Healthcare Compliance Blog

MAY 9, 2022

A home health services company headquartered in Kentucky, and its related entities, paid $2.1 million to the United States government to settle claims of improperly billing the Medicare Program for home health services provided to beneficiaries living in Florida.

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Healthcare It News

APRIL 15, 2022

West Virginia will use the U.S. Postal Service and an online account this summer to connect with Medicaid enrollees about the expected end of the covid public health emergency, which will put many recipients at risk of losing their coverage. West Virginia has more than 600,000 Medicaid enrollees.

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American Medical Compliance

AUGUST 1, 2022

In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. HHS Examines Medicare Spending and COVID-19 Tests.

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Compliancy Group

FEBRUARY 28, 2024

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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AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

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Healthcare IT News - Telehealth

AUGUST 24, 2020

But when the pandemic began to unfold this spring, Central Maine Healthcare Chief Medical Information Officer Dr. Steven Martel said the system still worked to minimize risk to patients and team members while delivering the care people needed.

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HIPAA Journal

MARCH 29, 2024

While it is currently unclear what types of data were stolen in the attack, UnitedHealth Group said personally identifiable health information, eligibility and claims information, and financial information are likely to have been compromised. United Health Group has also confirmed that it has paid out more than $3.3

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American Medical Compliance

AUGUST 1, 2022

In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. HHS Examines Medicare Spending and COVID-19 Tests.

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Healthcare IT Today

AUGUST 28, 2023

Stephen Sofoul, SVP, Data & Decision Science Services at MultiPlan A critical challenge lies in the shortage of experienced financial analysts or data analysts capable of effectively analyzing the wealth of information that the healthcare industry holds. Finally, the current state of tech needs to be updated.

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Healthcare IT Today

SEPTEMBER 22, 2022

Zócalo Health set to deliver the only Latino healthcare experience focused on the culture of patients’ primary and social health needs. Zócalo Health , a Latino-founded healthcare service designed for Latino patients, announced today $5M in seed funding co-led by Animo, Virtue, and Vamos Ventures. million people.

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Healthcare Compliance Blog

JUNE 9, 2022

His exclusion means that no federal healthcare program payment may be made, either directly or indirectly, for any items or services furnished by him or at his direction or prescription. Between 2017 and 2019, the man, through a group of pain clinics he controlled, caused the submission of false claims for payment to Medicare.

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Healthcare Law Blog

MARCH 7, 2023

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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Med-Net Compliance

OCTOBER 27, 2022

A federal jury convicted a licensed Illinois psychologist of defrauding Medicare over the course of several years by causing the submission of fraudulent claims for psychotherapy services he never provided. Issue: It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.

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Healthcare IT News - Telehealth

JUNE 8, 2022

The Department of Health and Human Services once again (for the ninth time) extended the public health emergency this past month , stretching it beyond mid-July. But sooner or later, that provision of the Public Health Service Act will draw to a close. We spoke recently with Allison M.

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Med-Net Compliance

AUGUST 18, 2022

An Indiana provider of skilled nursing and long-term care services has agreed to pay $5,591,044.66 to resolve allegations that it violated the False Claims Act by submitting false claims to the Medicare program. The complaint alleged that the provider had engaged in conduct to defraud the Medicare program. to the United States.

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Compliancy Group

MARCH 19, 2024

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). healthcare.

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Med-Net Compliance

OCTOBER 19, 2022

The settlement resolves allegations that between 2013 and 2020, the company paid remuneration to its home health medical directors in Oklahoma and Texas for the purpose of inducing referrals of Medicare and TRICARE home health patients. The corporate officers were previously the CEO and COO of the company.

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YouCompli

SEPTEMBER 13, 2023

Enforcement agencies are prioritizing efforts to deter FWA as more individuals enroll in government healthcare programs like Medicare and Medicaid, and telehealth services continue to evolve post-pandemic. In addition, CMS education and outreach focuses on preventing, detecting, and reporting Medicare fraud and abuse.

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Bill of Health

JULY 26, 2022

billion acquisition of One Medical (NASDAQ: ONEM) by Amazon triggered significant hyperventilating about the transformative and immediate impact of this transaction on the health care industry. Important Disclosure: Flare Capital was a significant investor in Iora Health and had a board seat. By Michael Greeley. Last week’s $3.9

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Jane Sarashon

MARCH 12, 2024

That’s TMI for me to write about in the Health Populi blog, but this story has a current-events twist: the pharmacist could not electronically link with my insurance company to transact my payment. He tried a few work-flows, and ended up using a discount card which in the moment worked for us, and I paid the marked-down discount price.

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Healthcare Compliance Blog

MAY 19, 2022

million to settle allegations that it violated the False Claims Act by submitting false claims to Medicare. Following an internal review and audit, the hospital discovered irregularities regarding its billing of certain services, and proactively contacted the United States to self-disclose the issues.?The to resolve the claims.

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Healthcare IT News - Telehealth

JANUARY 4, 2021

Financial/Revenue Cycle Management Population Health Precision Medicine Telehealth Workforce From vaccines to virtual care, enterprise imaging to precision medicine, these are the growth areas that will shape the direction of healthcare, this year and beyond.

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Healthcare IT Today

JANUARY 2, 2024

The following is a guest article by Marlena Herrera, Director at Protegrity Healthcare organizations are becoming more lucrative targets for hackers, as their data is rich with extremely sensitive information and is often susceptible to vulnerabilities.

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Healthcare Law Blog

JANUARY 26, 2024

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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Med-Net Compliance

NOVEMBER 8, 2022

On November 3, 2022, the OIG released the results of a recent inspection of a nursing home by the Texas Health and Human Services (HHS) Office of Inspector General Audit and Inspections Division (OIG Inspections). OIG inspectors recommended the facility develop a process to collect this data and post the information as required.

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Healthcare IT News - Telehealth

MAY 6, 2020

According to a study published last week in the Journal of the American Informatics Association, virtual urgent care visits at NYU Langone Health grew by 683%, and non-urgent virtual-care visits grew by a staggering 4,345% percent between March 2 and April 14. As COVID-19 continues to hammer the U.S.,

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Healthcare Compliance Blog

APRIL 26, 2022

The Office of Inspector General (OIG) for the US Department of Health and Human Services (HHS) has made educational resources available for healthcare providers to comply with federal healthcare laws and regulations. Department of Health and Human Services (hhs.gov).

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Med-Net Compliance

JUNE 22, 2022

According to court records, the woman admitted to stealing or embezzling authentic COVID-19 vaccination record cards from the hospital—along with vaccine lot numbers necessary to make the cards appear legitimate—and then reselling those cards and information to individuals within the metro Detroit community. Update your policies as needed.

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Med-Net Compliance

OCTOBER 26, 2022

The US Department of Health and Human Services (HHS) Office of Inspector General (OIG) has announced that they will be enhancing their focus on potentially preventable hospitalizations of Medicare-eligible skilled nursing facility (SNF) residents. and 42 CFR § 483.25).

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Healthcare IT News - Telehealth

AUGUST 11, 2021

Department of Health and Human Services works to ensure the integrity of federal healthcare programs and to safeguard the health and welfare of those programs' beneficiaries. And I think it's important for us to recognize that we don't know a whole lot right now.

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Healthcare Law Blog

MARCH 17, 2022

On Thursday, March 16, the Office of the Inspector General for the Department of Health and Human Services (“OIG”) issued OIG Advisory Opinion (“AO”) No. 22-05 , relating to subsidization of certain Medicare cost-sharing obligations in the context of a clinical trial involving medical devices (the “Proposed Arrangement”).

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AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

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Compliancy Group

JANUARY 17, 2024

Understanding the OIG Work Plan The OIG Work Plan for physicians and health organizations is a dynamic document that lays out the various audits, reviews, and inspections the OIG intends to conduct in relation to healthcare programs and services within a time frame. HIPAA violations alone are incredibly costly to health providers.

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MedTrainer

OCTOBER 16, 2023

Dive with us as we explore the complexities and necessities of compliance in the healthcare sector. Health Insurance Portability and Accountability Act (HIPAA) HIPAA is a pivotal regulation that focuses on the protection of patient health information, enforced by the U.S. Department of Health and Human Services (HHS).

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Verisys

JUNE 13, 2023

Centers for Medicare & Medicaid Services : The US Department of Health and Human Services has issued a final rule update concerning guidelines for COVID-19 vaccination requirements for Long-Term Care Facilities (LTC) and Intermediate Care for Individuals with Intellectual Disabilities (ICFs-IID).

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Healthcare It News

JUNE 9, 2022

Christopher Crow is cofounder and CEO of Catalyst Health Group, a primary care network that works for physicians and patients. America spends half of what other developed countries spend on primary care, despite it being the single area of healthcare that has proven to deliver actual cost savings with better population health results.

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HIT Consultant

FEBRUARY 5, 2023

Understanding the Biden Administration’s Plans To Combat Cancer The Biden Administration is announcing new actions from inside and outside of government that will drive additional progress, drawing us closer to ending cancer as we know it today. And, the White House and Cancer Cabinet have held more than 50 community conversations and events.

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