Compliancy Group

DECEMBER 13, 2024

For example, some medical identity thieves take insurance information and make fraudulent claims to Medicare or Medicaid for services or goods. Handling sensitive data like Social Security numbers, insurance coverage or enrollment information, names, or credit card numbers always puts an organization at risk for identity theft.

Compliance Officers 94

Compliance Officers Compliance Electronic Medical Records Fraud 94

HIPAA Journal

JUNE 14, 2023

The ransomware attack prevented the hospital from submitting claims to insurers, Medicare, and Medicaid for months, piling even more financial pressure on the already struggling St. The ransomware attack itself did not trigger the closure, but it did play a key part in the decision to close. Margaret’s Health.

Ransomware 107

Ransomware Hospitals COVID-19 HIPAA 107

HIT Consultant

NOVEMBER 2, 2021

In 2010, the Affordable Care Act ushered in a new era for Medicaid Modularity, an approach anchored by breaking down large, monolith systems into smaller, more nimble and self-contained modules that can de-risk healthcare delivery and unlock innovation. Prior to SAS, he was the Chief Information Officer of Arkansas Medicaid.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare IT Today

OCTOBER 12, 2023

The Centers for Medicare & Medicaid Services (CMS) have taken a bold step by mandating a standard for prior authorization. The release of FHIR in the mid-2010 decade changed everything. The Dilemma of Prior Authorization Prior authorization, also known as a pre-approval, strikes fear into both patients and providers.

Electronic Medical Records 122

Electronic Medical Records Doctors Governance Medicaid 122

Jane Sarashon

FEBRUARY 27, 2024

In addition to highlighting the Patient’s Bill of Rights, NABIP’s keynotes and general sessions will speak to similar topics being brainstormed at VIVE this week — including mental health, maternal health, pharmacy and prescription drugs (pricing, PBMs), population health, and Medicare and Medicaid innovations.

ACA 118

ACA Prescription Drug Pricing Health Insurance Hospitals 118

Healthcare IT Today

FEBRUARY 7, 2024

According to Dr. Colin Banas, chief medical officer at DrFirst , they initiated EPCS in 2010, partnering with the Massachusetts Department of Health. Kelly says that a federal bill in 2021 required EPCS for Medicare prescriptions. How do you transmit the prescription to the pharmacy and record it in the PDMP?

Telemedicine 130

Telemedicine COVID-19 Doctors Medicare 130

Health Care Law Brief

APRIL 12, 2023

On April 5, the Centers for Medicare & Medicaid Services (“CMS”) released the 2024 Medicare Advantage and Prescription Drug Benefit Programs Final Rule (“Final Rule”), which will be codified at 42 C.F.R. The SRFs include low-income subsidy, dual eligibility (meaning eligible for Medicare and Medicaid) and disability.

Medicare 52

Medicare Medicare Overpayments Overpayment 52

Hall Render

FEBRUARY 22, 2024

In the FY 2024 IPPS Final Rule (the “Final Rule”), the Centers for Medicare & Medicaid Services (“CMS”) incorporated certain social risk factors into the Hospital Value-Based Purchasing (“VBP”) Program (“the Program”).

Hospitals 66

Hospitals Medicare Medicare Medicaid 66

HIPAA Journal

OCTOBER 21, 2022

However, in 2015, Congress partially relented its stance by passing the Medicare Access and CHIP Reauthorization Act which requires the Centers for Medicare and Medicaid to remove Social Security Numbers from Medicare cards and replace them with Medicare Beneficiary Numbers.

HIPAA 107

HIPAA Compliance Medicare Medicare 107

CMS.gov

NOVEMBER 16, 2018

2018 Medicare Fee-For-Service improper payment rate is lowest since 2010. Administrator, Centers for Medicare & Medicaid Services. 2018 Medicare Fee-For-Service improper payment rate is lowest since 2010 Significant progress in saving $4.59B in estimated improper payments for the Medicare Fee-For-Service program.

Medicare 20

Medicare Medicare Overpayments Overpayment 20

Healthcare Compliance Blog

MAY 17, 2022

The National Background Check Program, enacted by legislation in 2010, provides grants to states and territories to assist them in developing and improving systems to conduct federal and state background checks of prospective LTC employees.

Medicaid 59

Medicaid Medicaid Medicare Medicare 59

Medisys Compliance

AUGUST 4, 2022

The Centers for Medicare & Medicaid Services (CMS) on June 21, 2022, issued a proposed rule that proposes to update payment rates and policies under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to Medicare beneficiaries on or after January 1, 2023.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Payment Systems Medicare 59

Provider Trust

MAY 16, 2024

This landmark milestone represents a continued commitment by ProviderTrust and its nearly 1,000 healthcare client organizations to ensure Medicare and Medicaid dollars are protected from fraud, waste, and abuse.

Fraud 52

Fraud Medicaid Medicaid Licensing 52

Provider Trust

MAY 16, 2024

This landmark milestone represents a continued commitment by ProviderTrust and its nearly 1,000 healthcare client organizations to ensure Medicare and Medicaid dollars are protected from fraud, waste, and abuse.

Fraud 52

Fraud Medicaid Medicaid Licensing 52

MedTrainer

JULY 29, 2024

Regulatory compliance includes legal mandates directed by both federal and state governing bodies, including the Occupational Safety and Health Administration ( OSHA ), Centers for Medicare & Medicaid Services ( CMS ), Health Resources & Services Administration ( HRSA ), and the Office of Inspector General ( OIG ) of the U.S.

Compliance 52

Compliance US Department of Health and Human Services Regulatory Compliance Compliance Officers 52

Hall Render

JUNE 29, 2022

On June 9, 2022, the Centers for Medicare & Medicaid Services (“CMS”) published a notice seeking public comment on its plan to revise the way information is collected under its voluntary Self-Referral Disclosure Protocol (“SRDP”). CMS will accept comments on the proposed rule through August 8, 2022.

Medicaid 72

Medicaid Medicaid Medicare Medicare 72

HIPAA Journal

MARCH 31, 2023

The Centers for Medicare & Medicaid Services (CMS) requires records of healthcare providers submitting cost reports to be retained for a period of at least five years after the closure of the cost report, and that Medicare managed care program providers retain their records for ten years.

HIPAA 128

HIPAA Medicare Medicare Compliance 128

Kaiser Health News

JULY 11, 2023

Hospitals also claim as community benefits the difference between what it costs to provide a service and what Medicaid pays them, known as the Medicaid shortfall. ” Hospitals have long argued they need to charge private insurance plans higher rates to make up for the Medicaid shortfall.

Hospitals 72

Hospitals Medicaid Medicaid Medical Billing 72

Compliancy Group

NOVEMBER 16, 2022

In 2015, legislation known as the Medicare Access and CHIP Reauthorization Act (MACRA) was enacted. 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.

Medicare 52

Medicare Medicare HIPAA Medicaid 52

HIPAA Journal

MARCH 20, 2025

Causes of Healthcare Data Breaches Healthcare Hacking Incidents by Year Our healthcare data breach statistics show hacking is now the leading cause of healthcare data breaches, although it should be noted that healthcare organizations are now much better at detecting hacking incidents than they were in 2010. 55,000 2011 Indiana WellPoint Inc.

HIPAA 111

HIPAA Ransomware Compliance Hospitals 111

Innovaare Compliance

FEBRUARY 7, 2022

Health plans (collectively, “plan sponsors”) that contract with the Centers for Medicare & Medicaid Services (CMS) to provide health services to eligible Medicare beneficiaries are responsible for legal, contractual, and fiduciary obligations whether performed by the plan or those to whom the company delegates those obligations.

Medicare 52

Medicare Medicare Compliance Medicaid 52

HIPAA Journal

JANUARY 12, 2024

The changes attributable to the Genetic Information Nondiscrimination Act (GINA) were published as a Proposed Rule in April 2009, while the proposed modifications to the Privacy, Security, and Enforcement Rules were published in July 2010.

HIPAA 107

HIPAA Compliance Health Insurance Medicaid 107

Health Populi

JUNE 13, 2018

” That was written in the 2001-2010 period of healthcare spending, so an old story giving me feelings of déjà vu. Even with moderating medical trend growth, the Centers for Medicare and Medicaid Services (CMS) expect that healthcare spending will account for 20% of the U.S. economy by 2026.

Medicaid 63

Medicaid Medicaid Health Insurance Medicare 63

MedTrainer

JANUARY 12, 2024

Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation. Affordable Care Act (2010): The ACA introduced the concept of value-based care, emphasizing quality and patient outcomes over quantity of services.

Compliance 52

Compliance HIPAA Telemedicine ACA 52

Innovaare Compliance

FEBRUARY 9, 2021

Annually, the Centers for Medicare & Medicaid Services (CMS) releases star ratings, which measure the quality of care health plans deliver for its members. Medicare Advantage and Part D) for a comprehensive assessment of a health plan’s performance. Read More – Medicare Star Ratings Changes 2021 .

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Hall Render

AUGUST 10, 2023

On August 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its Final Hospital Inpatient Prospective Payment System (“IPPS”) and Long-Term Care Hospital (“LTCH”) PPS rule for fiscal year (“FY”) 2024 (“Final Rule”). The Final Rule increases the rate for IPPS payments by 3.3% in FY 2024 but applies a 0.2%

Hospitals 40

Hospitals Medicare Medicare Medicaid 40

CMS.gov

SEPTEMBER 22, 2020

On December 19, 2011, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule implementing the Physician Payments Sunshine Act, which was included as section 6002 of the Affordable Care Act of 2010.

Medicaid 20

Medicaid Medicaid Medicare Medicare 20

MedTrainer

MARCH 28, 2024

Law by law, regulations were added, increasing the complexity of maintaining compliance for healthcare organizations.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

NY Health Law

JANUARY 3, 2025

Since approving Gilenya in 2010, the FDA has imposed a first-dose observation requirement for new patients, who must be monitored by a doctor while attached to an electrocardiogram machine for six hours. Novartis Pharmaceuticals Corp.

Fraud 52

Fraud FDA Doctors Medicaid 52

Hall Render

NOVEMBER 28, 2023

On November 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update Final Rule (“2024 Final Rule”), which has since been filed in the Federal Register. CMS is finalizing this proposal. Deactivation.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

Bill of Health

MAY 22, 2023

The selections feature topics ranging from an analysis of government and industry investments for recently approved drugs, to a discussion of court decisions on mifepristone, and an examination of the added therapeutic benefit associated with the top-selling brand-name drugs in Medicare. Galkina Cleary E, Jackson MJ, Zhou EW, Ledley FD.

Pharmaceutical Industry 162

Pharmaceutical Industry Medicare Medicare Medicaid 162

Kaiser Health News

JUNE 16, 2022

Patient debt is piling up despite the landmark 2010 Affordable Care Act. Hospitals recorded their most profitable year on record in 2019, notching an aggregate profit margin of 7.6%, according to the federal Medicare Payment Advisory Committee. The law expanded insurance coverage to tens of millions of Americans. “The No.

US Department of Health and Human Services 145

US Department of Health and Human Services Medical Billing Hospitals Medicare 145

Healthcare Law Blog

JANUARY 6, 2023

In addition to funding, the Act modifies certain telehealth provisions, expands and extends components of the Medicare and Medicaid programs, and supports initiatives within the behavioral health and substance use treatment spaces. Medicare Extension & Adjustments. reduction of the Medicare conversion factor.

COVID-19 52

COVID-19 Medicaid Medicaid COVID-19 Vaccine 52

Kaiser Health News

JUNE 16, 2022

La deuda de los pacientes se acumula a pesar de la histórica Ley de Cuidado de Salud a Bajo Precio (ACA) de 2010. Los hospitales registraron su año más rentable de la historia en 2019, anotando un margen de beneficio agregado del 7,6%, según el Comité Asesor de Pagos de Medicare federal. No es complicado".

ACA 78

ACA Medicare Medicare Hospitals 78

Health Law Advisor

SEPTEMBER 1, 2023

On August 29, 2023, the Centers for Medicare & Medicaid Services (CMS) announced the ten (10) Medicare Part D drugs selected for the first round of negotiations of the Medicare Drug Price Negotiation Program (Program)—a few days before the September 1, 2023, statutory deadline imposed by the Inflation Reduction Act (IRA).

Medicare 69

Medicare Medicare Licensing Medicaid 69

Healthcare Law Blog

JANUARY 26, 2023

Medicaid and Medicare The Balanced Budget Act of 1997, Public Law 105–33, 111 Stat. The Medicaid and Medicare statutes also contain conscience provisions related to the performance of advanced directives, religious nonmedical healthcare providers and their patients.

ACA 105

ACA Medicaid Medicaid Compliance 105

Healthcare IT News - Telehealth

NOVEMBER 27, 2019

But at the tail end of the 'teens, we see a flowering of innovation that could only have been dreamed of in 2010. Of course, that's been the case every year over the past decade since the first meaningful use checks were mailed out, kickstarting the digital healthcare age as we know it.

Telemedicine 91

Telemedicine Health Analytics Governance Hospitals 91