HIPAA Journal

JULY 28, 2023

The HHS’ Centers for Medicare and Medicaid Services (CMS) is being urged not to implement the proposed standards for prior authorization attachments, as detailed in its December 2022 Notice of Proposed Rulemaking (NPR).

HIPAA 84

HIPAA Health Insurance Medicaid Medicaid 84

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.

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Medicaid 52

C&M Health Law

DECEMBER 23, 2022

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). For these reasons, CMS withdrew the December 2020 CMS Interoperability proposed rule.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

HIT Consultant

FEBRUARY 9, 2023

Czekai, MPH, VP of Strategic Partnerships at Cohere Health The Centers for Medicare & Medicaid Services (CMS) recently proposed a new rule to advance interoperability and improve the prior authorization (PA) process for Medicare and Medicaid patients.

Medicaid 98

Medicaid Medicaid Medicare Medicare 98

Healthcare IT Today

SEPTEMBER 30, 2023

Read more… Making Healthcare App Development and FHIR Data Access Easy. Digital health developers shouldn’t have to learn the hundreds of flavors of FHIR implementations and APIs to share data , Patrick Schiess at Darena Solutions told John. Welcome to our Healthcare IT Today Weekly Roundup. Cynthia Casatelli at e4.health

Medical Billing 110

Medical Billing HIPAA Doctors Compliance 110

Redox

FEBRUARY 1, 2024

Original prediction: We won’t see accelerated adoption of interoperability standards (e.g., HL7 ® , HL7 ® Fast Healthcare Interoperability Resources or FHIR ® ). Original prediction: We won’t see accelerated adoption of interoperability standards (e.g., HL7 ® , HL7 ® Fast Healthcare Interoperability Resources or FHIR ® ).

Telemedicine 64

Telemedicine Medicare Medicare 64

Redox

DECEMBER 21, 2023

Here are some specific reflections: FHIR adoption: We missed the mark on our HL7® Fast Healthcare Interoperability Resources (FHIR®) growth prediction. Here are some specific reflections: FHIR adoption: We missed the mark on our HL7® Fast Healthcare Interoperability Resources (FHIR®) growth prediction.

Telemedicine 59

Telemedicine Governance 59

Healthcare IT Today

DECEMBER 15, 2022

Many IT companies have tried to create solutions that advance interoperability in healthcare. While FHIR has made significant headway in creating common protocols and standards for data exchange, there is opportunity to create greater data fluidity among all healthcare stakeholders. These are just two of the many use cases.

Hospitals 90

Hospitals 90

HIT Consultant

SEPTEMBER 14, 2022

What You Should Know: – The full automation of prior authorization at the point of care leads to improved member experiences, enhanced outcomes, ongoing compliance, and reduced administrative burden. AI-Driven Advances in Prior-Authorization Systems.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare Law Blog

DECEMBER 15, 2022

The Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule , “Advancing Interoperability and Improving Prior Authorization Processes” (the “Proposed Rule”), that is intended to improve patient and provider access to health information and streamline processes related to prior authorization for medical items and services.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare IT Today

APRIL 28, 2024

Updates that require support for FHIR-based APIs should allow TEFCA participants to more easily exchange information directly, and enable individuals to more easily access their own information. Interoperability vendor Innovar Healthcare released an OSS Mirth Connect plugin that’s now available on AWS Marketplace.

Telemedicine 103

Telemedicine Nurses Medicare Medicare 103

Healthcare IT Today

AUGUST 10, 2023

The new company spun out of healthcare interoperability leader 1upHealth three months ago and secured $13M in funding, co-led by Craft Ventures and Obvious Ventures. The company also expects its predictive models to be extremely useful for a broad set of use cases including prior authorization and utilization management workflows.

Health Insurance 82

Health Insurance Medicaid Medicaid Medicare 82

Healthcare IT Today

FEBRUARY 25, 2024

A survey published in JAMIA found 73% of digital health vendors are using standards-based FHIR APIs when integrating with EHR systems. Edifecs said it will now enable compliance with CMS Interoperability and Prior Authorization Final Rule. Median hospital margins hit 5.2%

Telemedicine 95

Telemedicine Compliance FDA Hospitals 95

HIT Consultant

FEBRUARY 18, 2024

The challenges with rapidly evolving technology As the medical device market expands through ongoing innovation, healthcare leaders must take a pragmatic approach to evaluation prior to investment. Director, Clinical Services, CliniComp The types of medical devices available and their use in patient care continue to accelerate.

Patient Satisfaction 98

Patient Satisfaction Public Health Nurses Hospitals 98

Healthcare IT Today

OCTOBER 23, 2022

These disruptions range from delays in receiving documentation (such as prior authorization) to receiving conflicting information from different sources to being stuck between the provider and another entity (such as a payer or pharmacy) trying to resolve a dispute. Partnerships.

FDA 68

FDA Nurses Medicaid Medicaid 68

HIT Consultant

MARCH 21, 2023

Matt Hollingsworth, CEO and Co-founder, Carta Healthcare While the United States is generally viewed as one of the great nations with a bill of rights, views differ considerably regarding whether the country has an enlightened approach to healthcare; especially contentious is the ability to provide universal, cost-effective access.

Governance 52

Governance Licensing 52

HIT Consultant

FEBRUARY 21, 2024

The picture of this challenge is best crystalized in prior authorization policies that are designed, for better or worse, to limit care. CMS is now harnessing the power of digital interoperability to improve the accountability, transparency and ultimately availability of care, in particular in MA.

Medicare 52

Medicare Medicare Doctors Medicaid 52

CMS.gov

NOVEMBER 16, 2018

One of my commitments as the Administrator of the Centers for Medicare & Medicaid Services (CMS) is to ensure we remain steadfast in our commitment to strengthen Medicare by making sure that tax dollars are spent appropriately. In our country, 1 of every 5 tax dollars is spent on healthcare, so we cannot afford to spend them inappropriately.

Medicare 20

Medicare Medicare Overpayments Overpayment 20

HIT Consultant

JANUARY 17, 2024

What You Should Know: The Biden-Harris Administration has finalized a new rule that streamlines the prior authorization process and improves health data exchange across the healthcare system. – Clearer communication: All payers must provide specific reasons for denial, allowing for easier resubmissions or appeals.

Compliance 97

Compliance Health Outcomes Doctors Nurses 97

Healthcare IT Today

JANUARY 11, 2023

Healthcare Analytics and Interoperability. And now, check out our community’s healthcare analytics and interoperability predictions. We asked the Healthcare IT Today community to submit their predictions and we received a wide ranging set of responses that we grouped into a number of themes. Healthcare AI. Healthcare Workforce.

Hospitals 108

Hospitals Health Outcomes Public Health Governance 108

Healthcare IT Today

SEPTEMBER 19, 2023

While the key components of privacy (administrative, uses and disclosures, individual rights, and general security) are all necessary today, I would put privacy, security, breach – and relevant 21 Century Cures Interoperability topics – all together and make sure everyone handling any type of sensitive information be subject to these rules.

Hospitals 132

Hospitals HIPAA Nurses Governance 132

Redox

NOVEMBER 18, 2021

Health plans can take shelter with TEFCA, FHIR, and Redox. Major interoperability progress is expected in 2022 as version 1 of the Trusted Exchange Framework and Common Agreement (TEFCA) will be finalized in Q1 and Qualified Health Information Networks (QHIN) are expected to be operationalized by the end of the year.

COVID-19 52

COVID-19 Doctors Compliance 52

Redox

DECEMBER 21, 2022

A few things seemed to proceed as expected, including the adoption of FHIR standards across the EHR market base, but much was rather unexpected. Antiquated methods will be kicked to the curb in favor of APIs, FHIR, nationwide networks, patient authorized retrieval, and more.” Garrett Rhodes.

Federal Policy 52

Federal Policy 52

HIT Consultant

JUNE 1, 2023

It’s called interoperability, where disparate systems can seamlessly connect and share data with each other and it’s almost always in real or virtually real-time. Initiatives to improve interoperability in our industry began in the 1960s with the push for electronic data interchange for claims adjudication.

Governance 98

Governance Hospitals 98

Healthcare IT Today

JANUARY 2, 2023

2022 Predictions for Healthcare Interoperability – A third predictions post doing so well. 2022 Predictions for Healthcare Interoperability – A third predictions post doing so well. Does this mean people cared about RPM and Healthcare Interoperability the most in 2022? Most Visited Healthcare IT Resource Pages.

Electronic Medical Records 90

Electronic Medical Records HIPAA Hospitals 90