HIT Consultant

JULY 18, 2024

Physician practices, burdened with updating information across multiple platforms, contribute to the problem. The Impact: Patients can face delays in care due to incorrect contact information. National Standards: Establishing national standards for how provider information is exchanged could be a less disruptive solution.

Medicaid 98

Medicaid Medicaid Medicare Medicare 98

Healthcare It News

OCTOBER 25, 2022

With those flexibilities due to sunset 151 days after the federal Public Health Emergency expires, HIMSS is calling on its members to contact their senators and representatives and urge them to extend coverage of telehealth services under Medicare until at least December 31, 2024.

COVID-19 245

COVID-19 Medicaid Medicaid Public Health 245

Hall Render

OCTOBER 22, 2024

Effective October 1, 2024, the Centers for Medicare & Medicaid Services (“CMS”) introduced significant updates to the CMS-855A form , specifically requiring a new Skilled Nursing Facility (“SNF”) Attachment for every SNF. Additionally, SNFs structured as trusts must disclose all trustees.

Medicare 40

Medicare Medicare Nurses Medicaid 40

MRO Compliance

AUGUST 8, 2024

The Role of Clinical Data Registries According to the latest information from the Centers for Medicare and Medicaid Services (CMS), 90% of payments are now linked to value, with 40% flowing through alternative payment models (APMs), showing the shift towards more cost-effective care driven by data from registries.

Patient Satisfaction 147

Patient Satisfaction Medicare Medicare Medicaid 147

Hall Render

FEBRUARY 10, 2023

North Carolina legislators are considering a Medicaid expansion bill that includes a repeal of its CON law. Higher interest rates have resulted in fewer government and non-profit health care providers going to market to place debt. Hall Render blog posts and articles are intended for informational purposes only.

Medicaid 40

Medicaid Medicaid Hospitals Governance 40

HIT Consultant

MARCH 8, 2022

Under the PHE, states must keep Medicaid enrollees continuously covered, irrespective of their circumstances. . By December 2021, enrollment in Medicaid and CHIP (Children’s Health Insurance Program) grew to a record high of more than 83 million individuals, primarily due to the continuous coverage requirements of the PHE.

Public Health 98

Public Health Medicaid Medicaid COVID-19 98

Verisys

FEBRUARY 8, 2024

The bill requires the board to post an online statement directing the public to contact the board for more information concerning a formal name change. Federal regulations require Medicaid to enroll an Ordering, Referring, and Prescribing (ORP) practitioner as a participating provider for services billable to the Medicaid program.

Regulatory Compliance 52

Regulatory Compliance Compliance Licensing Nurses 52

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. What Is Considered a Primary Source?

Governance 52

Governance Licensing Malpractice Medicaid 52

Hall Render

OCTOBER 28, 2024

The Centers for Medicare & Medicaid Services (“CMS”) is reinforcing regulatory expectations regarding nursing home residents’ rights to vote. Nursing homes certified by Medicare or Medicaid must ensure that their residents can fully exercise their rights as United States citizens, including their right to vote. 42 CFR §483.10(b)(1)

Nursing Homes 40

Nursing Homes Nurses Medicaid Medicaid 40

Compliancy Group

SEPTEMBER 23, 2024

Understanding the OIG Exclusion List The LEIE provides a complete list of any entity or individual excluded from participating in programs such as Medicare and Medicaid, as well as other federal healthcare programs. Cross-Referencing With Other Lists Cross-referencing your search with other lists will complement your OIG LEIE search.

Fraud 52

Fraud Compliance Medicare Medicare 52

Medisys Compliance

MAY 20, 2024

Payer type: Private insurance companies, Medicare, and Medicaid have their own reimbursement structures. Understanding Your Reimbursement Rates Here’s how to stay informed about your reimbursement rates: Review Your Insurance Contracts: These contracts detail the specific reimbursement rates for services you provide under each plan.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicare 59

Compliancy Group

AUGUST 30, 2024

HIPAA The Health Insurance Portability and Accountability Act (HIPAA) of 1996 governs how healthcare organizations handle protected health information (PHI). This set of regulations relates to sharing, collecting, storing, and disposing of health records, patient data, and other sensitive information.

Compliance 52

Compliance Fraud Compliance Officers HIPAA 52

Hall Render

AUGUST 8, 2022

The web server contained ePHI, including patients’ names, Medicaid numbers, health care provider names, dates of service, dates of birth, addresses and treatment information. Further, data governance is key to proactively managing ePHI. Your primary Hall Render contact.

HIPAA 73

HIPAA Governance Medicaid Medicaid 73

Compliancy Group

OCTOBER 4, 2024

Maintaining the security and integrity of sensitive information and preventing waste, fraud, and abuse is essential to quality healthcare and promoting workplace safety. While few people enjoy the thought of undergoing an audit, this process can be informative and beneficial for a healthcare organization.

Compliance Officers 59

Compliance Officers Compliance Regulatory Compliance Fraud 59

HIPAA Journal

OCTOBER 10, 2022

The Wisconsin Department of Health Services (DHS) has recently confirmed that there has been an accidental disclosure of protected health information via email. According to the breach notice, a presentation was emailed to the DHS Children’s Long-Term Support Council in April 2021 that contained protected health information.

Medicaid 57

Medicaid Medicaid Governance Fraud 57

Healthcare IT Today

OCTOBER 20, 2023

SDoH data is a major component of the information captured by Wellframe , a digital health management platform used by health plans. A patient who signs up to be a member of Wellframe provides SDoH information, which the Wellframe platform then shares information with care managers who can contact the members to address the problems.

Medicaid 123

Medicaid Medicaid COVID-19 Doctors 123

Verisys

MARCH 1, 2022

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. Government and Non-Government Sources.

Governance 52

Governance Licensing Malpractice Medicaid 52

Hall Render

JULY 25, 2024

FFL Partners announced the acquisition of a majority stake in Medicus IT, a managed information technology and cybersecurity services provider to more than 6,500 health care practitioners across 30 states. Hall Render blog posts and articles are intended for informational purposes only.

Medicaid 40

Medicaid Medicaid Governance Compliance 40

Innovaare Compliance

JUNE 8, 2023

The Centers for Medicare & Medicaid Services (CMS) has released new audit protocol changes for Medicare and Medicaid plans. These changes, which went into effect on January 1, 2023, are designed to ensure health plans are accurately reporting their costs and that they are not overcharging the government.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

C&M Health Law

SEPTEMBER 11, 2023

Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (“CMS”) issued a much anticipated and contested proposed rule that seeks to establish minimum staffing level requirements for nursing homes. The report evaluated four staffing requirements ranging between 3.3 HPRD proposed by CMS. HPRD from NAs.

Nursing Homes 98

Nursing Homes Nurses Medicaid Medicaid 98

MedTrainer

OCTOBER 11, 2024

As you may have discovered (hopefully not the hard way), meeting the basic requirements set forth by the Centers for Medicare and Medicaid (CMS) and OSHA should be a bare minimum. To truly be prepared with a multi-hazard approach, you should conduct risk assessments and use all the tools and resources available to you.

Compliance Officers 52

Compliance Officers Compliance Medicaid Medicaid 52

Hall Render

DECEMBER 5, 2022

The FAQ does note that some states chose to be the primary enforcers of the GFE requirements, rather than the federal government. Your primary Hall Render contact. Hall Render blog posts and articles are intended for informational purposes only. Hall Render blog posts and articles are intended for informational purposes only.

Medicaid 72

Medicaid Medicaid Medicare Medicare 72

Medisys Compliance

MARCH 7, 2024

These codes are integral to the billing and reimbursement process, as they enable payers, such as insurance companies and government agencies, to determine the appropriate payment for rendered services. Moreover, CPT codes facilitate data analysis, research, and quality improvement initiatives within the healthcare system.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Regulatory Compliance COVID-19 59

Kaiser Health News

NOVEMBER 11, 2021

Yet federal officials say complaints are rising from seniors tricked into buying policies — without their consent or lured by questionable information — that may not cover their drugs or include their doctors. To use the new option, beneficiaries should contact their state’s health insurance assistance program at www.shiphelp.org/.

Medicare 145

Medicare Medicare Doctors Fraud 145

Healthcare IT News - Telehealth

NOVEMBER 2, 2020

More than 85% of the patients served by Temple are covered by government programs, including Medicare and Medicaid. Patients dually eligible for both Medicare and Medicaid make up roughly half of the Medicare inpatient base. More than 40% of total inpatient cases include a behavioral health diagnosis.

Telemedicine 171

Telemedicine COVID-19 Nurses Medicare 171

Hall Render

DECEMBER 18, 2023

government with uncovering these crimes, but it will also help international efforts to expose individuals that defraud governments around the world. The CTA mandates the creation of the Beneficial Ownership Secure System (“BOSS”) database and requires entities to disclose information regarding beneficial ownership.

Governance 40

Governance Compliance Licensing Medicaid 40

Hall Render

JUNE 28, 2024

On June 28, 2024, the Supreme Court of the United States overturned a long-standing doctrine, known as Chevron deference, that impacts a court’s deference to a government agency’s action during administrative proceedings. Hall Render blog posts and articles are intended for informational purposes only. Special thanks to Kelsey A.

Governance 40

Governance Medicaid Medicaid Medicare 40

Health Law Advisor

JULY 5, 2023

New York City Councilmember Julie Menin, who is largely spearheading this effort, stated: “We cannot allow exorbitant health care costs to burden our families, businesses, and city government any longer. 2] For more information regarding these new requirements please contact Arthur J. Fried and Amy Cooperstein. [1]

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Hall Render

JANUARY 27, 2023

The main drivers of the increase in filings were increased labor and supply costs, interest rate increases, lack of government stimulus funds and lower investment returns. The Kaiser Family Foundation released a summary of all of the Medicaid Waivers (section 1115) that are pending or that have been approved by each state.

Medicaid 40

Medicaid Medicaid Hospitals Governance 40

MedTrainer

AUGUST 5, 2024

Inaccurate or incomplete application information, lagging peer references, and administrative backlogs may result in delays. They must be able to produce all documentation and approvals for the privileges to simplify information requests during audits and surveys. Ongoing Process: Privileging is not a one-time event.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

SEPTEMBER 8, 2023

The breach occurred in 2013 when four unencrypted laptops containing the electronic protected health information (ePHI) of over 4 million patients were stolen from an Advocate Health administrative building. Details of the settlement indicate the submission of false claims to Medicare, Medicaid, TRICARE, and FECA programs.

Compliance 52

Compliance HIPAA Medicaid Medicaid 52

Healthcare IT Today

OCTOBER 19, 2023

According to Karl Ulfers, co-founder and vice president of growth at DUOS , governments offer excellent listings of resources with which care managers and clinicians can address housing, food, transportation, and other SDoH. The company employs visits, phone calls, and online contacts to get the data.

Department of Veterans Affairs 117

Department of Veterans Affairs Nursing Homes Health Outcomes Hospitals 117

Dossier

SEPTEMBER 30, 2024

Inflation has increased the cost of supplies, utilities, and services, while reimbursement rates from insurance companies and government programs often fail to keep pace. For example, many hospitals grapple with reduced Medicare and Medicaid reimbursements, disproportionately affecting those serving a higher percentage of low-income patients.

Hospitals 52

Hospitals Nurses Patient Satisfaction Medicaid 52

YouCompli

JANUARY 18, 2023

Featured speakers : Eric Gold , Chief, Massachusetts Attorney General’s Office Healthcare Division; Jennifer Goldstein , Managing Attorney, Medicaid Fraud Division, Massachusetts Attorney General’s Office; and Steven Sharobem , Assistant US Attorney, District of Massachusetts. Priorities for Massachusetts’s Medicaid Fraud Division.

Fraud 52

Fraud COVID-19 Compliance Medicaid 52

Compliancy Group

APRIL 17, 2024

are subject to OIG risk adjustment audits, which can result in payment adjustments based on beneficiary health status and risk adjustment data that entities submit to the Centers for Medicare and Medicaid Services. and cybersecurity threats. Organizations using M.A.

Compliance Officers 52

Compliance Officers Compliance Medicare Medicare 52

MedTrainer

MARCH 28, 2024

Regardless of the size of a healthcare organization, the Office of the Inspector General (OIG) recommends identifying a compliance contact who is responsible for ensuring that compliance activities are completed. Health Information Management (HIM) Department Ensures the integrity and security of patient health information (PHI).

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

MedTrainer

JUNE 15, 2022

When changes are made to government regulations, they have far-reaching effects. By coordinating care and sharing information about their patients, ACOs are able to provide Medicare patients with the treatment they need at the appropriate time, avoiding errors as much as possible. Contact MedTrainer Today. What Is an ACO?

Medicare 52

Medicare Medicare Medicaid Medicaid 52