HIPAA Journal

JULY 31, 2023

a government services contracting company, has announced in a Securities and Exchange Commission (SEC) filing that hackers exploited a zero-day vulnerability in Progress Software’s MOVEit Transfer solution in May 2023 and accessed the protected health information (PHI) of between 8 and 11 million individuals. Reston, VA-based Maximus Inc.,

Governance 71

Governance Medicare Medicare Ransomware 71

Medisys Compliance

MARCH 31, 2023

Ohio Medicaid is a government-sponsored healthcare program that provides medical benefits to eligible individuals in Ohio. To become a provider for Ohio Medicaid, you must first enroll in the Ohio Medicaid program. Here are the steps of provider enrollment for Ohio Medicaid: Provider Enrollment for Ohio Medicaid 1.

Medicaid 52

Medicaid Medicaid Licensing Medical Billing Outsourcing 52

MRO Compliance

JUNE 1, 2022

Information You Need to Know about a HEDIS Audit from Revenue Cycle Experts. Below we explore some common questions about HEDIS and review important information your team should know now and in the future. HEDIS works as a government rating tool. HEDIS audits are important for Medicare and Medicaid health plans.

Medicare 130

Medicare Medicare Compliance Medicaid 130

Kaiser Permanente

DECEMBER 24, 2021

Medicaid provides health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements and is jointly funded by states and the federal government. Virginia’s Medicaid program is known as Medallion Medicaid.

Medicaid 52

Medicaid Medicaid Governance 52

HIPAA Journal

NOVEMBER 17, 2022

HIPAA Journal is conducting interviews with healthcare professionals and service providers to find out more about their compliance journeys, how the HIPAA Rules have affected their working lives, and the successes and challenges they have faced with HIPAA compliance. Tell the readers about your career in the healthcare industry.

Governance 86

Governance HIPAA Compliance Nursing Homes 86

Med-Net Compliance

NOVEMBER 2, 2022

Massachusetts Attorney General Maura Healey announced that her office’s Medicaid Fraud Division recovered more than $71 million during the most recent federal fiscal year, which ended on September 30. The AG’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state’s Medicaid program, MassHealth.

Fraud 59

Fraud Medicaid Medicaid Compliance 59

Healthcare Law Blog

OCTOBER 2, 2023

The government buys billions of dollars in healthcare-related goods and services every year, and no government procurement is perfect. If the answer is “yes”—or even “maybe”—healthcare companies may file a bid protest at the Government Accountability Office (“GAO”) or the U.S. B-417836, 2020 CPD ¶ 47 ( Nov.

Governance 52

Governance Department of Veterans Affairs Medicaid Medicaid 52

Healthcare It News

APRIL 29, 2024

Salesforce for public health and other government agencies could integrate natural language processing to ease administrative burdens and generate richer case files. With the new platform, government users would also be able to leverage Appointment Assistant, Slack and Visual Remote Assistant.

Public Health 287

Public Health Governance Medicaid Medicaid 287

HIPAA Journal

MARCH 6, 2023

Cedar Park, TX-based Dental Health Management Solutions (DHMS), a provider of dental services to the government/military and private patients has recently announced – via its legal counsel – that the protected health information of certain patients was exposed in a 2021 hacking incident.

Electronic Medical Records 76

Electronic Medical Records HIPAA Licensing Nurses 76

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

Medisys Compliance

MARCH 14, 2023

Home Health Medicare and Medicaid are two of the largest insurance providers for home health services, and they have specific guidelines for wound care reimbursement. Medicare reimbursement for wound care in SNFs is governed by the Medicare Part A Skilled Nursing Facility Prospective Payment System (SNF PPS).

Payment Systems 52

Payment Systems Medical Billing Medicare Medicare 52

Health Populi

DECEMBER 9, 2021

But even with health insurance coverage, most health-insured people are concerned about medical costs in America, found in a MITRE-Harris Poll on U.S. ” Younger people point to the government’s and provider’s responsibility for informing and educating them on health insurance coverage, along with health plans.

Medical Billing 73

Medical Billing Health Insurance Medicaid Medicaid 73

Provider Trust

MARCH 16, 2022

Exclusions are administrative actions that are placed upon an individual or entity by HHS OIG, a state agency or Medicaid Fraud Control Unit (MFCU), or by one of the many agencies associated with SAM.gov. To learn more about the differences between permissive and mandatory exclusions, check out post on OIG exclusion monitoring.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare IT Today

APRIL 5, 2024

The acquisition advances Healthy Together’s mission to improve collective health and make government and enterprises more efficient. About Healthy Together Healthy Together is a health technology company that builds SaaS technology for government, education, and enterprise. 5 star rating.

Public Health 85

Public Health Medicaid Medicaid Governance 85

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

MedTrainer

MAY 21, 2024

With the odds of a person entering your healthcare facility dealing with a behavioral or mental health issue at about 20% , new and existing clinical providers must receive behavioral health compliance training to ensure patients receive the highest quality care. Learn more about MedTrainer.

Compliance 52

Compliance Medicaid Medicaid HIPAA 52

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 297

Licensing Health Outcomes Medicaid Medicaid 297

Kaiser Health News

APRIL 16, 2024

District Court for the Southern District of Florida, two such call centers paid tens of thousands of dollars a day to buy names of people who responded to misleading advertisements touting free government “subsidies” and other rewards. Learn more about KFF.

ACA 131

ACA Health Insurance Governance Medical Billing 131

HIPAA Journal

JUNE 9, 2023

Prior to the Supreme Court ruling, there was no distinction between an identity thief stealing an individual’s identity and running up huge debts, a lawyer rounding up bills and only charging full hours, a waitress overcharging customers, and a doctor overbilling Medicaid. The Supreme Court decision related to the latter.

Fraud 99

Fraud Medicaid Medicaid Doctors 99

Healthcare IT News - Telehealth

JANUARY 23, 2023

We spoke with the HIMSS government relations team for their thoughts on those priorities and more in 2023 and beyond. HIMSS has also aggressively supported the Connect for Health Act , and a bill that's expected to be reintroduced this year, said Amanda Krzepicki, government relations manager at HIMSS.

Medicare 157

Medicare Medicare Governance Medicaid 157

HIT Consultant

MAY 2, 2023

For decades, the industry lacked a patient-centric approach focused on efficiency, reliability, and accessibility for all populations, especially those enrolled in Medicare Advantage and Medicaid plans. In a recent study , 21% of U.S. adults without access to a vehicle or public transportation skipped needed medical care last year.

Medicaid 96

Medicaid Medicaid Medicare Medicare 96

AIHC

MARCH 12, 2024

Written by the AIHC Education Department This article provides an overview of how the media and government are reacting to the potential of artificial intelligence (AI) and potential threats associated with this advanced technology. A Government-Commissioned Report Released February 2024 The U.S.

Ransomware 59

Ransomware Governance Compliance HIPAA 59

Kaiser Permanente

JANUARY 27, 2022

Medicaid provides health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements and is jointly funded by states and the federal government. Kaiser Permanente’s Participation in QUEST Integration (Hawaii).

Health Insurance 52

Health Insurance Medicaid Medicaid Governance 52

HIT Consultant

NOVEMBER 8, 2021

Jessica Altman, Pennsylvania’s insurance commissioner sums it up well : “When we talk about bringing something back to state control, that is a real narrative that can appeal to both sides of the aisle. There is nothing political about making health insurance more affordable.”. Consider how you want the SBM to work with Medicaid.

Health Insurance 98

Health Insurance Medicaid Medicaid Governance 98

Kaiser Permanente

DECEMBER 24, 2021

Medicaid provides health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements and is jointly funded by states and the federal government. Maryland’s Medicaid program is known as HealthChoice.

Medicaid 52

Medicaid Medicaid Governance 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. Cozen O’Connor is a research and consulting firm with practices in litigation, business law and government relations.

Telemedicine 190

Telemedicine COVID-19 Governance Medicare 190

Kaiser Permanente

DECEMBER 24, 2021

Medicaid provides health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements and is jointly funded by states and the federal government. Oregon’s Medicaid program is known as Oregon Health Plan.

Medicaid 52

Medicaid Medicaid Governance 52

Kaiser Permanente

DECEMBER 24, 2021

Medicaid provides health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements and is jointly funded by states and the federal government. Hawaii’s Medicaid program is known as QUEST Integration.

Medicaid 52

Medicaid Medicaid Governance 52

Kaiser Permanente

DECEMBER 24, 2021

Medicaid provides health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements and is jointly funded by states and the federal government. Colorado’s Medicaid program is known as Health First Colorado.

Medicaid 52

Medicaid Medicaid Governance 52

Kaiser Permanente

DECEMBER 24, 2021

Medicaid provides health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements and is jointly funded by states and the federal government. California’s Medicaid program is known as Medi-Cal.

Medicaid 52

Medicaid Medicaid Governance 52

Kaiser Permanente

DECEMBER 24, 2021

Medicaid provides health coverage to eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements and is jointly funded by states and the federal government. Washington’s Medicaid program is known as Apple Health.

Medicaid 52

Medicaid Medicaid Governance 52

HIT Consultant

FEBRUARY 13, 2023

Tom Wriggins, Principal Industry Advisor at SAS John Maynard, CPA, CFE, AHFI Principal Solutions Architect at SAS In 2022, the Center for Medicare and Medicaid Services (CMS) established health equity as a pillar of its future work. Health outcomes and Medicaid program integrity Health outcomes are a function of the quality of care.

Fraud 52

Fraud Medicaid Medicaid Medicare 52

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 Health Insurance 98

HIT Consultant

JULY 17, 2023

Cessation of PHE telehealth, prescribing, and mental health access exceptions could impact the Medicaid population the most. Twenty-one percent of Medicaid enrollees have mild, moderate, or severe SUD, compared to 16% of commercially insured individuals. And as of the latest data, 7.3% And as of the latest data, 7.3%

Public Health 98

Public Health Medicaid Medicaid Electronic Medical Records 98

AIHC

MARCH 12, 2024

Written by the AIHC Education Department This article provides an overview of how the media and government are reacting to the potential of artificial intelligence (AI) and potential threats associated with this advanced technology. A Government-Commissioned Report Released February 2024 The U.S.

Ransomware 52

Ransomware Governance Compliance HIPAA 52

Med-Net Compliance

JUNE 16, 2022

Attorney General John O’Connor announced that a former Oklahoma-based medical supply company has agreed to pay $363,116 to resolve allegations that the company violated the Oklahoma Medicaid False Claims Act by inflating prices and shipping charges of durable medical equipment. Update policies and procedures as needed.

Fraud 59

Fraud Medicaid Medicaid Medicare 59

Healthcare IT News - Telehealth

FEBRUARY 3, 2023

An excepted benefit allows employers to finance additional medical care, like vision or dental coverage, according to the Centers for Medicare & Medicaid Services FAQs for insurance agents and brokers, requiring Congress to amend previous public health and funding laws. In an announcement about the bipartisan bill, Rep.

Public Health 168

Public Health COVID-19 Medicare Medicare 168