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. Department of Health and Human Services found a 63-fold jump in Medicare telehealth use during the pandemic. WHY IT MATTERS. Athenahealth.

COVID-19 212

COVID-19 Hospitals Telemedicine Medicare 212

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.

COVID-19 52

COVID-19 Medicare Medicare Medical Billing 52

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

Healthcare IT News - Telehealth

JANUARY 13, 2022

A new project in the Australian state of Victoria aims to improve the telehealth capabilities of mental health and palliative care services. million) funding from the federal government-backed Digital Health Cooperative Research Centre (DHCRC) for its Enhanced Telehealth Capabilities project. WHY IT MATTERS. million ($1.5

Health Cooperatives 136

Health Cooperatives Governance Doctors Medicare 136

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?

Governance 40

Governance Compliance Hospitals Regulatory Compliance 40

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. 1395w-22(a) ). d)(2) ).

Medicare 40

Medicare Medicare Hospitals Medicaid 40

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

Governance 97

Governance Licensing Fraud Medicare 97

Healthcare IT News - Telehealth

MAY 9, 2024

The department claimed that this change, which follows the recommendations made by the Strengthening Medicare Taskforce , will make it easier for healthcare providers to coordinate care and access information and empower patients to participate in their healthcare. million ($5.2 million) to establish this model.

Public Health 121

Public Health Medicare Medicare Governance 121

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

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?

Medicare 52

Medicare Medicare Medical Billing Outsourcing Health Outcomes 52

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 Schrank of the U.S.

Medicaid 75

Medicaid Medicaid Medicare Medicare 75

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.

Medicare 40

Medicare Medicare Hospitals Governance 40

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 changes to telehealth are being done to support the continuity of patient care amid the current COVID-19 restrictions and to help relieve the pressure on the overwhelmed hospital system.

COVID-19 194

COVID-19 Governance Public Health Medicare 194

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.

Hospitals 52

Hospitals Compliance Patient Advocacy Medicare 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?

Telemedicine 185

Telemedicine COVID-19 Governance Medicare 185

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. Permanently allow health centers and rural health clinics to provide telehealth services.

Medicare 135

Medicare Medicare COVID-19 Doctors 135

Healthcare Law Blog

APRIL 13, 2022

The California Department of Managed Health Care (“DMHC”) issued a recent guidance interpreting the application of the No Surprises Act (“NSA”)—a new federal law prohibiting out-of-network healthcare providers from balance-billing patients for certain emergency and non-emergency services—in California. Background of the NSA.

Governance 52

Governance Medical Billing Licensing Medicare 52

Medisys Compliance

MAY 30, 2022

The regulations governing PCS requirements are specified in the Code of Federal Regulations at 42 CFR 410.40(d). These regulations are the basis for Medicare guidelines. There is no specific Medicare-approved form for PCS. Regardless of the form you choose to use, the information on the form must comply with Medicare guidelines.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Medicare 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.

Medicare 52

Medicare Medicare Medicaid Medicaid 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 PINC AI™ Data Analysis.

Hospitals 52

Hospitals COVID-19 Payment Systems Medicaid 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

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.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

Health Law Advisor

AUGUST 14, 2023

During the COVID-19 PHE, CMS issued temporary waivers, including a waiver of the “location requirement” of the In-Office Ancillary Services (“IOAS”) exception. 1] With the end of the PHE having occurred over three months ago, that temporary waiver of sanctions ended and can no longer be relied upon for legal compliance with the Stark Law. [2]

COVID-19 52

COVID-19 Medicare Medicare Public Health 52

Healthcare It News

OCTOBER 31, 2022

Through the secure collection, documentation, reporting, access and use of data across provider types, ONC aims to address health inequities that have their root causes in poverty and racism. Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org.

Licensing 272

Licensing Health Outcomes Medicaid Medicaid 272

Healthcare IT Today

NOVEMBER 15, 2023

Their interventions, goals, and measures depend a lot on who’s paying for the service. Many employees using the service report sleeping better, feeling more confident and energetic, and other quality-of-life changes. The pandemic has significantly boosted in-home hospital care, just as it did telemedicine.

Medicare 97

Medicare Medicare Hospitals Compliance 97

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

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. WHY IT MATTERS. Lamar Alexander, R-Tenn., Meanwhile, U.S. Butterfield, D-N.C., and Glenn Thompson, R-Pa.,

US Department of Health and Human Services 203

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

Healthcare IT News - Telehealth

JULY 21, 2022

Monash Health, a public health service in Victoria, has piloted its pharmacist-led virtual clinic for managing the blood pressure of patients with chronic diseases. The online service, touted as the world's first, is being tried out among liver disease patients. Monash Health pilots virtual clinic for blood pressure management.

COVID-19 117

COVID-19 Community Health Services Medicare Medicare 117

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. And the list goes on.… The Primary Source Organizations.

Governance 52

Governance Licensing Malpractice Medicaid 52

AIHC

NOVEMBER 29, 2023

Over the past decades, the traditional method of reimbursing providers was in a fee-for-service (FFS) model. A provider would see a patient, document the visit, and select the procedure code(s) for the service(s). Therefore, the provider would be reimbursed a fee for each service (CPT code) provided.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Healthcare IT News - Telehealth

OCTOBER 27, 2020

Virtual care may be popular among patients, but if providers can't get paid for their services, it's unlikely they'll be able to continue to provide them. The government has signaled its support for reimbursing some telehealth services, at least in the short term.

COVID-19 198

COVID-19 Governance Medicare Medicare 198

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.

Medicare 40

Medicare Medicare COVID-19 Payment Systems 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.

Medicare 144

Medicare Medicare Doctors Fraud 144

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.,

US Department of Health and Human Services 40

US Department of Health and Human Services Medicare Medicare Overpayments 40

Provider Trust

JANUARY 25, 2024

Every year, the Department of Health and Human Services (HHS) and the Office of Inspector General (OIG) publish a summary of the Top Management and Performance Challenges Facing HHS. These programs ensure that the government engages only with law-abiding individuals and uses taxpayer dollars appropriately.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

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."

Nurses 191

Nurses Patient Satisfaction COVID-19 Hospitals 191

AIHC

NOVEMBER 29, 2023

Over the past decades, the traditional method of reimbursing providers was in a fee-for-service (FFS) model. A provider would see a patient, document the visit, and select the procedure code(s) for the service(s). Therefore, the provider would be reimbursed a fee for each service (CPT code) provided.

Medicare 52

Medicare Medicare Medicaid Medicaid 52