HIPAA Journal

JULY 31, 2023

a government services contracting company, has announced in a Securities and Exchange Commission (SEC) filing that hackers exploited a zero-day vulnerability in Progress Software’s MOVEit Transfer solution in May 2023 and accessed the protected health information (PHI) of between 8 and 11 million individuals.

Governance 73

Governance Medicare Medicare Ransomware 73

Kaiser Permanente

JANUARY 27, 2022

Medicaid provides health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements and is jointly funded by states and the federal government. Kaiser Permanente’s Participation in Oregon Health Plan.

Health Insurance 52

Health Insurance Medicaid Medicaid Governance 52

HIPAA Journal

NOVEMBER 21, 2022

million being defrauded from Medicaid, Medicare, and private health insurance programs. Five state Medicaid programs, two Medicare Administrative Contractors, and two private health insurers were tricked into changing the bank account details for payments. million, and $6.4 million, and $6.4

Medicaid 79

Medicaid Medicaid Medicare Medicare 79

HIPAA Journal

MARCH 15, 2023

FHKC is a state-created entity that offers health and dental insurance to children in Florida between the ages of 5 and 18. FHKC receives Medicaid funds and state funds for providing health insurance programs for children in Florida.

Health Insurance 76

Health Insurance HIPAA Due Diligence Fraud 76

HIPAA Journal

APRIL 29, 2024

Berry, Dunn, McNeil & Parker, LLC (BerryDunn) provides health data analytics services to healthcare providers, health insurers, and government regulatory and healthcare policy agencies and its clients provide BerryDunn with personal and health data to allow the firm to perform its contracted services.

Health Insurance 97

Health Insurance Health Analytics HIPAA Medicaid 97

Bill of Health

JANUARY 23, 2024

Medicaid pays for more than 40% of births in the U.S., Examining efforts at the federal and state level, I highlight three options, leveraging Medicaid as a policy lever. In the past, when individuals were Medicaid-eligible due to pregnancy, federal law required states to provide coverage for at least 60 days postpartum.

Medicaid 111

Medicaid Medicaid Patient Satisfaction Health Insurance 111

Kaiser Health News

APRIL 16, 2024

District Court for the Southern District of Florida, two such call centers paid tens of thousands of dollars a day to buy names of people who responded to misleading advertisements touting free government “subsidies” and other rewards. Some consumers were switched multiple times or had duplicative policies.

ACA 138

ACA Health Insurance Governance Medical Billing 138

Bill of Health

DECEMBER 6, 2023

By Hannah Rahim Many mental health provider directories for private and public insurance plans contain inaccurate or outdated provider information , which creates a misleading illusion of accessible care. These ghost networks result in many patients being unable to access essential mental health care.

Governance 144

Governance Medicaid Medicaid Medicare 144

Health Populi

JUNE 18, 2021

with employer-sponsored health insurance worry that a major health event in their household could lead to bankruptcy, according to research gathered by West Health and Gallup in Business Speaks: The Future of Employer-Sponsored Insurance. Health Populi’s Hot Points: U.S. One-half of U.S.

ACA 133

ACA Health Insurance Medicaid Medicaid 133

Health Populi

SEPTEMBER 17, 2020

Census Bureau found that the level of health insurance enrollment fell by 1 million people in 2019 , with about 30 million Americans not covered by health insurance. The coronavirus pandemic has only exacerbated the erosion of the health insured population. lacked health insurance.

COVID-19 62

COVID-19 Health Insurance Public Health Health Care Access 62

HIT Consultant

MARCH 8, 2022

The steep incline in unemployment and fears that millions of people would lose their health coverage drove the declaration of the national public health emergency (PHE) on January 31, 2020. Under the PHE, states must keep Medicaid enrollees continuously covered, irrespective of their circumstances. .

Public Health 98

Public Health Medicaid Medicaid Health Insurance 98

Bill of Health

MARCH 15, 2022

Similarly, our health care system is a significant barrier to employment because most private health insurance companies do not cover critical supports for disabled people, such as personal assistant services. However, expanding safety net programs , such as SSI and Medicaid, would be important as an interim measure.

COVID-19 246

COVID-19 ADA Medicaid Medicaid 246

HIT Consultant

JULY 17, 2023

Cessation of PHE telehealth, prescribing, and mental health access exceptions could impact the Medicaid population the most. Twenty-one percent of Medicaid enrollees have mild, moderate, or severe SUD, compared to 16% of commercially insured individuals. And as of the latest data, 7.3% And as of the latest data, 7.3%

Public Health 98

Public Health Medicaid Medicaid Electronic Medical Records 98

American Medical Compliance

JANUARY 9, 2024

When someone uses your personal information, such as your name, Social Security number, or Medicare number, to make false claims to Medicare and other health insurers without your consent, it is known as medical identity theft. This wastes taxpayer money and interferes with your medical care. trillion in 2015.

Fraud 52

Fraud Medicare Medicare Compliance 52

Medisys Compliance

FEBRUARY 27, 2024

Understanding Regulatory Framework Radiology billing is governed by a multitude of regulations at the federal, state, and local levels. Radiology practices must stay updated on these regulations to ensure compliance. Our expert team ensures accuracy and adherence to regulations, optimizing revenue for radiology practices.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 59

American Medical Compliance

APRIL 17, 2024

The law has 3 primary goals: Make affordable health insurance available to more people. Expand the Medicaid program to cover all adults with income below 138% of the FPL. Not all states have expanded their Medicaid programs. In terms of work, Title I of the ADA covers both employees and job seekers.

ADA 52

ADA ACA Compliance Health Care Reform 52

Healthcare IT News - Telehealth

FEBRUARY 3, 2023

WHY IT MATTERS The bill aims to keep stand-alone telehealth benefits separate, not as a replacement of medical plans, offering them under a group health plan or group health insurance coverage as excepted benefits. In addition to improving access, telehealth reduces burdens on healthcare providers.

Public Health 168

Public Health COVID-19 Medicare Medicare 168

Verisys

FEBRUARY 14, 2024

Governance, Risk Management, and Compliance (GRC) in healthcare is an integrated approach that helps healthcare organizations manage their overall governance, enterprise risk management, and comply with regulatory requirements in a cohesive and aligned manner. What is healthcare data governance? What is GRC in Healthcare?

Governance 52

Governance Compliance Regulatory Compliance Compliance Framework 52

Verisys

JANUARY 8, 2024

This includes adherence to standards set by the Health Insurance Portability and Accountability Act (HIPAA) , the Centers for Medicare & Medicaid Services (CMS), and other regulatory bodies. Involves ensuring adherence to laws and regulations specific to the healthcare industry.

Compliance 52

Compliance Regulatory Compliance Health Insurance Medicaid 52

MedTrainer

APRIL 11, 2024

They are responsible for developing policies that govern the employment relationship between the organization and its employees. They develop and implement compliance programs that include policies, practices, and procedures to ensure all departmental operations align with federal and state laws.

Compliance Officers 52

Compliance Officers Compliance Medicaid Medicaid 52

Provider Trust

JANUARY 25, 2024

Ensuring the Financial Integrity of HHS Programs In fiscal year (FY) 2022, improper payments within healthcare programs like Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) were estimated at a staggering $131.6 With Medicaid, the challenges are equally formidable.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

Health Populi

DECEMBER 9, 2021

being covered by health insurance is one of the social determinants of health. Without a health plan, an uninsured person in America is far more likely to file for bankruptcy due to medical costs, and lack access to needed health care (and especially primary care). In the U.S.,

Medical Billing 73

Medical Billing Health Insurance Medicaid Medicaid 73

Innovaare Compliance

MARCH 24, 2024

According to the National Health Care Anti-Fraud Association, the financial losses due to healthcare fraud are estimated to be in the billions of dollars annually. The Centers for Medicare & Medicaid Services (CMS) reported that in the fiscal year 2020, they recovered $3.1 billion in healthcare fraud judgments and settlements.

Fraud 52

Fraud Health Insurance Compliance Medicaid 52

HIPAA Journal

FEBRUARY 23, 2022

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? What is HIPAA Title II?

HIPAA 92

HIPAA Fraud Health Insurance Medicaid 92

Healthcare IT News - Telehealth

OCTOBER 2, 2020

Department of Health and Human Services to issue guidance to states about how to increase access to telehealth under Medicaid and the Children’s Health Insurance Program. Existing strategies states can use to integrate telehealth and other virtual health care services into value-based health care models.

US Department of Health and Human Services 154

US Department of Health and Human Services COVID-19 Medicaid Medicaid 154

Florida Health Care Law Firm

FEBRUARY 7, 2022

Enrollment periods for healthcare are exactly what they sound like — they are the only time of year when it is possible to sign up for health insurance coverage. For those who get health insurance through their employer, the open enrollment period will vary. Is the Healthcare Open Enrollment Period Different for Medicaid?

Health Insurance 52

Health Insurance Medicaid Medicaid Governance 52

MedTrainer

JANUARY 12, 2024

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. What is Healthcare Compliance?

Compliance 52

Compliance HIPAA Telemedicine ACA 52

Medisys Compliance

JANUARY 30, 2023

The medical billing industry is a complex and ever-changing field, and it is crucial for healthcare providers and billing companies to stay compliant with government regulations. Violations of the False Claims Act can result in significant financial penalties, including fines and exclusion from government healthcare programs.

Compliance 52

Compliance Medical Billing Medical Billing Outsourcing HIPAA 52

American Medical Compliance

MARCH 15, 2024

Furthermore, it prohibits knowingly submitting false or false claims to Medicare, Medicaid, or other federally funded healthcare programs. HIPAA regulations govern the use, disclosure, and safeguarding of protected health information (PHI) by covered entities and their business associates.

Compliance 105

Compliance Fraud HIPAA Health Insurance 105

Healthcare It News

FEBRUARY 28, 2023

The payer mix of health insurance is typical, with 35% of patients representing government insurance such as Medicare or Medicaid, 60% commercial insurance, and 6% self-pay patients. The majority of patients using the virtual-first clinic are females (70%), and the average age range has been 40-50.

Electronic Medical Records 243

Electronic Medical Records Telemedicine Health Insurance Health Outcomes 243

Health Care Law Brief

JUNE 5, 2023

In 2013, Jelly Bean contracted with the Florida Health Kids Corporation (“ FHKC ”)—a state-created entity that offers health and dental insurance for Florida children—to create, host, and maintain HealthyKids.org, where, in part, parents and others could apply for state Medicaid insurance coverage for eligible children.

Fraud 52

Fraud Due Diligence Medicaid Medicaid 52

MedTrainer

NOVEMBER 14, 2023

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. Exclusion from Government Programs: Entities found non-compliant may be barred from participating in government healthcare programs like Medicare and Medicaid. What Is Healthcare Compliance?

Compliance 52

Compliance HIPAA Governance Medicare 52

Healthcare Compliance Blog

MARCH 31, 2022

The agencies received millions of dollars in funding from Medicaid, which is funded in part by the federal government, and much of that money was meant to pay the wages and benefits of their aides. Under the Wage Parity Law, which is funded by Medicaid, aides are to be paid a minimum amount in total compensation.

Medicaid 59

Medicaid Medicaid Governance Fraud 59

MedTrainer

JANUARY 12, 2024

Healthcare facilities, from hospitals and clinics to insurance providers, are deeply affected by the regulations set forth by the Health Insurance Portability and Accountability Act (HIPAA). Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry.

HIPAA 52

HIPAA Compliance Health Insurance Hospitals 52

Healthcare IT Today

AUGUST 20, 2023

Only 45% of consumers are fully satisfied with their health insurance , according to a survey from HealthEdge, and 40% blame insurers for the high cost of care. That said, 66% trust their health plan more that the government or non-traditional entities such as Amazon or Walmart to their health insurance.

Health Insurance 91

Health Insurance Medicaid Medicaid FDA 91

MedTrainer

JUNE 28, 2023

The primary goal of a Certified Fraud Examiner in healthcare is to safeguard the integrity of healthcare systems and protect patients, insurance providers, and government programs from financial losses due to fraudulent activities. Health Insurance Portability and Accountability Act (HIPAA). Anti-Kickback Statute (AKS).

Fraud 52

Fraud Compliance Governance Compliance Officers 52

Compliancy Group

JANUARY 3, 2024

Medical billing compliance ensures that providers and administrators engage in ethical and accurate billing practices. It pays to know the law and avoid temptations to cut corners.

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 52