Fierce Healthcare

DECEMBER 2, 2021

Google rolls out new search tools for health information on Medicare services, languages spoken by providers. Thu, 12/02/2021 - 10:59.

Medicare 126

Medicare Medicare 126

Compliancy Group

APRIL 25, 2024

Maintaining Medicare compliance and avoiding legal and financial repercussions requires Medicare compliance training for employees at all organizational levels. Examples of Medicare fraud include billing for unrendered services and using a billing code or a service that’s more expensive than what a patient received.

Fraud 59

Fraud Medicare Medicare Compliance 59

MedTrainer

APRIL 18, 2024

Behavioral health credentialing exploded in 2023 and 2024 as providers could enroll in Medicare for the first time. CAQH credentialing is designed to alleviate the work for providers because many major payers can access that information without the provider completing a separate application.

Medicare 52

Medicare Medicare Licensing Compliance 52

MRO Compliance

JUNE 1, 2022

Information You Need to Know about a HEDIS Audit from Revenue Cycle Experts. Below we explore some common questions about HEDIS and review important information your team should know now and in the future. HEDIS (Healthcare Effectiveness and Data Information Set) is part of a review process for Medicare Advantage plan quality measures.

Medicare 130

Medicare Medicare Compliance Medicaid 130

Electronic Health Reporter

JANUARY 12, 2022

That saturation can make useful information hard to find. The article How To Market to Medicare Patients appeared first on electronichealthreporter.com. Nowadays our lives are engulfed with advertisements from gigantic billboards on the streets to our TVs to pop-ups online. Because of this chaotic promotion method, many […].

Medicare 133

Medicare Medicare 133

Medisys Compliance

JANUARY 31, 2024

Introduction Understanding the details of Medicare coding and claims submission can be daunting for anyone. This article serves as a guide to help you avoid billing mistakes for Medicare and ensure smooth claims processing for your Medicare patients. Ensure they have current Medicare coverage and no pending eligibility changes.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

HIT Consultant

OCTOBER 30, 2023

Under the Medicare Shared Savings Program, a healthcare provider that is an Accountable Care Organization (ACO), ACO participant, or ACO provider or supplier would be deemed ineligible to participate in the program for a period of at least one year. “HHS

Medicare 98

Medicare Medicare Payment Systems Hospitals 98

HIPAA Journal

APRIL 27, 2023

The Centers for Medicare & Medicaid Services (CMS) has started notifying certain Medicaid beneficiaries about an impermissible disclosure of some of their protected health information due to a mailing error at one of its contractors. The CMS believes that the risk of identity theft and Medicare fraud is minimal.

Medicare 91

Medicare Medicare Medicaid Medicaid 91

Healthcare IT Today

FEBRUARY 22, 2023

There’s widespread consensus that payments to Medicare Advantage Organizations (MAOs) are a mess. These programs, which care for more than 30 million of the nearly 64 million Medicare enrollees , operate on the cutting edge of health care and suffer serious problems in data collection and billing.

Medicare 87

Medicare Medicare Overpayments Overpayment 87

HIPAA Journal

DECEMBER 15, 2022

HMS is a subcontractor of ASRC Federal Data Solutions, LLC (ASRC Federal), which is a business associate of the HHS’ Centers for Medicare and Medicaid Services (CMS). The CMS says up to 254,000 Medicare beneficiaries have potentially been affected and had some of their PII and PHI exposed.

Ransomware 102

Ransomware Medicare Medicare HIPAA 102

HIPAA Journal

MARCH 6, 2023

The Department of Justice has announced one of its first prosecutions under the Medicare Access and CHIP Reauthorization Act of 2015 in a case involving the theft and sale of Medicare Beneficiary Identifiers. MACRA also made it illegal to buy, sell, or distribute Medicare Beneficiary Identifiers without proper authority.

Medicare 89

Medicare Medicare Fraud Medicaid 89

Healthcare IT News - Telehealth

MARCH 30, 2022

Department of Health and Human Services Office of Inspector General released a study examining how Medicare beneficiaries used telehealth during the first year of the COVID-19 pandemic. "Telehealth was critical for providing services to Medicare beneficiaries during the first year of the pandemic," read the report.

Medicare 144

Medicare Medicare US Department of Health and Human Services COVID-19 144

Medisys Compliance

DECEMBER 23, 2022

The internet is ringing with the news of the CMS Updates Final rule for the 2023 Medicare Physician Fee Schedule. The finalized 2023 Medicare Physician Fee Schedule was announced by the Centers for Medicare & Medicaid Services (CMS) on November 1 2022. Medicare reimbursement for telehealth services. Principles of PFS.

Medicare 98

Medicare Medicare Medical Billing Medical Billing Outsourcing 98

Healthcare It News

APRIL 5, 2024

Diabetes WA discloses data breach Diabetes WA, the peak body for diabetes in Western Australia, has reported unauthorised access to the personal information of some of their contacts. The organisation already reached out to the affected individuals and recommended they apply for a replacement Medicare number.

COVID-19 263

COVID-19 Medicare Medicare Hospitals 263

Healthcare IT News - Telehealth

JUNE 12, 2020

introduced new legislation this week that would provide for permanent Medicare payments for telehealth services at federally qualified health centers and rural health clinics. introduced a bill that would mandate a study on the effects of telehealth, noting that data informs policy changes. " WHY IT MATTERS. Robin Kelly, D-Ill.,

Medicare 208

Medicare Medicare Nursing Homes Medicaid 208

Foster Swift

APRIL 16, 2024

In both circumstances, the former doctors carried out their sexual abuse under the guise of medical procedures and without the informed consent of their targets. Read More › Tags: Health Care Reform , Hospitals , Lawsuit , Medicare/Medicaid , Privacy

Informed Consent 52

Informed Consent Health Care Reform Doctors Medicaid 52

Innovaare Compliance

FEBRUARY 19, 2024

On January 31, 2024, the Centers for Medicare & Medicaid Services (CMS) released a draft of the 2025 Advance Notice describing the Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ahead of the final notice to be published on April 1, 2024.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Innovaare Compliance

FEBRUARY 19, 2024

On January 31, 2024, the Centers for Medicare & Medicaid Services (CMS) released a draft of the 2025 Advance Notice describing the Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ahead of the final notice to be published on April 1, 2024.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare IT Today

APRIL 6, 2023

Ortiz, who teaches holistic nursing at the Pacific College of Health and Science , says that a patient might have many reasons to alter or divert from the medical plan, and might not inform the healthcare provider aboiut not taking the medicine as prescribed.

Doctors 96

Doctors Nurses Medicare Medicare 96

Kaiser Health News

JANUARY 28, 2022

A three-judge federal appeals court panel in Connecticut has likely ended an 11-year fight against a frustrating and confusing rule that left hundreds of thousands of Medicare beneficiaries without coverage for nursing home care, and no way to challenge a denial. But it can have serious repercussions.

Nursing Homes 145

Nursing Homes Medicare Medicare Nurses 145

HIT Consultant

NOVEMBER 18, 2021

What You Should Know: – Easyhealth raises $135M to redesign Medicare with its end-to-end Medicare experience to help 50 million Medicare members find the best plan and support them through their healthcare journey. Redesigning The Medicare Experience. Improved Medicare Plan Performance.

Medicare 98

Medicare Medicare Health Outcomes 98

YouCompli

AUGUST 22, 2023

Approximately 65 million Americans are enrolled in Medicare – about 34 million in traditional Medicare and the rest in Medicare Advantage. Traditional Medicare is administered by the federal government, and individuals pay a separate monthly premium for hospital visits, doctors/outpatient, and prescription drugs.

Medicare 52

Medicare Medicare US Department of Health and Human Services Compliance 52

Health Law RX

FEBRUARY 21, 2024

The Centers for Medicare & Medicaid Services (CMS) has revised certain payment policies under the Medicare physician fee schedule, and updated provider and supplier enrollment regulations. CMS recently published a final rule (the Final Rule ) effective January 1, 2024.

Medicare 52

Medicare Medicare Licensing Compliance 52

Innovaare Compliance

FEBRUARY 25, 2024

The Centers for Medicare & Medicaid Services (CMS) uses the Hierarchical Condition Category (CMS-HCC) medicare risk adjustment model to determine monthly capitation fees for Medicare Advantage (MA) plans. Prescription Drug Encounter (PDE) data are used to predict plan spending in a future year.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Fierce Healthcare

JULY 31, 2023

Hundreds of thousands of beneficiaries are caught up in a Medicare program contractor breach that compromised the personal information of millions of people, according to statements and filings rel | Medicare program contractor Maximus Federal Services, which uses MOVEit for file sharing, told CMS that beneficiaries' sensitive data may have been (..)

Medicare 75

Medicare Medicare 75

Kaiser Health News

FEBRUARY 3, 2022

For the readmission penalties , Medicare cuts as much as 3 percent for each patient, although the average is generally much lower. The patient safety penalties cost hospitals 1 percent of Medicare payments over the federal fiscal year, which runs from October through September. Below are look-up tools for each type of penalty.

Medicare 105

Medicare Medicare Hospitals Governance 105

Hall Render

APRIL 16, 2024

Department of Health and Human Services (“HHS”), through the Centers for Medicare & Medicaid Services (“CMS”) released a memorandum to state survey agency directors highlighting revisions and clarification to the Hospital Interpretive Guidelines for Informed Consent (the “Guidance”).

Informed Consent 40

Informed Consent Hospitals Compliance HIPAA 40

Hall Render

NOVEMBER 29, 2023

On November 2, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule Final Rule (“Final Rule”) for calendar year (“CY”) 2024. Standards for benchmarking and data completeness for the Medicare CQM collection type will mirror the MIPS benchmarking and scoring policies.

Medicare 40

Medicare Medicare Nurses Payment Systems 40

Medisys Compliance

AUGUST 1, 2022

Medicare enrollment is the first step towards becoming Medicare provider or supplier. CMS has shared complete process flow chart for successful Medicare enrollment. Being leading medical billing company, Medisys Data Solutions helped lots for providers and suppliers in successful Medicare enrollment.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

HIT Consultant

APRIL 17, 2024

What You Should Know: Wolters Kluwer Health , a leading provider of healthcare information and analytics, has introduced a new weapon in the fight against potential financial penalties for Medicare Advantage Organizations (MAOs) – the Regulatory Audit Module.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Innovaare Compliance

DECEMBER 11, 2023

Before the Medicare Advantage Open Enrollment Period (MA OEP) [1] begins on January 1, 2024, Medicare Advantage Organizations (MAOs) still have time to review if they are completely ready for a new contract year. The Annual Election Period (AEP) has ended. Reporting of the latter began in December 2023 [2]. the disabled.

Medicare 52

Medicare Medicare Compliance Medicaid 52

Compliancy Group

MARCH 8, 2023

are missing out on most of these opportunities because their names are on the HHS OIG (Health and Human Services, Office of Inspector General) Medicare Exclusion List. How the OIG Exclusion Database Came to Be HHS oversees the CMS (Center for Medicare Services), which administers the Medicare program.

Medicare 52

Medicare Medicare Fraud HIPAA 52

Medisys Compliance

JUNE 27, 2022

The Centers for Medicare and Medicaid Services (CMS) has announced a shift in its eligibility criteria for coverage of lung cancer screening using low-dose CT (LDCT), with implementation date of October 3 rd , 2022. CMS Announcement for Revised Coverage. Reduced the eligibility criteria for the reading radiologist.

Medicare 97

Medicare Medicare Medical Billing Medical Billing Outsourcing 97

Medisys Compliance

JULY 5, 2022

What is Medicare Overpayment? A Medicare overpayment exceeds regulation and statute properly payable amounts. When Medicare identifies an overpayment, the amount becomes a debt a healthcare provider owes the federal government. Based on this new information, CMS takes action to recover the mistaken Medicare payment.

Overpayments 52

Overpayments Overpayment Medicare Medicare 52

Healthcare IT Today

JULY 28, 2021

Former Iora Health executives create holistic Medicare concierge service to assist seniors in selecting and receiving the most out of healthcare coverage Boston MA, JULY 28, 2021 — Connie Health, a tech-enabled consumer Medicare navigation platform helping Americans make more informed health and financial choices, announces a $13 million Series A (..)

Medicare 103

Medicare Medicare 103

Medisys Compliance

JULY 13, 2023

Medicare recognizes the importance of diabetes self-management training and offers coverage for eligible beneficiaries. However, there are specific guidelines and conditions that need to be met for Medicare billing. Diabetes Education Billing Guidelines for Medicare Who May Furnish the Training?

Medicare 52

Medicare Medicare Medical Billing Outsourcing Health Outcomes 52

Healthcare Law Blog

MAY 22, 2023

With the Medicare Comprehensive Error Rate Testing program projected error rate for skilled nursing facilities (SNFs) showing a significant increase in 2022 (15.1%, up from 7.9% 1:1 education will include claim specific information and allow the SNF to review the claim decision, ask questions and receive feedback.

Medicare 52

Medicare Medicare Medicaid Medicaid 52