Healthcare IT News - Telehealth

DECEMBER 7, 2021

Telehealth Access for America is aimed at educating members of the public about the need to enact permanent legislation around virtual care services. American Hospital Association. It also offers users the chance to sign up for email updates about the campaign. Alliance for Connected Care. American Heart Association.

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COVID-19 Hospitals Telemedicine Medicare 212

YouCompli

AUGUST 22, 2023

Approximately 65 million Americans are enrolled in Medicare – about 34 million in traditional Medicare and the rest in Medicare Advantage. Traditional Medicare is administered by the federal government, and individuals pay a separate monthly premium for hospital visits, doctors/outpatient, and prescription drugs.

Medicare 52

Medicare Medicare US Department of Health and Human Services Compliance 52

Medisys Compliance

MARCH 14, 2023

Wound care is provided in various healthcare settings like inpatient hospital, outpatient clinics, long-term care facilities, home health settings, hospice and skilled nursing facilities. For example, patients who require ongoing wound care but do not need to be hospitalized can receive treatment in outpatient clinics.

Payment Systems 52

Payment Systems Medical Billing Medicare Medicare 52

Medisys Compliance

MAY 19, 2022

The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. During the COVID-19 public health emergency, any health care provider who is eligible to bill Medicare can bill for telehealth services regardless of where the patient or provider is located. Cost-sharing.

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COVID-19 Medicare Medicare Medical Billing 52

HIT Consultant

APRIL 1, 2024

will be divided between the US government and various states. Key Allegations The lawsuit alleged that TRG engaged in improper billing practices related to radiology services provided to hospitals and other healthcare providers across the country. . – The settlement amount of $3.1M

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Governance Licensing Fraud Medicare 97

Healthcare Compliance Blog

MAY 19, 2022

An acute care hospital in Oklahoma has paid over $1.1 million to settle allegations that it violated the False Claims Act by submitting false claims to Medicare. Throughout the investigation, the hospital cooperated with the above entities. The hospital agreed to pay the United States $1,151,770.50 to resolve the claims.

US Department of Health and Human Services 59

US Department of Health and Human Services Hospitals Medicare Medicare 59

Hall Render

JUNE 8, 2023

On June 7, CMS issued a much-anticipated Final Rule addressing the placement of Medicare Advantage patient days within the Medicare DSH calculation. The Final Rule adopts a retroactive policy that will place Medicare Advantage days in the Medicare Fraction of the DSH calculation for discharges before October 1, 2013.

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Medicare Medicare Hospitals Governance 40

Healthcare IT News - Telehealth

MAY 30, 2023

This change is yet another signal that the country is working to move past the pandemic, which falls in line with recent moves by the federal government to move the pandemic to a more controlled phase. Further, what should CIOs and other health IT leaders at hospitals and health systems be doing to address new telemedicine challenges?

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Telemedicine COVID-19 Governance Medicare 186

Healthcare Law Today

DECEMBER 15, 2022

The case asks whether the government has authority to dismiss an FCA suit after initially declining to proceed with the action, and if so, what standard would apply. Petitioner-Relator Polansky is a doctor and former consultant for Executive Health Resources (EHR), a company that submits claims to Medicare on behalf of health care providers.

Governance 52

Governance Doctors Medicare Medicare 52

Hall Render

JUNE 16, 2023

The Court’s opinion settles two outstanding questions about the authority of the Government to dismiss FCA actions in which it first declines to intervene but that whistleblowers continue to pursue on the Government’s behalf. The Government and Defendants favored the broadest authority permitted in the D.C.

Governance 40

Governance Medicare Medicare Hospitals 40

Hall Render

DECEMBER 4, 2023

The Centers for Medicare & Medicaid Services (“CMS”) finalized significant updates to the Hospital Price Transparency regulation for the first time since the rule took effect on January 1, 2021. Below are additional details about the updates, including effective dates and implementation timelines.

Hospitals 52

Hospitals Compliance Patient Advocacy Medicare 52

HIT Consultant

APRIL 21, 2022

What You Should Know: – Centers for Medicare & Medicaid Services’ (CMS) payment adjustments did not adequately address hospitals increased costs for FY 2021, according to new data from Premier. – The data reveals this discrepancy has resulted in hospitals receiving only a 2.4 Labor makes up about 67.6

Hospitals 52

Hospitals COVID-19 Payment Systems Medicaid 52

MedTrainer

OCTOBER 13, 2023

Because no one talks about it. Most payers created their own portal, most state and federal government agencies brought documents and databases online, and tech companies did their best to streamline processes. But, the fact is, no one ever talks about going back to black and white TV.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

MedTrainer

JUNE 15, 2022

When changes are made to government regulations, they have far-reaching effects. This is the case for proposed changes to the Medicare Shared Savings Program, as they’ll impact ACOs in more ways than one if they’re enacted. ACO stands for accountable care organization and is made up of care providers, doctors, and hospitals.

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Medicare Medicare Medicaid Medicaid 52

Healthcare IT News - Telehealth

JUNE 20, 2023

A bipartisan group of legislators has reintroduced the Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act – first introduced in 2016 – to expand opportunities and coverage for telehealth through Medicare. This is the second time the bill has been reintroduced. Mike Thompson (D-Calif.)

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Medicare Medicare COVID-19 Doctors 136

Health Populi

JULY 16, 2020

The median charge for hospitalizing a patient with COVID-19 ranged from $34,662 for people 23 to 30, and $45,683 for people between 51 and 60 years of age, according to FAIR Health’s research brief, Key Characteristics of COVID-19 Patients published July 14th, 2020. They used two ICD-10-CM diagnostic codes for this research: U07.1,

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COVID-19 Hospitals Health Insurance Medicare 145

Kaiser Health News

NOVEMBER 11, 2021

Finding the best private Medicare drug or medical insurance plan among dozens of choices is tough enough without throwing misleading sales tactics into the mix. The problems are especially prevalent during Medicare’s open-enrollment period, which began Oct. “You’re not from Medicare,” Heimer told her.

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Medicare Medicare Doctors Fraud 144

Healthcare It News

OCTOBER 31, 2022

The USCDI standard consists of a core set of data classes and elements for health information exchanges to capture information about conditions outside of medical practice that put a person’s health and well-being at risk – chiefly food, housing and transportation access. Andrea Fox is senior editor of Healthcare IT News.

Licensing 274

Licensing Health Outcomes Medicaid Medicaid 274

Healthcare IT Today

JANUARY 17, 2024

Insights are also from auditing professional and hospital claims totaling more than $5 billion and denials from commercial and government payors exceeding $150 billion. Those are the high-level findings of MDaudit’s 2023 Benchmark Report on the trends, challenges, and opportunities encountered by U.S. healthcare organizations.

Compliance 106

Compliance Overpayments Overpayment Medicare 106

Healthcare IT Today

NOVEMBER 15, 2023

The technique involves finding data from public sources such as Centers for Medicare & Medicaid Services (CMS). Resilient Healthcare Employs Extensive Data Analytics Resilient Healthcare provides in-home care for conditions that have traditionally required a hospital stay. She says there is “lots of data to slice and dice.”

Medicare 98

Medicare Medicare Hospitals Compliance 98

Healthcare IT News - Telehealth

OCTOBER 27, 2020

The government has signaled its support for reimbursing some telehealth services, at least in the short term. "The government can play a very positive role in telehealth by establishing clear standards and clear reimbursement guidelines," said Selesnick. "You put a lot of hurdles in, you're gonna have diminished use."

COVID-19 198

COVID-19 Governance Medicare Medicare 198

Verisys

DECEMBER 5, 2023

For the medical staff services team at a hospital to properly verify a healthcare practitioner’s credentials, dozens of primary sources must be contacted directly, and those primary source organizations must then verify the credentials of the practitioner in question. The policy issuer for malpractice insurance verifies insurance coverage.

Governance 52

Governance Licensing Malpractice Medicaid 52

Healthcare IT News - Telehealth

JUNE 30, 2020

Signers pointed out that the authorities granted to the Department of Health and Human Services and the Centers for Medicare and Medicaid Services are restricted to the public health emergency period triggered by COVID-19. introduced legislation earlier this month to codify Medicare reimbursement of virtual care at FQHCs and RHCs.

US Department of Health and Human Services 203

US Department of Health and Human Services COVID-19 Telemedicine Medicare 203

YouCompli

FEBRUARY 22, 2023

Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. It is “prospective” because hospitals and other providers know ahead of time what they will be reimbursed. The CCR is determined by a hospital’s cost report that is reconciled with the local Medicare contractor.

Compliance 52

Compliance US Department of Health and Human Services Overpayments Overpayment 52

HIT Consultant

AUGUST 17, 2023

The declining birth rate is especially a problem for rural hospitals, many of which aren’t meeting the required number of deliveries per year to meet safety standards. Hospitals in under-resourced areas have less to offer new doctors in terms of equipment, support, and quality of life. Simplifying the funding application process.

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Medicaid Medicaid Doctors Telemedicine 98

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 We’ve broken down the report’s primary themes and how they affect healthcare organizations moving forward in 2024.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

Healthcare IT News - Telehealth

JULY 16, 2020

Now, the question becomes : How many of those changes, particularly regarding temporary waivers issued by the Centers for Medicare and Medicaid Services, will become permanent? Among other provisions, the act would eliminate most geographic and originating site restrictions on the use of telehealth in Medicare.

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COVID-19 Medicare Medicare Governance 145

Healthcare IT News - Telehealth

NOVEMBER 8, 2021

National Nurses United and the California Nurses Association released a joint statement this past week criticizing Kaiser Permanente's aims to expand advanced hospital services into patients' homes. "The Advanced Care at Home Program does not limit the role of nurses in hospitals." WHY IT MATTERS.

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Nurses Patient Satisfaction COVID-19 Hospitals 191

Healthcare IT News - Telehealth

JUNE 8, 2022

But even now, hospitals and health systems should be preparing proactively to meet the regulatory demands of a post-PHE future. 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. Cohen, a Washington, D.C.-based

US Department of Health and Human Services 184

US Department of Health and Human Services Compliance Overpayments Overpayment 184

Verisys

MARCH 23, 2023

3 Healthcare Fraud and Abuse Laws Providers Should Know About In 2021, the Department of Justice reported recovering over $5.5 Abuse of government healthcare programs is a federal offense with severe penalties. This guide will cover three federal fraud and abuse laws that healthcare providers need to know about.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

Health Law Advisor

NOVEMBER 23, 2021

On November 12, 2021, the Centers for Medicare and Medicaid Services (“CMS”) released final guidance confirming that hospitals can be co-located with other hospitals or healthcare providers. The latter exclusion raises questions as to how hospitals co-located with physician offices in multi-tenant buildings will be surveyed.

Hospitals 40

Hospitals Compliance Medicare Medicare 40

Healthcare IT News - Telehealth

AUGUST 19, 2022

Surgeon General’s recent advisory about clinician burnout cited numerous societal, cultural, structural and organizational causes – including excessive workloads, administrative burden and lack of organizational support. What was the gist of the Surgeon General’s recent advisory about clinician burnout?

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COVID-19 Hospitals Nurses Licensing 190

Hall Render

JUNE 15, 2022

On June 15, in American Hospital Association v. Becerra , the Supreme Court ruled the payment cuts made by the Department of Health and Human Services’ (“HHS”) Centers for Medicare & Medicaid Services (“CMS”) for 340B eligible outpatient drugs were not permissible under the governing statute.

Medicare 45

Medicare Medicare Hospitals Governance 45

MedTrainer

NOVEMBER 14, 2023

A healthcare organization’s commitment to compliance is crucial — it’s about maintaining the integrity of medical practice, navigating the complexities of legal frameworks, and embracing ethical decision-making. The Stark Law is primarily enforced by the Centers for Medicare and Medicaid Services. What Is Healthcare Compliance?

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Compliance HIPAA Governance Medicare 52

Pharmacy Law Blog

FEBRUARY 13, 2018

On November 22, 2017, a Florida woman who was accused of a $45 million Medicare fraud, received a six-and-a-half-year prison sentence, following a 2016 U.S. Supreme Court decision in her case holding that the government could not freeze untainted assets. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

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Fraud Medicare Medicare Governance 40

Healthcare IT News - Telehealth

JANUARY 23, 2023

government passed the Advancing Telehealth Beyond COVID-19 Act of 2022, which allows Medicare patients access to telehealth services, including audio-only services, through 2024. And it's not simply about virtual appointments, many patients want greater visibility and access to their whole health history online.

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Telemedicine COVID-19 Medicare Medicare 202

Healthcare IT News - Telehealth

NOVEMBER 2, 2020

Located in the heart of North Philadelphia, Temple University Hospital serves one of the nation’s most economically challenged and diverse urban populations. More than 85% of the patients served by Temple are covered by government programs, including Medicare and Medicaid. ” USING FCC AWARD FUNDS.

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Telemedicine COVID-19 Nurses Medicare 170