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The History of Healthcare Compliance

MedTrainer

The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation.

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CMS Finalizes its Proposal to Advance Interoperability and Improve Prior Authorization Processes

Healthcare Law Blog

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

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UnitedHealth Group Confirms Data Stolen in Change Healthcare Ransomware Attack

HIPAA Journal

United Health Group has also confirmed that it has paid out more than $3.3 billion in loans to healthcare providers under its temporary funding program to help ease the financial strain caused by delays to the processing of insurance claims and providers will have 45 days to pay back the loans. 40% of the $3.3

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CMS Issues a New “Advancing Interoperability and Improving Prior Authorization Processes” Proposed Rule

C&M Health Law

The regulations impact CMS-regulated payers and provide incentives for providers and hospitals that participate in the Medicare Promoting Interoperability Program and the Merit-based Incentive Payment System (MIPS). Most of the Proposed Rule’s provisions will be effective on January 1, 2026. Our initial takeaways are summarized below.

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Why Data Analytics are Critical in a Value-Based Care (VBC) Environment

AIHC

Prior to this time, commercial carriers were already pushing HMOs (health maintenance organizations) and capitation contracts with physician networks or instituting “reasonable and customary charges” requiring physicians to collect data to negotiate reasonable contracts. healthcare system were exorbitant.

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Why Data Analytics are Critical in a Value-Based Care (VBC) Environment

AIHC

Prior to this time, commercial carriers were already pushing HMOs (health maintenance organizations) and capitation contracts with physician networks or instituting "reasonable and customary charges" requiring physicians to collect data to negotiate reasonable contracts. healthcare system were exorbitant.

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Health Provider News

Hall Render

1 CMS final rule boosts Medicare hospice payments by 3.1% 1 CMS final rule boosts Medicare hospice payments by 3.1% Will Nemours’ Medicaid move leave 10,000 special-needs kids behind? 4 Rankings show average health across Northeast Michigan MINNESOTA Essentia Health Opens $900M Replacement Hospital In Duluth, Minn.