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From Evolution to Innovation, from Health Care to Health: How Health Plans With Collaborators Are Re-Defining the Industry

Jane Sarashon

As a constant observer and advisor across the health/care ecosystem, for me the concept of a “health plan” in the U.S. Furthermore, health plan members now see themselves as medical bill payers, seeking value and consumer-level services for their health insurance premium investment. Consulting Noah Webster….and

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What’s Your Approach to CMS Compliance Requirements?

Compliancy Group

Within the US Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) is responsible for overseeing and administering various healthcare programs, including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).

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Importance of Regulatory Compliance in Healthcare

Compliancy Group

Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. It also reduces waste, fraud, and abuse that threaten the efficiency of healthcare delivery and services. name, phone number).

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Bipartisan TIKES Act would improve telehealth access for kids

Healthcare IT News - Telehealth

The Telehealth Improvement for Kids’ Essential Services, or TIKES, Act of 2020 would require the Secretary of the U.S. Department of Health and Human Services to issue guidance to states about how to increase access to telehealth under Medicaid and the Children’s Health Insurance Program.

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Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

In one incident, a New Jersey pharmacy admitted to conspiracies to defraud benefits providers, including Medicare and Medicaid, of $65 million for medications never provided to patients. Department of Health and Human Services, Office of Inspector General (HHS-OIG), said.

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CMS’s Administrative Simplification Rule Aims to Increase Efficiency and Standardization for Health Care Attachments

Healthcare Law Blog

The Centers for Medicare & Medicaid Services (“CMS”), on behalf of the U.S. Department of Health and Human Services (“HHS”), recently issued a proposed rule to adopt standards under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) for “health care attachment” transactions (the “Proposed Rule”).

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How Healthcare Can Manage Compliance with Fine-Grained Protection

Healthcare IT Today

Combining this with the increasing number of digital-first health applications and services on the market, protecting data at every touchpoint is mission-critical. By analyzing policyholder data trends, health insurers can learn where their resources are over or underutilized and adjust as needed to better balance their initiatives.