Innovaare Compliance

FEBRUARY 19, 2024

These changes will significantly impact risk adjustment factor (RAF) scores and how health plans and medical practices manage enrollee risk – an enrollee’s risk scores can be altered with or without a change in the enrollee’s health status. 1] Version 28 includes changes in the MA capitation rate and risk adjustment methodologies.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

JUNE 22, 2022

On Friday, June 17, 2022, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2023 Home Health Prospective Payment System Rate Update (“PPS Rule”). The CY2023 annual payment update percentage is 2.9%, which is well below current inflation, which peaked at 8.5%

COVID-19 40

COVID-19 Payment Systems Medicare Medicare 40

Healthcare Law Blog

JUNE 21, 2023

(“Merck”), as well as four chambers of commerce , have filed suits against the federal government, arguing that the Medicare Drug Price Negotiation Program introduced by the Inflation Reduction Act of 2022 stands in violation of multiple constitutional provisions. FOOTNOTES [1] Inflation Reduction Act, P.L.

Medicare 52

Medicare Medicare Public Health Governance 52

Health Law Advisor

MAY 4, 2023

In this episode of the Diagnosing Health Care Podcast : The Inflation Reduction Act (IRA), signed into law in August 2022, included significant and controversial drug-pricing provisions. What key compliance issues must industry stakeholders consider as these provisions are put into effect?

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Health Law Advisor

AUGUST 1, 2023

In this episode of the Diagnosing Health Care Podcast : In July, the Centers for Medicare & Medicaid Services made significant headway in its implementation of the drug pricing provisions of the Inflation Reduction Act (IRA).

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIT Consultant

JANUARY 18, 2023

Community pharmacists trusted to deliver care: In 2023, pharmacists will play an integral role as part of the team managing patient care for diseases like diabetes, hypertension, or multiple comorbidities. But this decentralization of care poses consistency and quality challenges that are quickly coming to the fore.

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Compliance Medicaid Medicaid Medicare 98

Healthcare Law Blog

FEBRUARY 22, 2023

The Rebate Programs are administered as part of the prescription drug affordability provisions of the Inflation Reduction Act (the “IRA”), which is aimed at “lower[ing] out-of-pocket drug costs for people with Medicare and improv[ing] the sustainability of the Medicare program for current and future generations.” [1]

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

NOVEMBER 28, 2023

On November 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update Final Rule (“2024 Final Rule”), which has since been filed in the Federal Register. or $140 million in 2024. 0.97110 1.0124 1.0012 0.9998 1.010 $1,998.56

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

HIPAA Journal

DECEMBER 24, 2022

Penalties for HIPAA violations can be issued by the Department of Health and Human Services’ Office for Civil Rights (OCR) and state attorneys general. Tier 2: A violation that the covered entity should have been aware of but could not have avoided even with a reasonable amount of care.

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HIPAA Compliance Hospitals COVID-19 122

Healthcare Law Blog

AUGUST 25, 2022

The Inflation Reduction Act (“IRA”) was signed into law by President Biden on August 16, 2022. The expansive legislation includes key health care provisions, including drug pricing reforms, inflationary rebates, Medicare Part D benefit redesign, as well as myriad other updates. Other Updates.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Health Law Advisor

MAY 22, 2023

Senate Committee on Health, Education, Labor and Pensions (the “HELP Committee” or the “Committee”) passed a bipartisan bill to expand federal regulation of pharmacy benefit managers (“PBMs”) for group health plans. [1] Unlike the IRA, which targeted the Medicare program, the provisions of S. 1339 the Committee passed last week.

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Medicaid Medicaid Medicare Medicare 52

HIPAA Journal

MARCH 13, 2023

The Department of Health and Human Services has requested an additional $78 million in federal funding for the Office for Civil Rights (OCR), almost doubling the appropriations OCR currently receives. reduction in total penalties compared to 2018 despite a 100% increase in the number of penalties. In 2022, OCR saw a 92.6%

HIPAA 88

HIPAA Compliance 88

Health Populi

SEPTEMBER 9, 2022

In this this third chart, I’ve focused in on grocery, retail, healthcare and pharmaceutical sectors which have become core touchpoints in consumers’ health ecosystems. Health Populi’s Hot Points : For some context, remember that 2008 was the advent of the Great Recession. Fourth in line: retail.

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Prescription Drug Pricing Health Insurance Medical Billing Doctors 62

C&M Health Law

DECEMBER 13, 2022

midterm elections—during which voters were focused on the economy, public safety, and health care and abortion issues—will have longstanding consequences for the development of health care policy over the next two years. The results of the 2022 U.S. With the U.S. House of Representatives and U.S.

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COVID-19 Medicare Medicare Hospitals 98

HIPAA Journal

DECEMBER 14, 2022

The last update to the HIPAA Rules was the HIPAA Omnibus Rule in 2013, which introduced new requirements mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act. 2020 CARES Act Aligned 42 CFR Part 2 Regulations More Closely with HIPAA. Capito (R-WV) and Manchin (D-WV).

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HIPAA COVID-19 COVID-19 Vaccine Compliance 124

HIPAA Journal

MARCH 17, 2023

Considering the Health Insurance Portability and Accountability Act (HIPAA) is now in its third decade, the Privacy Rule took effect 20 years ago, and compliance with the HIPAA Security Rule has been mandatory for 18 years, there have been relatively few financial penalties over the years, with just 130 imposed by OCR to resolve HIPAA violations.

HIPAA 85

HIPAA Compliance Health Insurance Governance 85

Hall Render

APRIL 7, 2023

5 moves to know Most hospital websites routinely transfer patient data via tracking tools Nonprofit hospitals that pay board members linked to less charity care Nurses, federal lawmakers push for staffing ratio legislation Reports of serious adverse events rose in 2022: Joint Commission Doctors are drowning in paperwork.

US Department of Health and Human Services 40

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

Hall Render

JUNE 16, 2023

Artificial Intelligence Poses Threat to Patient Privacy Bill for Rural Hospital Cyber Skills Passes Senate Committee Chemotherapy shortages push cancer centers toward crisis CMS estimates national spending on hospital care grew just 0.8% What are they doing to address it?

US Department of Health and Human Services 40

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

Kaiser Health News

OCTOBER 13, 2022

The Biden administration this week issued regulations aimed at fixing the Affordable Care Act’s “family glitch,” which has prevented families that can’t afford their employer insurance from getting subsidized coverage from the insurance marketplaces. Wade , which had guaranteed access across the country.

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Medicare Medicare ACA Governance 67

Kaiser Health News

AUGUST 12, 2022

The giant health care, climate, and tax bill expected to pass the House on Friday and be sent to the president for his signature won’t be as sweeping as the Democrats who wrote it had hoped, but it would help millions of Americans better afford their prescription drugs and health insurance. “It’s historic.

Medicare 88

Medicare Medicare Prescription Drug Pricing Governance 88

Kaiser Health News

JANUARY 12, 2023

Julie Rovner is Chief Washington Correspondent and host of KHN’s weekly health policy news podcast, “What the Health?” ” A noted expert on health policy issues, Julie is the author of the critically praised reference book “Health Care Politics and Policy A-Z,” now in its third edition.

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US Department of Health and Human Services FDA Medicare Medicare 52