEMBER 10, 2023

California physician convicted of healthcare fraud, kickbacks California’s healthcare minimum wage boost to cost $4B City Council upholds approval of Hollywood Presbyterian medical offices at 1321 N. Will it survive the next few years?

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

MARCH 22, 2024

NATIONAL 79 percent have positive outlook for senior living and care: NIC 12 key legal issues impacting health systems AHA: 94% of hospitals financially impacted by Change Healthcare’s cyberattack A conversation about the HHS plan on AI in health care A new kind of hospital is coming to rural America.

Nursing Homes 40

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

Hall Render

MARCH 15, 2024

A doctor shares the latest HHS opens probe into UnitedHealth’s cybersecurity as hack fallout continues HHS sends letter to healthcare leaders on Change cyberattack Hospitals face rising labor bill How 4 major payers have been affected by Change Healthcare attack Nonprofit hospitals still have negative outlook, but Fitch projects ‘better times’ Operating (..)

US Department of Health and Human Services 40

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

Kaiser Health News

OCTOBER 13, 2022

For the first time, Medicare Advantage plans are poised to enroll more than half of the Medicare population despite allegations that many of the largest insurers are getting billions of dollars in overpayments from the federal government. Questions have been raised about federal payments to the plans.

Medicare 67

Medicare Medicare ACA Governance 67

Med League

MARCH 23, 2022

Med League Support Services provides medical billing expert witness to review medical billing fraud cases. million fraud scheme against payers and patients. Dr. Rosen was part of this large fraud scheme where physician prescribes expensive drugs through network of pharmacists who then pay bribes to fill the order.

Medical Billing 40

Medical Billing Fraud Overpayments Overpayment 40

Drug & Device Law

AUGUST 24, 2022

He filed a putative class action based on various state consumer fraud laws, breach of contract, breach of warranty, etc., The Amara court held that the plaintiff had alleged an economic injury of overpayment, but had not alleged “any future harm to himself that is real and immediate and/or certainly impending.”

Fraud 119

Fraud Overpayments Overpayment FDA 119