The Health Law Firm

MARCH 6, 2014

Board Certified by The Florida Bar in Health Law The Centers for Medicare and Medicaid Services (CMS) continues to stop fraudulent repayment claims before they happen. The agency performed a similar enrollment moratorium in July 2013. Indest III, J.D., Click here to read the press release from CMS.

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Health Care Law Brief

JUNE 5, 2023

In 2013, Jelly Bean contracted with the Florida Health Kids Corporation (“ FHKC ”)—a state-created entity that offers health and dental insurance for Florida children—to create, host, and maintain HealthyKids.org, where, in part, parents and others could apply for state Medicaid insurance coverage for eligible children.

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Fraud Due Diligence Medicaid Medicaid 52

American Medical Compliance

JANUARY 9, 2024

When someone uses your personal information, such as your name, Social Security number, or Medicare number, to make false claims to Medicare and other health insurers without your consent, it is known as medical identity theft. This wastes taxpayer money and interferes with your medical care. trillion in 2015.

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HIPAA Journal

OCTOBER 21, 2022

The passage of HIPAA resulted in multiple benefits for the health insurance industry, the healthcare industry, and the people that they serve. For example, the Administrative Requirements (Part 162) helped reduce insurance fraud and accelerated eligibility inquiries, authorization requests, and claims processing.

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HIPAA Compliance Medicare Medicare 105

MedTrainer

SEPTEMBER 8, 2023

The breach occurred in 2013 when four unencrypted laptops containing the electronic protected health information (ePHI) of over 4 million patients were stolen from an Advocate Health administrative building. Details of the settlement indicate the submission of false claims to Medicare, Medicaid, TRICARE, and FECA programs.

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Healthcare Law Blog

MAY 31, 2022

The FTC’s increasing interest in health information that sits outside of HHS/OCR’s reach is likely to only expand in light of health-related metaverse use cases. For example, services that are billed to Medicaid or Medicare must comply with regulations that may not apply to services that are paid for in cash. 1, 2021). [2]

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Health Populi

DECEMBER 7, 2018

These annual numbers come out of the annual report from the Centers for Medicare and Medicaid Services, published yesterday in Health Affairs. Underneath these macro-health economic numbers is the fact that inflation averaged 1.6% This means that health care spending grew twice the rate of inflation.

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Health Insurance Medicaid Medicaid Medicare 54

HIPAA Journal

JULY 4, 2024

In 1996, Congress passed the Health Insurance Portability and Accountability Act ( HIPAA ) with the objective of reforming the health insurance industry. When large scale changes occur – such as happened in 2013 with the HIPAA Omnibus Rule – almost every covered entity and business associate is impacted by the changes.

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HIPAA Compliance Fraud Medicare 58

CMS.gov

MARCH 6, 2013

By: Christine Stahlecker, Director, Administrative Simplification Group, Office of E-Health Standards and Services, Centers for Medicare & Medicaid Services. These requirements are in place to lower costs, create uniform electronic standards, and streamline exchanges between health care providers and payers.

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Jane Sarashon

JUNE 5, 2023

Points well-taken, but my perspective through my own health economics lens has been that the more costs are borne by a patient, the more that person grows (or should grow) consumer-style “muscles.” family income — most recently pegged at around $70,000. mortality rate.

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Medicaid Medicaid COVID-19 Health Insurance 52

Healthcare Law Blog

MARCH 25, 2022

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger insurers. Once the new rules were published, Vista Health Plan, Inc., at 15,432 ); and.

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ACA US Department of Health and Human Services Health Insurance Medicaid 52

HIPAA Journal

DECEMBER 31, 2022

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was introduced to simplify the administration of healthcare, eliminate wastage, prevent healthcare fraud, and ensure employees could maintain healthcare coverage between jobs. What is HIPAA and Who Does It Apply To? What are the 3 types of HIPAA violations?

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HIPAA Due Diligence Compliance Fraud 135

HIPAA Journal

JULY 24, 2023

HHS was one of the first Departments to have an Office of Inspector General in 1976 due to billions of dollars being lost each year to Medicaid fraud. HHS OIG alleged that the organization had billed New York Medicaid for services furnished by the personal assistant. What is the HHS OIG Exclusions List?

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HIPAA Journal

JANUARY 2, 2023

The following is a small selection of those we have reported on: In May 2013, Dianna Hereford was terminated from her position of staff nurse at the Norton Audubon Hospital for improperly disclosing the condition of a patient with Hepatitis C. Milestones of the Health Insurance Portability and Accountability Act.

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HIPAA Compliance Hospitals Medicare 110

New Jersey Healthcare Blog

JANUARY 12, 2022

1791(c), the Department of Human Services, Division of Aging Services, Office of the State Health Insurance for the Aged and Disabled, readopted a rule regarding the Senior Gold Prescription Program Manual. The Manual extends Medicaid eligibility to certain persons not eligible under the provisions at N.J.A.C.

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Hall Render

DECEMBER 13, 2024

Care Taps Health Net Exec as New CEO COLORADO Aurora’s Fitzsimons plans development opportunities on 60 acres Boulder drug discovery co. operating margin in Q3 JLL Arranges $13.4M 3 in the U.S. for maternity care Healthcare Shifts Driving Demand For Outpatient Facilities In Denver Insider Breach, Email Attacks Net $1.7M

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US Department of Health and Human Services Nursing Homes Hospitals Nurses 40

CMS.gov

OCTOBER 22, 2018

New State Relief and Empowerment Waiver Guidance Gives States Tools to Help Fix Broken Health Insurance Markets. Administrator, Centers for Medicare & Medicaid Services. million Americans remain without health insurance. percent in 2019 and more insurers will enter the market—premiums are still far too high.

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Health Insurance ACA Medicaid Medicaid 55

HIPAA Journal

MARCH 30, 2022

For example: Had the health insurance industry been allowed to continue operating as it did prior to HIPAA, tens of millions of Americans would be excluded from health plan benefits. Had the momentum to improve health care not been given a kickstart by HIPAA, subsequent health care initiatives may never have happened.

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HIPAA Fraud Health Insurance Health Care Reform 127

CMS.gov

NOVEMBER 26, 2018

Today the Centers for Medicare & Medicaid Services (CMS) announced proposed changes to Medicare Part D to lower prescription drug costs for beneficiaries. Part D uses private insurance plans to cover drugs that are picked up at a pharmacy. But the policy was never intended to be permanent.

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Medicare Medicare Pharmaceutical Industry Health Insurance 52

HIPAA Journal

JANUARY 9, 2023

The Health Insurance Portability and Accountability Act was signed into law in 1996 and while there have been some significant HIPAA updates over the last two decades, the last set of major HIPAA updates occurred in 2013 with the introduction of the HIPAA Omnibus Final Rule. In each category, a maximum penalty of $1.5

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HIPAA COVID-19 COVID-19 Vaccine Compliance 114

Health Populi

DECEMBER 6, 2018

In contrast, in 2013 the Affordable Care Act was in implementation and consumer-adoption mode, accompanied by aggressive anti-“Obamacare” campaigns in mass media. Gallup points out in its analysis that the government is already a major health care channeler and funder through Medicare and Medicaid.

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Kaiser Health News

JUNE 29, 2022

The watchdogs also recommended imposing limits on home-based “health assessments,” arguing these visits can artificially inflate payments to plans without offering patients appropriate care. KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Cathy Rodgers (R-Wash.)

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Health Populi

MARCH 1, 2018

The report is aptly titled, Americans’ Views on Health Insurance at the End of a Turbulent Year. This is the sixth survey conducted by the Fund to track Americans’ views of the Affordable Care Act; the first survey was fielded in mid-to-fall 2013. The Fund surveyed 2,410 U.S.

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