Health Populi

AUGUST 16, 2021

adults favor increased government funding allocated to lowering the out-of-pocket costs for patients. For prescription drug manufacturers, several cost line items: providing or maintaining administrative support services, direct financial assistance (like copay cards), and donating drugs to insured patients via patient assistance programs.

COVID-19 129

COVID-19 Nurses Doctors Medicaid 129

AIHC

MARCH 28, 2022

Written by: AIHC Blogger This article provides educational information related to fighting unreasonable denials by working through a complex payer appeals process. This information is not all-inclusive and the article is a truncated version of Lesson 3 from our Certified Outpatient Clinical Appeals Specialist (COCAS SM ) training program.

Medicare 52

Medicare Medicare Compliance Governance 52

AIHC

NOVEMBER 29, 2023

The Centers for Medicare & Medicaid Services (CMS) HCC model was initiated in 2004 and is becoming increasingly prevalent as the environment shifts to value-based payment models. We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. healthcare system were exorbitant.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

AIHC

NOVEMBER 29, 2023

The Centers for Medicare & Medicaid Services (CMS) HCC model was initiated in 2004 and is becoming increasingly prevalent as the environment shifts to value-based payment models. We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. healthcare system were exorbitant.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Kaiser Health News

JUNE 6, 2022

For the second time in three years, Espinosa faces the prospect of losing permission to work, which would cost him not only his job providing tech support at a software company, but also his health insurance. Without health insurance, his daughter would lose her eligibility for transplants.

Health Insurance 72

Health Insurance Doctors Governance Licensing 72

Kaiser Health News

MAY 31, 2022

Cigna’s negotiated rate was $4,144, and Melville’s share under her insurance was $2,185. And often the doctors and hospitals are the ones who decide when those categories shift and a patient can be charged — but those decisions often are debatable.

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ACA Doctors Medical Billing Hospitals 103

Healthcare Law Blog

MAY 16, 2022

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). Enrollee Participation in Dual Eligible Special Needs Plan (“D-SNP”) Governance (§ 422.107).

Medicare 52

Medicare Medicare Medicaid Medicaid 52

HIPAA Journal

JANUARY 9, 2023

The Health Insurance Portability and Accountability Act was signed into law in 1996 and while there have been some significant HIPAA updates over the last two decades, the last set of major HIPAA updates occurred in 2013 with the introduction of the HIPAA Omnibus Final Rule. OCR asked 54 different questions in its RFI.

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HIPAA COVID-19 COVID-19 Vaccine Compliance 112

HIPAA Journal

MARCH 31, 2023

These generally fall into two categories – HIPAA medical records retention and HIPAA records retention requirements. The distinction between the two categories is that there are no HIPAA medical records retention requirements, but requirements exist for other documentation. Information Security and Privacy Policies.

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HIPAA Medicare Medicare Compliance 129

NY Health Law

APRIL 15, 2021

While the laws governing telehealth were becoming gradually more permissive, progress was slow. diminished quality of care, increased opportunity to violate scope of practice or informed consent laws, etc.) seem not to have been a major concern. The Legislature is also working to address outstanding issues.

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Informed Consent Malpractice Telemedicine Medicaid 52

Health Populi

DECEMBER 25, 2018

This bill would create a government-run drug company to produce and distribute generic medicines. Employers will endeavor to artfully design consumer-directed benefit plans (CDHPs) that nudge insured workers toward healthier habits, while integrating a broader definition of wellness.

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Health Insurance Hospitals Doctors Medicaid 104

Kaiser Health News

FEBRUARY 9, 2023

He urged Congress to do more, including making permanent the boosted insurance premium subsidies added to the Affordable Care Act during the pandemic. He took a victory lap on recent accomplishments like capping prescription drug costs for seniors on Medicare.

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US Department of Health and Human Services Medicare Medicare FDA 52

Healthcare Law Blog

JANUARY 11, 2023

It’s also enough to cause the chief executive officers of these three plans to discuss the possibility of industry litigation against the federal government – which threat was effective in an earlier round of health plans versus CMS and delayed audits, enforcement actions and repayments under the Medicare Advantage risk adjustment program for years.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

HIPAA Journal

JANUARY 2, 2023

Texas Department of Aging and Disability Services – $1,600,000 penalty for risk analysis failures, access control failures, and information system monitoring failures. Impermissible Disclosures of Protected Health Information. Removing protected health information from a healthcare facility places that information at risk of exposure.

HIPAA 109

HIPAA Compliance Hospitals Medicare 109

Kaiser Health News

JANUARY 12, 2023

Still to be determined is whether Medicare — which provides insurance to most people with Alzheimer’s — will cover the drug. They really scrutinized a lot of government contracts — like no-bid government contracts that funneled lots and lots of money to things that did not pan out or help anybody. That’s not true.

US Department of Health and Human Services 52

US Department of Health and Human Services FDA Medicare Medicare 52

Hall Render

MARCH 25, 2022

Alabama lawmaker’s push to extend postpartum Medicaid coverage. $12 Florida Medicaid hits Sunshine Health with $9M sanction for not paying providers’ claims. increase for 2023 Medicaid budget. Orthopedic surgeon allegedly exaggerated patient visits to defraud insurers. State overcounts vaccinations by 600,000 people.

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COVID-19 US Department of Health and Human Services Nursing Homes Nurses 40