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Medicare Patients Win the Right to Appeal Gap in Nursing Home Coverage

Kaiser Health News

A three-judge federal appeals court panel in Connecticut has likely ended an 11-year fight against a frustrating and confusing rule that left hundreds of thousands of Medicare beneficiaries without coverage for nursing home care, and no way to challenge a denial. But it can have serious repercussions.

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ŌURA Secures $200 Million in Series D Funding

Healthcare IT Today

Further, URA recently announced the acquisitions of Sparta Science and Veri, a first-of-its-kind partnership with Medicare Advantage provider Essence Healthcare, and a strategic metabolic-health partnership with Dexcom. Since its founding in 2013, URA has been redefining the future of health wearables.

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The Physician Payments Sunshine Act – Compliance in a Nutshell                                                                     

AIHC

The "Sunshine Act," officially known as the Physician Payments Sunshine Act, mandates those manufacturers of drugs, medical devices, and biologics report payments and transfers of value to physicians and teaching hospitals to the Centers for Medicare & Medicaid Services (CMS).

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The Doctor Won’t See You Now: The Unintended and Perhaps Inevitable Consequences of Medicare-for-All

Electronic Health Reporter

In the fall of 2013, when cancellation letters—notices of cancelled plans—went out to approximately four […]. The article The Doctor Won’t See You Now: The Unintended and Perhaps Inevitable Consequences of Medicare-for-All appeared first on electronichealthreporter.com. But the promise was impossible to keep.

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CMS’s Final Rule on Medicare Advantage Risk Adjustment Data Validation

Health Law Advisor

On February 1, 2023, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining its audit methodology and related policies for its Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. The final rule codifies long-awaited regulations first proposed by CMS in 2018.

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Monthly Round-Up of What to Read on Pharma Law and Policy

Bill of Health

Fulfillment of Postmarket Commitments and Requirements for New Drugs Approved by the FDA, 2013-2016. Medicare’s National Coverage Determination for Aducanumab – A One-Off or a Pragmatic Path Forward? Brown BL, Mitra-Majumdar M, Darrow JJ, Moneer O, Pham C, Avorn J, Kesselheim AS. JAMA Intern Med. 2022 Oct 3:e224226.

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What did the HIPAA Omnibus Rule Mandate?

HIPAA Journal

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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