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The History of Healthcare Compliance

MedTrainer

The protection of patient data, adherence to privacy regulations like the Health Insurance Portability and Accountability Act (HIPAA) in the United States, and the prevention of cyber threats have become paramount concerns. Compliance now involves reporting quality data and participating in payment models that incentivize better care.

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MIPS Rules for 2023: Onward and Upward

Compliancy Group

Under MACRA, the Centers for Medicare and Medicaid Services (CMS) created regulations to encourage healthcare providers to use secure health information technology. One of these incentives is the Merit-Based Incentive Payment System, or MIPS, program. Providers need not complete the SRA all by their lonesome(s).

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MIPS and MACRA 2022: What’s New?

Compliancy Group

healthcare system since 2010’s Affordable Care Act. Under MACRA, the Centers for Medicare and Medicaid Services created regulations for healthcare providers’ use of health information technology. One of these incentives is the Merit-Based Incentive Payment System, or MIPS. Complete Your SRA. Find Out More!

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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

HHS Issues Guidance for Providers Affected by Change Healthcare Ransomware Attack The Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), and the Administration for Strategic Preparedness and Response (ASPR) have issued guidance to help entities impacted by the Change Healthcare ransomware attack.

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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

In 1983 Medicare shifted to the inpatient Prospective Payment System (PPS) and DRGs (Diagnostic Related Groups) and only paying a limited number of days to the hospital regardless of the actual length of stay. healthcare system were exorbitant. Hospital reimbursement also changed.