Kaiser Health News

JANUARY 28, 2022

A three-judge federal appeals court panel in Connecticut has likely ended an 11-year fight against a frustrating and confusing rule that left hundreds of thousands of Medicare beneficiaries without coverage for nursing home care, and no way to challenge a denial. But it can have serious repercussions.

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The Health Law Firm Blog

NOVEMBER 18, 2023

Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. This came in a ruling that limits regulators’ power to control what the program pays for certain [.]

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Medicare Medicare Hospitals Governance 40

MedTrainer

NOVEMBER 14, 2023

While federal operations are slowed, reduced, or put on pause during a government shutdown, healthcare services must continue to operate. What Is a Government Shutdown? Without budget authorization from Congress, a variety of government services and operations come to a halt. But what does this mean for your healthcare business?

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The Health Law Firm Blog

AUGUST 23, 2022

Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. This came in a ruling that limits regulators’ power to control what the program pays for certain [.].

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HealthIT Answers

NOVEMBER 14, 2022

By Jordan Rau - The federal government has eased its annual punishments for hospitals with higher-than-expected readmission rates in an acknowledgment of the upheaval the covid-19 pandemic has caused, resulting in the lightest penalties since 2014.

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Hall Render

OCTOBER 1, 2022

In a continuing resolution passed to keep the government from shutting down at midnight on September 30 th , Congress has included provisions that extend the low-volume hospital adjustment and Medicare Dependent Hospital program.

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Medicare Medicare Hospitals Governance 40

HIT Consultant

MARCH 18, 2022

What You Should Know: – The 32BJ Health Fund, a self-insured fund that provides care for 32BJ SEIU members and their dependents, today released a report that lays bare the stark price disparities between Medicare and private hospitals, and outlines solutions to both reins in prices and holds hospital systems accountable for these practices.

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Healthcare Blog

APRIL 13, 2023

As hospitals have become increasingly complex organizations, effective governance, risk, and compliance (GRC) strategies have become essential for ensuring patient safety and regulatory compliance. What are the Key Components of a Successful Governance, Risk, and Compliance (GRC) Strategy?

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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.

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Healthcare IT News - Telehealth

DECEMBER 7, 2021

American Hospital Association. We owe it to our patients to make health care access easier, and patients with Medicare should not be excluded from this opportunity," said Dr. Brian Hasselfeld, medical director of digital health and telemedicine at Johns Hopkins Medicine, in a statement. Alliance for Connected Care. Athenahealth.

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Hall Render

NOVEMBER 17, 2023

The Centers for Medicare and Medicaid Services (“CMS”) Medicare Advantage final rule for 2024 (“Final Rule”) clarified that Medicare Advantage plans must adhere to the “two-midnight rule” when making coverage determinations for inpatient services. The Final Rule went into effect on June 5, 2023, and can be found here.

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Healthcare It News

NOVEMBER 23, 2023

Victoria to complete Altera EMR rollout across Gippsland The state government of Victoria has committed to finishing the deployment of an integrated EMR system across the rural region of Gippsland. It recently announced A$12 million in funding over four years to support health services in the region to upgrade their systems.

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Public Health Governance Hospitals Medicare 243

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. Eligible services.

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HIPAA Journal

NOVEMBER 21, 2022

million being defrauded from Medicaid, Medicare, and private health insurance programs. The payments were intended for hospitals for providing covered medical services. The arrests were related to a series of scams that spoofed hospital email accounts. million, and $6.4

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Medisys Compliance

JULY 13, 2023

Medicare recognizes the importance of diabetes self-management training and offers coverage for eligible beneficiaries. However, there are specific guidelines and conditions that need to be met for Medicare billing. Diabetes Education Billing Guidelines for Medicare Who May Furnish the Training?

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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.

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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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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 93

Hanys

DECEMBER 16, 2022

The stopgap spending bill passed by the Senate late Thursday extends current funding levels on programs, including HANYS-supported Medicare-dependent Hospital and enhanced Low-volume Adjustment programs, through Dec. 23, and gives lawmakers an extra week to finish a $1.7 trillion year-end spending package.

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Hanys

APRIL 19, 2024

Collecting and reporting SDOH data April 23 Addressing your liability risks during the healthcare staffing crisis April 24 Hospital antibiotic stewardship efforts update: The CDC perspective April 25 Government relations update series April 26 The impact of artificial intelligence on language access in healthcare April 29 Establishing referral processes (..)

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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.

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Governance Doctors Medicare Medicare 52

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. All hospital MRFs must now comply with a CMS template, a markedly more prescriptive approach than previously allowed.

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Hospitals Compliance Patient Advocacy 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.

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Governance Medicare Medicare Hospitals 40

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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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 PINC AI™ Data Analysis.

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Hospitals COVID-19 Payment Systems Medicaid 52

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 184

Compliancy Group

APRIL 17, 2024

Office of Inspector General (OIG) in the Department of Health and Human Services (DHHS) oversees efforts in the healthcare sector to identify, reduce, and prevent incidents of fraud, waste, and abuse of funds from programs like Medicare. Medicare Advantage (M.A.): and cybersecurity threats. Organizations using M.A.

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Compliance Officers Compliance Medicare Medicare 52

Hanys

APRIL 12, 2024

How student loan debt forgiveness counseling can help attract and retain employees April 15 Medicare post-acute care and inpatient psychiatric facility proposed rules April 15 HANYS' events during the AHA 2024 Annual Meeting in Washington April 15-16 SOGI data best practices April16 Standing membership call on state and federal issues April 16 Improve (..)

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Medicare Medicare Governance Hospitals 52

Healthcare IT News - Telehealth

JANUARY 17, 2022

The Australian government is briefly subsidising some telehealth services as it deals with a new COVID-19 outbreak. These include specialist inpatient video and phone consultation items under the Medicare Benefits Schedule, complex specialist telephone consultations and level C or longer telephone consultations for general practitioners.

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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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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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Health Law Advisor

AUGUST 14, 2023

2] This means, in most cases, that Medicare beneficiaries must now come to a physician practice’s office location to pick up their DME – including IUCs – when the DME items are furnished and billed by physicians or their practices. The IOAS exception does NOT apply.

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The Health Law Firm

OCTOBER 9, 2013

Board Certified by The Florida Bar in Health Law The University of Miami Hospital allegedly owes Medicare $3.7 This is according to an audit report of the hospital’s billing practices that found the hospital allegedly overbilled the health care program in 2009 and 2010. Indest III, J.D.,

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US Department of Health and Human Services Medicare Medicare Overpayments 40

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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Health Law Attorney

DECEMBER 18, 2020

The Centers for Medicaid & Medicare Services ( CMS ) recently released the 2021 Outpatient Prospective Payment System ( OPPS ) and Ambulatory Surgical Center ( ASC ) Final Rule, which may be accessed here. CMS Administrator Seema Verma indicated there would be less micromanagement from the government regarding such decisions.

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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. offering in-home treatment.

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Verisys

FEBRUARY 9, 2024

Million Full Story Doctor Agrees to Pay $95,000 to Settle Allegations of Health Care Fraud Full Story Columbia Physician Indicted for False Statements to Medicare Full Story Pharmacist Fraud Current and Former Owners of Center City Philadelphia Pharmacy Agree to Pay Over $4.6

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