AIHC

SEPTEMBER 5, 2023

Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs. This is also called “store-and-forward telemedicine.”

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

AIHC

APRIL 5, 2022

Audit Coding, Billing and Documentation for Accuracy Insurance carriers and government contractors have the authority to review any claims at any time. If the payer, such as Medicare, performs an extrapolation, reducing each overpayment dollar through appeal can mean thousands less to pay back.

Fraud 52

Fraud Compliance Medicare Medicare 52

Hall Render

MAY 10, 2024

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Hall Render

FEBRUARY 23, 2024

CT’s Medicaid reimbursement rates lower than peer states: report Better safety training, reporting, escorts for CT home health care workers focus of new legislation D.C. Mary’s unveils new name, but mission remains unchanged UCHealth sues thousands of patients every year. What they say sets them apart.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

AIHC

MARCH 28, 2022

But first, learn more about how a complex payer audit system works. Government Accountability Office (GAO), improper payments have been estimated to total almost $1.7 trillion government-wide from fiscal years 2003 through 2019. Auditing and denying claims after the claims have been paid is “big money” for the government.

Medicare 52

Medicare Medicare Compliance Governance 52

Hall Render

JANUARY 19, 2024

Francis emergency room KENTUCKY Apollo’s 220-hospital ‘stranglehold’ harms patients and workers, report alleges Humana cuts ‘small’ number of jobs in multiple locations LMU School of Nursing will open Lexington site at CHI Saint Joseph Health Mercy Health announces acquisition of orthopedic center in Paducah, Ky.

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

APRIL 26, 2024

New California rule aims to limit health care cost increases to 3% annually UC San Diego Health operations deal with California hospital slows to crawl Kaiser reports data breach affecting 13.4M in 256-Slice CT scanner Lifepoint reports $200M+ economic impact in Cen Ky St.

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses Hospitals 40

HIPAA Journal

MARCH 30, 2022

However, when HIPAA was passed, the standards governing health care data, patients´ rights, and the flow of information were still several years away. However, there were concerns about the financial consequences of complying with HIPAA due to the cost of health care for higher-risk individuals and the reduced premiums from small businesses.

HIPAA 121

HIPAA Fraud Health Insurance Health Care Reform 121

Healthcare Law Blog

JANUARY 5, 2023

Just in time for the holidays, the Centers for Medicare and Medicaid Services (“CMS”) issued the Contract Year 2024 Proposed Rule for Medicare Advantage organizations (“MAOs”) and Part D sponsors (the “Proposed Rule”). We’ve summarized some of the key changes in the Proposed Rule. Comments on due February 13, 2023. Star Ratings.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

MARCH 22, 2024

NATIONAL 79 percent have positive outlook for senior living and care: NIC 12 key legal issues impacting health systems AHA: 94% of hospitals financially impacted by Change Healthcare’s cyberattack A conversation about the HHS plan on AI in health care A new kind of hospital is coming to rural America.

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses Hospitals 40

HIT Consultant

MARCH 1, 2022

In Ohio, unemployment overpayments reached $3.86 Medicaid systems are struggling as potential expansion looms Clearly, many state unemployment information systems are in dire need of upgrades. For Medicaid, the threat comes as potential expansion looms. Centers for Medicare and Medicaid Services (CMS) reimbursed states $34.3

Medicaid 52

Medicaid Medicaid Overpayments Overpayment 52

Kaiser Health News

JUNE 29, 2022

Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars every year, government watchdogs told a House panel Tuesday. ” The health plan required patients to have an X-ray first to prove a CT scan was needed.

Medicare 102

Medicare Medicare Governance Overpayments 102

Kaiser Health News

OCTOBER 13, 2022

For the first time, Medicare Advantage plans are poised to enroll more than half of the Medicare population despite allegations that many of the largest insurers are getting billions of dollars in overpayments from the federal government. Questions have been raised about federal payments to the plans.

Medicare 66

Medicare Medicare ACA Governance 66