Bill of Health

FEBRUARY 6, 2024

State Government Opportunities: States can increase expungement rates by amending laws to apply automatic expungement to minor drug possession convictions and seal the records. States can also remove barriers to local governments setting a livable local minimum wage. Code § 32) by making the tax credit monthly. 34:11-56a et seq.

Governance 300

Governance Public Health Local Policy Medicaid 300

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.

Governance 69

Governance Medicare Medicare Ransomware 69

HIT Consultant

NOVEMBER 9, 2023

Director of Healthcare Strategy, LexisNexis Risk Solutions During the peak of the Covid-19 pandemic, over 10 million Americans enrolled in Medicaid – nearly a 14% increase from the beginning of 2020. A month before the public health emergency ended on May 11, 2023, 87 million individuals were enrolled in Medicaid.

Medicaid 64

Medicaid Medicaid Health Insurance Health Outcomes 64

HIT Consultant

JULY 20, 2022

Kristen Ballantine, VP of Government Relations at Gainwell. However, with the CMS Interoperability and Patient Access Final Rule , consumers, specifically Medicaid members, there is a greater push to give access to, and ownership of, this data. About Kristin Ballantine.

Governance 95

Governance Medicaid Medicaid Public Health 95

Healthcare Law Blog

AUGUST 25, 2023

On August 21, 2023, the New York State Office of the Medicaid Inspector General (OMIG) announced updates to the Medicaid overpayment self-disclosure program, which now includes an abbreviated process for reporting and explaining overpayments that are considered routine or transactional in nature and have been already voided and adjusted.

Overpayments 52

Overpayments Overpayment Medicaid Medicaid 52

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

HIPAA Journal

JUNE 8, 2023

The Iowa Department of Health and Human Services has announced there have been three separate breaches of the protected health information of Iowa Medicaid recipients in the past two months – two hacking incidents and an impermissible disclosure, all three of which involved third-party contractors.

Medicaid 78

Medicaid Medicaid Ransomware Health Insurance 78

Total Medical ComplianceHIPAA

APRIL 12, 2024

We’re excited to announce the launch of our new service, Exclusion Screening, that will assist healthcare organizations in adherence to requirements such as the initial screening of potential employees/contractors and monthly screening of current employees/contractors. Permissive exclusions typically range from 0 to 3 years.

Compliance 72

Compliance Fraud Medicaid Medicaid 72

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-421325, 2023 CPD ¶ 74 (Mar.

Governance 52

Governance Department of Veterans Affairs Medicaid Medicaid 52

HIPAA Journal

FEBRUARY 8, 2024

Department of Health & Human Services Office of Inspector General (HHS-OIG) has published a Roadmap for New Physicians on avoiding Medicare and Medicaid fraud and abuse. Exclusion means Federal health care programs will not pay for items or services furnished, ordered, or prescribed by excluded individuals.

Fraud 40

Fraud Medicaid Medicaid Medicare 40

Healthcare Law Blog

FEBRUARY 3, 2023

Part 521 governing the implementation and operation of effective compliance programs for certain “required providers,” including, now for the first time, Medicaid managed care organizations (MMCOs). [1] New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R.

Medicaid 52

Medicaid Medicaid Compliance Overpayments 52

Fierce Healthcare

NOVEMBER 20, 2023

billion in improper payments in fiscal year 2023, according to new data from the federal government. | The Centers for Medicare & Medicaid Services released its annual look at improper payments and found that the overall rate in Medicare was 7.38%, which sits below the 10% level mandated in statute.

Medicare 130

Medicare Medicare Medicaid Medicaid 130

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. Medicare, Medicaid, and private health insurers suffered losses of more than $4.7 million, and $6.4 million, and $6.4 Schrank of the U.S.

Medicaid 75

Medicaid Medicaid Medicare Medicare 75

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

Healthcare Law Blog

JANUARY 31, 2023

Overview Digital health services have exploded since the onset of the COVID-19 pandemic, and behavioral health services have seen large increases in utilization. ii] Investments in behavioral digital health services have the potential to transform the healthcare system in several key areas.

COVID-19 105

COVID-19 Medicare Medicare Medicaid 105

Healthcare Compliance Blog

JANUARY 24, 2022

On January 19, 2022, the Massachusetts Medicaid Fraud Division announced that in calendar year 2021, more than $55 million was recovered from individuals and entities who defrauded the state. The Attorney General’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state Medicaid program, MassHealth.

Fraud 59

Fraud Medicaid Medicaid Nursing Homes 59

Healthcare Compliance Blog

APRIL 27, 2022

A Georgia district court has issued a summary judgment against a state rehabilitation center for 808 false claims billed to Medicaid and Tricare between November 2015 and June 2020. A robust compliance and ethics program can help identify false claims therefore reducing fraud, waste, and abuse of government funds.

Medicaid 59

Medicaid Medicaid Compliance Governance 59

Hall Render

DECEMBER 20, 2023

For NFs, the data would be reported via means prescribed by the applicable state Medicaid agency. The post Buyer Beware: CMS Finalizes Ownership Disclosure Requirements for Medicare Skilled Nursing Facilities and Medicaid Nursing Facilities appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

Nurses 40

Nurses Medicaid Medicaid Medicare 40

Center for Health Insurance Reform

MAY 15, 2024

The Centers for Medicare & Medicaid Services have recently finalized rules and standards governing health plans and Marketplaces under the Affordable Care Act.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare It News

DECEMBER 12, 2022

Unite Us, which seeks to use software to address social determinants of health, will help PVA's Veterans Career Program assist transitioning service members, veterans, military spouses and their caregivers connect with essential resources, like housing, transportation, mental health and more. WHY THIS MATTERS.

Medicaid 244

Medicaid Medicaid Governance Hospitals 244

Bill of Health

AUGUST 22, 2022

The federal government and several states have implemented strategies to improve and promote OUD treatment access, especially for the relatively inexpensive and effective medication buprenorphine.

Medicaid 246

Medicaid Medicaid COVID-19 Health Services Administration 246

HIPAA Journal

OCTOBER 10, 2022

Wisconsin Department of Health Services: Accidental Disclosure of PHI via Email. The Wisconsin Department of Health Services (DHS) has recently confirmed that there has been an accidental disclosure of protected health information via email. Smith, Gambrell & Russell, LLP: Files Potentially Stolen in 2021 Data Breach.

Medicaid 57

Medicaid Medicaid Governance Fraud 57

Compliancy Group

JULY 18, 2023

The Office of Inspector General (OIG) plays a crucial role in ensuring the integrity of healthcare services. Let’s delve into how OIG ultimately safeguards the overall quality and accessibility of healthcare services for all. OIG Verification: Why it’s Important So why is OIG verification so important? Please Wait.

Compliance 52

Compliance Fraud Governance Medicaid 52

HIPAA Journal

APRIL 29, 2024

Berry, Dunn, McNeil & Parker, LLC (BerryDunn) provides health data analytics services to healthcare providers, health insurers, and government regulatory and healthcare policy agencies and its clients provide BerryDunn with personal and health data to allow the firm to perform its contracted services.

Health Insurance 94

Health Insurance Health Analytics HIPAA Medicaid 94

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. Additionally, there are varying, disparate State Medicaid exclusions sources that require periodic screening.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Health Law Advisor

AUGUST 30, 2023

United States Department of Health and Human Services (“HHS”)(“TMA III”). Departments of Health and Human Services, Labor, and Treasury, along with the Office of Personnel Management (the “Departments”). The Centers for Medicare & Medicaid Services (“CMS”) responded to the ruling by temporarily suspending all Federal (i.e.,

Governance 105

Governance Medicaid Medicaid Medicare 105

Healthcare Law Blog

FEBRUARY 24, 2023

Earlier today, the Department of Labor, the Treasury, and the Department Health and Human Services Centers for Medicare and Medicaid Services (the “Departments”) issued a new directive to Certified Independent Dispute Resolution (IDR) Entities regarding issuing payment determinations for certain pending out-of-network (OON) disputes.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Fierce Healthcare

MARCH 5, 2024

FarmboxRx is part of Medicaid and Medicare programs as an Advantage Benefit.

Governance 62

Governance Medicaid Medicaid Medicare 62

American Medical Compliance

FEBRUARY 15, 2023

Every year, organizations that provide prescription drugs, health care, or administrative services to persons who have Medicare Advantage (MA) or Prescription Drug Plan (PDP) instead of a health plan must complete this training. The Centers for Medicare and Medicaid Services (CMS) require FWA training.

Fraud 52

Fraud Medicare Medicare Compliance 52

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? AHA Trustee Services. News Medical.

Governance 40

Governance Compliance Hospitals Regulatory Compliance 40

HIT Consultant

APRIL 16, 2024

This initiative is especially timely, coinciding with the Centers for Medicare & Medicaid Services’ (CMS) upcoming launch of the Transforming Maternal Health Model (TMaH). This government program aims to bolster infrastructure and improve maternal mental healthcare quality and safety for vulnerable populations.

Medicaid 111

Medicaid Medicaid Medicare Medicare 111

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-19 237

COVID-19 Medicaid Medicaid Public Health 237

Medisys Compliance

FEBRUARY 27, 2024

Understanding Regulatory Framework Radiology billing is governed by a multitude of regulations at the federal, state, and local levels. Radiologists must document all services provided, including interpretations, procedures, and findings, by established guidelines.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 59

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 284

Licensing Health Outcomes Medicaid Medicaid 284

Healthcare IT News - Telehealth

JULY 19, 2019

" When it comes to ways states can be incentivized to adopt pro-telehealth policies, in the Medicaid world, they'll see more proof points from their peers that telehealth provides value – access at lower cost – to their beneficiaries. "The progress at the Federal level helps drive state action."

Telemedicine 128

Telemedicine Medicaid Medicaid HIPAA 128

Health Law Advisor

AUGUST 25, 2023

It is axiomatic that New York State requires every Medicaid provider to have an “effective” compliance program. New York Social Services Law § 363-d. Part 521, make several important changes that will affect all Medicaid Providers’ compliance programs throughout New York State. The final regulations, codified at 18 N.Y.C.R.R.

Compliance 52

Compliance Overpayments Overpayment Compliance Officers 52

Healthcare IT News - Telehealth

FEBRUARY 21, 2023

BroadbandOhio, a division of the Ohio Department of Development, selected OCHIN as its statewide telehealth administrator to help expand healthcare services for Ohio’s K-12 students. WHY IT MATTERS The new initiative aims to help administrators in at least 10 districts implement school telehealth programs.

Governance 131

Governance Medicaid Medicaid Public Health 131