HIPAA Journal

JANUARY 12, 2024

What was the HIPAA Omnibus Rule of January 2013? The HIPAA Omnibus Rule of January 2013 was comprised of four Final Rules which were combined into one Omnibus Rule to reduce the impact of the changes and the number of times covered entities and business associates would need to undertake compliance activities.

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HIPAA Journal

JUNE 9, 2023

Prior to the Supreme Court ruling, there was no distinction between an identity thief stealing an individual’s identity and running up huge debts, a lawyer rounding up bills and only charging full hours, a waitress overcharging customers, and a doctor overbilling Medicaid. The Supreme Court decision related to the latter.

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Healthcare Law Blog

APRIL 6, 2022

On April 1, 2022 , the Centers for Medicare & Medicaid Services (“CMS”) announced states may seek to extend Medicaid postpartum coverage from 60 days to one year through a new state plan option offered by the American Rescue Plan Act (“ARPA”). This option is available for five years and ends on March 31, 2027.

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Healthcare IT News - Telehealth

JULY 18, 2022

"Since 2013, we had provided e-consults as one of the original AAMC Project CORE institutions," she added. "In 2019, UVA Health created a multi-stakeholder strategic plan for telemedicine.

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The Health Law Firm

MARCH 4, 2013

A report released by the Government Accountability Office (GAO) on February 27, 2013, announced that Medicare will remain a "high-risk" program with respect to its fraud and waste vulnerability. Leider, J.D., The Health Law Firm.

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Health Law Attorney

APRIL 22, 2021

The Act extends the temporary suspension of certain mandatory Medicare FFS claim payment reductions until December 31, 2021. President Obama issued a Sequestration Order in March 2013. Amongst other things, the CARES Act temporarily suspended sequestration of Medicare FFS claims from May 1, 2020 through December 31, 2020.

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Med-Net Compliance

SEPTEMBER 9, 2022

to resolve allegations that they submitted false claims to Medicare and Medicaid. The ophthalmologist was identified by HHS-OIG as one of the top outliers for billing the Medicare program across all medical specialists in West Virginia, far exceeding the average of Medicare claims submitted by his peers.

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HIT Consultant

AUGUST 17, 2023

They also serve a majority of Medicaid and non-insured patients, which makes it harder to keep the doors open on maternity wards, whose cost of upkeep can be substantial. Incentivizing Medicaid capture. Hospitals in under-resourced areas have less to offer new doctors in terms of equipment, support, and quality of life.

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HIPAA Journal

FEBRUARY 23, 2022

The preamble could give the impression that the Administrative Simplification provisions of HIPAA Title II will improve accessibility to and affordability of the Medicare and Medicaid programs, or that the development of a health information system would streamline the provision of healthcare between providers.

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Jane Sarashon

MARCH 3, 2025

For several years, I was a member of HIMSS Patient Engagement committee from its launch around 2013. We’ll see dozens of vendors with AI-baked into offerings that speak to population health, especially as value-based care continues to be demanded by certain payers and health plan benefit designs. Enhance the health care experience.

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Medical Billing Health Insurance Doctors Electronic Medical Records 59

Healthcare Compliance Blog

JANUARY 14, 2022

million to settle allegations that the company sold custom fabricated shoe inserts to Medicare recipients that did not meet Medicare standards. Custom shoe inserts for diabetic patients can be covered by Medicare and Medicaid. A Florida based diabetic shoe company has agreed to pay over $5.5

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HIT Consultant

NOVEMBER 8, 2021

States can also decide how they want to determine Medicaid eligibility. While popular back in 2013, custom solutions have proven in most cases to be too costly and time-consuming to be sustainable. Consider how you want the SBM to work with Medicaid. These are just a few of the many decisions a state will need to make.

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Healthcare IT Today

FEBRUARY 27, 2024

HealthBeacon was founded in 2013 in Dublin, Ireland. The product is patent protected, FDA cleared, and FSA, HSA, Medicare, and Medicaid eligible. Postal Service’s approved mail-back program. HealthBeacon also provides a digital risk management platform for prescribing restricted medication to oncology patients.

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The Health Law Firm

AUGUST 16, 2013

According to the Daytona Beach News-Journal, the surgeon allegedly made an initial incision into a patient’s right leg when it was suppose to be made in the left leg on July 3, 2013.

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CMS.gov

OCTOBER 2, 2018

Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Administrator, Centers for Medicare & Medicaid Services. Medicaid & CHIP. Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Between 2013 and 2016, Federal spending on Medicaid grew by over $100 billion.

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HIPAA Journal

MAY 30, 2023

MCNA), which also does business as MCNA Dental – a provider of dental benefits and services for state Medicaid and Children’s Health Insurance Programs – has recently reported a major data breach to the Maine Attorney General that has affected 8,923,662 individuals. Managed Care of North America, Inc. Nascentia Health, Inc.

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Hall Render

NOVEMBER 17, 2023

The Centers for Medicare and Medicaid Services (“CMS”) Medicare Advantage final rule for 2024 (“Final Rule”) clarified that Medicare Advantage plans must adhere to the “two-midnight rule” when making coverage determinations for inpatient services. 1395w-22(a) ). d)(2) ).

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Healthcare Compliance Blog

MAY 9, 2022

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. Juan Antonio Gonzalez, US Attorney for the Southern District of Florida, stated, “The fraudulent billing of Medicare will not be tolerated.

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US Department of Health and Human Services Medicare Medicare Compliance 59

AIHC

JANUARY 28, 2022

For more information on filing compliance cost reports, attend the Medicare Cost Report Camp in March 2022 presented by KraftCPAs and sponsored by the American Institute of Healthcare Compliance. This is calculated based on the hospital’s relative share of uncompensated care nationally. This is known as the hospital “market basket.”

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HIT Consultant

APRIL 20, 2022

Since the passage of the Medicare Improvements for Patients & Providers Act in 2008, the U.S. Hospitals report the data to the Centers for Medicare & Medicaid Services (CMS), which uses that data to create the Overall Hospital Quality Star rating for each hospital. Tom Zaubler, MD, Chief Medical Officer of NeuroFlow.

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Health Populi

DECEMBER 6, 2018

In 2006, Medicare Part D launched, which may have boosted consumers’ faith in Federal healthcare programs. In contrast, in 2013 the Affordable Care Act was in implementation and consumer-adoption mode, accompanied by aggressive anti-“Obamacare” campaigns in mass media.

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HIPAA Journal

OCTOBER 21, 2022

In 2013, HHS confirmed that paper-to-paper, non-digital faxes are not covered transactions). Advocates of NPIs are hoping that the introduction of Medicare Beneficiary Numbers (which went into effect in January 2020) will demonstrate to Congress that the benefits of NPIs far outweigh the costs. #4.

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HIPAA Compliance Medicare Medicare 107

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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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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US Department of Health and Human Services Medicare Medicare Medicaid 59

The Health Law Firm

AUGUST 30, 2013

Board Certified by The Florida Bar in Health Law On August 2, 2013, the Centers for Medicare and Medicaid Services (CMS) released the 2014 Inpatient Prospective Payment System (IPPS) Final Rule (the 2014 IPPS Final Rule). By Lance O. Leider, J.D., The Health Law Firm and George F. Indest III, J.D.,

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Hospitals Payment Systems Medicaid Medicaid 40

HIPAA Journal

MARCH 20, 2025

WI Business Associate 4,112,892 Hacking/IT Incident 24 2023 Colorado Department of Health Care Policy & Financing CO Health Plan 4,091,794 Hacking/IT Incident 25 2013 Advocate Health and Hospitals Corporation, d/b/a Advocate Medical Group IL Healthcare Provider 4,029,530 Theft 26 2024 Concentra Health Services, Inc.

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HIPAA Ransomware Compliance Hospitals 111

The Health Law Firm

AUGUST 21, 2013

Board Certified by The Florida Bar in Health Law On August 19, 2013, Shands Healthcare agreed to pay $26 million to settle a lawsuit that stemmed from a whistleblower/qui tam claim. Indest III, J.D.,

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Medicaid Medicaid Medicare Medicare 40

The Health Law Firm

SEPTEMBER 23, 2013

million, according to the Department of Justice (DOJ) on September 13, 2013. The providers were accused of defrauding Medicare, Medicaid and TRICARE by performing unnecessary and improperly supervised procedures from 2007 until 2011. Indest III, J.D.,

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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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Fraud Medicare Medicare Compliance 52

Healthcare Law Blog

MAY 31, 2022

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. Which regulations are implicated will depend upon how those services are rendered, as well as how those services are funded and paid. 1, 2021). [2]

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HIPAA Journal

MARCH 30, 2022

Furthermore, it could also be argued that neither Rule was effectively enforced until the Omnibus Final Rule was published in 2013. billion recovered relating to Medicare fraud alone. It was not until 2002 that the Privacy Rule was published, and 2003 that the Security Rule was published. How HIPAA Addressed Health Insurance Reform.

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HIPAA Fraud Health Insurance Health Care Reform 137

Medval Compliance Blog

MARCH 10, 2022

by Frank Fairchok, Vice President of Medicare Reporting Services. Last week, the Centers for Medicare & Medicaid Services (CMS) advanced the rulemaking process in two long-awaited areas. 0938-AT85 – Medicare Secondary Payer and Future Medicals (CMS-6047). Figure 1 – 0938-AT85 (Click image to go to website).

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US Department of Health and Human Services Medicare Medicare Medicaid 52

Innovaare Compliance

MARCH 4, 2024

Until the enactment of the Medicare Modernization Act (MMA) in 2006 [1] , the Centers for Medicare & Medicaid Services does not cover most outpatient prescription drugs under Part B (“Part B drugs”). However, some drugs self-administered by Medicare beneficiaries at home are Part B eligible.

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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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Compliance HIPAA Medicaid Medicaid 52

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.

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Medicare Medicare Compliance Medicaid 52

Provider Trust

MAY 17, 2022

Federal regulators such as the HHS-OIG, the Department of Justice (DOJ), the Centers for Medicare and Medicaid Services (CMS), and others have regulations and guidelines regarding the prohibition of reimbursements of federal healthcare dollars (Medicaid, Medicare, CHIPS, TriCare, and others) to excluded vendors.

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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. The list now covers more than just Medicare and State Health Care Programs and includes programs such as CHIP, TRICARE, and Veterans Affairs. What is the HHS OIG Exclusions List?

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