Healthcare IT Today

FEBRUARY 26, 2023

million at-risk patients access preventative services – and stronger standards for Medicaid network adequacy – which could give nearly 300,000 additional Black children access to specialty hospitals and drive $912 million annual Medicaid savings due to reduced avoidable admissions. billion total transactions since 2014.

Medicaid 81

Medicaid Medicaid FDA Health Insurance 81

Health Populi

JUNE 18, 2021

workers with private insurance more likely report poor access to health care, greater costs of care, and lower satisfaction with care versus people covered by public health insurance plans — whether Medicaid, Medicare, VHA or military coverage. Health Populi’s Hot Points: U.S. households.

ACA 139

ACA Health Insurance Medicaid Medicaid 139

Med-Net Compliance

AUGUST 5, 2022

New York Attorney General Letitia James announced the indictment of a physician and his company for defrauding Medicaid by forcing patients to get unnecessary and invasive medical tests. He then directed his staff to submit claims for payment to Medicaid for those medically unnecessary tests. ?.

Medicaid 59

Medicaid Medicaid Fraud 59

Kaiser Health News

JANUARY 12, 2024

Under the law, which has offered coverage through state and federal marketplaces since 2014, insurers are barred from rejecting people with preexisting conditions and cannot charge higher premiums for them, either. For those with very low incomes, the law expanded eligibility for Medicaid, which is a state-federal program.

Health Insurance 141

Health Insurance ACA Medicaid Medicaid 141

Kaiser Health News

MARCH 15, 2022

But the new benefit for people enrolled in Medi-Cal, the state’s Medicaid health insurance program, has been delayed twice as the state and doulas — nonmedical workers who help parents before, during, and after birth — haggle over how much they should get paid.

Medicaid 90

Medicaid Medicaid Health Insurance Public Health 90

The Health Law Firm

FEBRUARY 21, 2014

Board Certified by The Florida Bar in Health Law A licensed speech therapist faces up to five years in prison for allegedly defrauding Medicaid during the summer of 2013. Indest III, J.D., Click here to read the press release from the AG.

Medicaid 40

Medicaid Medicaid Fraud Licensing 40

The Health Law Firm

JANUARY 29, 2015

This hypothetical situation begs the question: Why would physicians agree to treat Medicaid patients? Treating Medicaid patients has never been a money maker for physicians. However, for the past two years, Medicaid programs have been required to reimburse primary care providers at Medicare levels, which is typically higher.

Medicaid 40

Medicaid Medicaid ACA Medicare 40

Healthcare IT News - Telehealth

AUGUST 21, 2020

Most of its patients fall below the poverty line, and most qualify for Medicaid. MEBS already had been using Azalea Health’s electronic health record software since 2014. THE PROBLEM. MEBS treats a vulnerable population. These patients face difficult socioeconomic barriers that limit their access to care.

COVID-19 213

COVID-19 Telemedicine Medicaid Medicaid 213

HIT Consultant

JULY 14, 2023

FCA Allegations The allegations contends that NextGen falsely obtained certification for its software in connection with the 2014 Edition certification criteria published by HHS’s Office of the National Coordinator. The whistleblowers in this case will receive $5.58M.

Governance 94

Governance Medicaid Medicaid Medicare 94

Compliancy Group

AUGUST 23, 2023

In a shocking turn of events, a dental office manager from Worcester has been sentenced for participating in a scheme to defraud the Massachusetts Medicaid program, MassHealth. Deceiving MassHealth: The Disturbing Truth Behind Dental Services From 2014 to 2018, a shocking scheme unfolded within the realm of dental services.

Fraud 52

Fraud Medicaid Medicaid Governance 52

The Health Law Firm

AUGUST 22, 2016

Board Certified by The Florida Bar in Health Law On July 11, 2016, a federal appeals court stated that a bankruptcy judge did not have the authority to block government health officials from cutting off Medicare and Medicaid payments to a Florida nursing home that was alleged to have violated patient-care regulations. Indest III, J.D.,

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Medicaid Medicaid 40

Health Law Advisor

FEBRUARY 2, 2023

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.

Medicare 98

Medicare Medicare Overpayments Overpayment 98

Healthcare Compliance Blog

MARCH 31, 2022

The agencies received millions of dollars in funding from Medicaid, which is funded in part by the federal government, and much of that money was meant to pay the wages and benefits of their aides. Under the Wage Parity Law, which is funded by Medicaid, aides are to be paid a minimum amount in total compensation.

Medicaid 59

Medicaid Medicaid Governance Fraud 59

HIT Consultant

MARCH 2, 2023

Centers for Medicare and Medicaid Services (CMS) to continue its work supporting Healthcare.gov. – In 2014, Accenture Federal Services was awarded a prime contract to take over management of the Federally-Facilitated Exchange (FFE).

Health Insurance 52

Health Insurance Medicaid Medicaid Medicare 52

The Health Law Firm

APRIL 8, 2014

Board Certified by The Florida Bar in Health Law On March 17, 2014, Carousel Pediatrics in Austin, Texas, agreed to pay the state a $3.75 By Lenis L. Archer, J.D., The Health Law Firm and George F. Indest III, J.D.,

Medicaid 40

Medicaid Medicaid 40

Compliancy Group

FEBRUARY 16, 2024

We also covered two Medicaid fraud schemes , one resulting in billions of dollars in billing for medical supplies that were never received. for Medicaid Fraud In March 2014, the Maryland Board of Dental Examiners received complaints against Seyed Hamid Tofigh, DDS, claiming the dentist posed a risk of harm, and suspended his license.

Fraud 52

Fraud Licensing Medicaid Medicaid 52

Healthcare Law Blog

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). Additional Opportunities for Integration through State Medicaid Agency Contracts.

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

McGuire Wood

AUGUST 2, 2022

Founded in 2006, the company specializes in motor vehicle accident, third-party liability, workers’ compensation, Veterans Administration, out-of-state Medicaid, and Medicaid eligibility and enrollment claims. Founded in 2014, VHP aims to commit equity investments ranging from $20 million to $60 million.

Medicaid 52

Medicaid Medicaid 52

Med-Net Compliance

JULY 20, 2022

A federal jury convicted a New York ENT doctor for defrauding Medicare and Medicaid by causing the submission of false and fraudulent claims for surgical procedures that were not performed. Specifically, between January 2014 and February 2018, the doctor billed Medicare and Medicaid approximately $585,000 and was paid approximately $191,000.

Fraud 59

Fraud Doctors Medicare Medicare 59

Healthcare IT Today

APRIL 21, 2023

Funding Will Grow Medication Adherence Services for Medicaid and Other Under-Resourced Populations Scene Health , the leading medication engagement company, has closed an oversubscribed $17.7 This financing brings the total investment in Scene to over $25 million since its founding in 2014.

Medicaid 64

Medicaid Medicaid Medicare Medicare 64

The Health Law Firm

JANUARY 13, 2014

Board Certified by The Florida Bar in Health Law The Centers for Medicare and Medicaid Services (CMS) is proposing to exclude providers from Medicare if the government determines a pattern of abusive prescribing practices of Medicare Part D drugs. CMS described these efforts on January 6, 2014, in a proposed rule. Indest III, J.D.,

Medicare 40

Medicare Medicare Medicaid Medicaid 40

VW Health Care Law Blog

NOVEMBER 9, 2016

The Centers for Medicare and Medicaid Services finalized a rule in March 2014 that required healthcare providers prescribing medication, where the prescription is paid for by a Medicare Part D plan, to enroll in Medicare as a prescriber.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

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 six-month moratorium began January 31, 2014. Indest III, J.D., Click here to read the press release from CMS.

Fraud 40

Fraud Medicaid Medicaid Medicare 40

HIPAA Journal

JULY 3, 2024

Indeed, many of the classification systems that would eventually be adopted as the HIPAA transactions and code sets rules were already mandated for use in some federal and state healthcare programs – including Medicare and Medicaid. Health Plan Premium Payments. Coordination of Benefits.

HIPAA 58

HIPAA Medicaid Medicaid Compliance 58

The Health Law Firm

APRIL 4, 2014

The Health Law Firm On February 28, 2014, the Centers for Medicare and Medicaid Services (CMS) issued its revised emergency preparedness checklist for health care facility planning. By Lenis L. Archer, J.D.,

Medicaid 40

Medicaid Medicaid Medicare Medicare 40

HIPAA Journal

SEPTEMBER 11, 2023

In 2016, a media outlet reported that members of the health plan were able to access the protected health information (PHI) of other members via the online member portal over a 2-day period in 2014 due to a manual processing error. OCR informed L.A. Care Health Plan it had initiated a compliance review and in February 2016, L.A. The post L.A.

HIPAA 79

HIPAA Compliance Medicaid Medicaid 79

The Health Law Firm

JUNE 6, 2014

Under a rule finalized by the Centers for Medicare and Medicaid Services (CMS) on May 19, 2014, doctors and other health care professionals will be required to enroll in the Medicare program, or have a valid opt-out affidavit on file, for prescriptions to be covered under Part D. By Lance O. Leider, J.D., The Health Law Firm.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Health Populi

MARCH 22, 2022

Cancer patients living in state that had not yet or only recently expanded Medicaid also were more likely to report medical debt and being less prepared for the costs of cancer care. As with many aspects of U.S. The CFPB report also examined households with all medical debt by race and ethnic origin of the householder.

COVID-19 71

COVID-19 Medicaid Medicaid Medical Billing 71

The Health Law Firm

APRIL 21, 2014

Board Certified by The Florida Bar in Health Law For years, the Centers for Medicare and Medicaid Services (CMS) kept private its records on Medicare reimbursement payments made to physicians, however, on April 9, 2014, that all changed. Indest III, J.D.,

Medicare 40

Medicare Medicare Medicaid Medicaid 40

The Health Law Firm

JUNE 4, 2014

A final rule released by the Centers for Medicare and Medicaid Services on May 19, 2014, requires health care providers to enroll in the Medicare program, or have a valid opt-out affidavit on file, for prescriptions to be covered under Part D. Leider, J.D.,

Medicare 40

Medicare Medicare Medicaid Medicaid 40

The Health Law Firm

DECEMBER 11, 2014

Board Certified by The Florida Bar in Health Law Stop me if you've heard this one before: the Centers for Medicare and Medicaid Services (CMS) recently increased Medicare's authority over physicians and other health care providers. On December 3, 2014, CMS released these new anti-fraud measures. Indest III, J.D.,

Medicare 40

Medicare Medicare Fraud Medicaid 40

The Health Law Firm

SEPTEMBER 18, 2017

The charges allege embezzling more than $500,000 of the clinic's money and diverting it to her personal account, from approximately August through September of 2014. Much of the money came from reimbursement the clinic received from the state's Medicaid program. The Investigation.

Fraud 40

Fraud Medicaid Medicaid 40

Healthcare Law Blog

FEBRUARY 1, 2023

On January 30, 2023 , the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”). One thing that is certain, CMS can expect further challenges to its RADV audit methodology. See also Ratanasen v.

Medicare 105

Medicare Medicare Overpayments Overpayment 105

HIT Consultant

APRIL 20, 2022

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. Analysts looked at the health care costs of individuals enrolled in commercial insurance, Medicare, and Medicaid in the United States.

Medicare 98

Medicare Medicare Telemedicine Medicaid 98

Med-Net Compliance

AUGUST 16, 2022

In addition, from in and around June 2014 to in and around June 2021, the CEO conspired with two regional-level employees and others to commit healthcare fraud. Billing Medicare or Medicaid for services that were not provided is fraudulent activity that is often punishable by fines and imprisonment.

Fraud 59

Fraud Nurses Medicaid Medicaid 59

HIT Consultant

AUGUST 20, 2024

This is especially true among Medicaid enrollees, who report more problems with prior authorization and provider availability compared to people with other insurance types, and are less likely than their peers to describe their own health as “excellent.” Member engagement is foundational to all of these goals.

Medicaid 64

Medicaid Medicaid Health Outcomes Doctors 64

Health Populi

AUGUST 24, 2018

The line chart come from a new study into Multimorbidity Trends in United States Adults, 1988-2014 , published in the July-August 2018 issue of the Journal of the American Board of Family Medicine. ” Unless this trajectory reverses, multimorbidity trends will continue to drive up healthcare costs in the U.S.

Public Health 72

Public Health Doctors Medicaid Medicaid 72