HIT Consultant

MAY 24, 2023

With an anticipated dramatic rise of Americans diagnosed with AD approaching, broad changes to Medicare are needed. While Medicare and other sources of financial assistance may cover some of these costs, they won’t cover it all, leaving individuals with AD or other dementias and their families with high out-of-pocket costs.

Medicare 97

Medicare Medicare FDA Governance 97

Healthcare Compliance Blog

FEBRUARY 8, 2022

The complaint alleges that an Alabama psychiatrist caused the submission to Medicare and Medicaid of false and fraudulent claims for the prescription drug Nuedexta. From 2015 through 2019, the pharmaceutical company that manufactures Nuedexta paid the Alabama psychiatrist more than $400,000 to make speeches about Nuedexta.

Nursing Homes 52

Nursing Homes Nurses Compliance Medicare 52

Hall Render

APRIL 6, 2022

Turning to the present case, in Safeway , the relator alleged that the defendant engaged in the submission of false claims to the government when it “reported its ‘retail’ price for certain drugs as its ‘usual and customary’ price.” This footnote originated as a footnote in a memorandum issued by CMS in October of 2006. Practical Takeaways.

Medicare 72

Medicare Medicare Medicaid Medicaid 72

Healthcare Law Today

JANUARY 2, 2023

” The currently proposed provision has similar effect to the language CMS proposed in 2012 and, after consideration of comments, ultimately rejected in the 2014 Final Rule (Medicare Advantage and Part D) and 2016 Final Rule (Medicare Part A and Part B). ” United States ex rel. Healthfirst, Inc. , 3d 370, 389 (S.D.

Overpayments 52

Overpayments Overpayment ACA Medicare 52

Kaiser Health News

JANUARY 19, 2022

” The changes are part of a 400-page proposed rule governing the federal health insurance marketplace and a few states that use the federal platform for their own exchanges. The new broker provision aims to deter fraudulent sign-ups by clarifying that applicants must attest that the income projections listed are correct.

ACA 80

ACA Health Insurance Licensing Governance 80

Healthcare IT Today

JULY 19, 2022

Additionally, with this certification, Canvas customers are now eligible for value-based payment models in Medicare and Medicaid programs, as well as many commercial value-based programs. . Founded in 2015, Canvas is reimagining the EMR for the future of healthcare. About Canvas Medical.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Health Law Advisor

FEBRUARY 3, 2022

According to DOJ’s statistics, the government paid out $238 million to relators in FY 2021, the lowest number since FY 2008. As it relates to the health care and life sciences industries, the $452 million collected in FY 2021 is the largest recovery since FY 2015 and the second largest recovery in reported history. KEY TAKEAWAYS.

Fraud 52

Fraud COVID-19 Governance Medicare 52

MedTrainer

JANUARY 12, 2024

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation. What is Healthcare Compliance?

Compliance 52

Compliance HIPAA Telemedicine ACA 52

HIT Consultant

JULY 18, 2022

Founded in 2015, Canvas Medical provides the digital infrastructure for care delivery companies. Additionally, with this certification, Canvas customers are now eligible for value-based payment models in Medicare and Medicaid programs, as well as many commercial value-based programs. Strategic Plans & Milestones.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIT Consultant

JUNE 5, 2024

The Affordable Care Act of 2010 (ACA) and the Medicare Access and CHIP Reauthorization Act of 2015 put providers on notice that quality of care measures, like reducing hospital readmissions and improving patient outcomes, would take precedence over fee-for-service models.

Nurses 52

Nurses Medicare Medicare Hospitals 52

Jane Sarashon

JUNE 10, 2024

We are all payers now, whether employers, government plans, unions and collectives, or patients-as-payers. More granularly, we’ll also be looking deeper into the future of Medicare (esp. Value-based care will be a big topic at AHIP 2024 with examples and case studies shared.

Health Insurance 59

Health Insurance Ransomware Hospitals Doctors 59

AIHC

NOVEMBER 6, 2023

government introduced the 21st Century Cures Act, which builds upon the HITECH Act and aims to promote innovation in HIT and improve patient access to healthcare services. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) is the government enforcement agency over both HIPAA and HITECH. In 2020, the U.S.

HIPAA 59

HIPAA Compliance Governance Health Insurance 59

The Digital Health Corner

OCTOBER 28, 2016

The Physician Quality Reporting System (PQRS) has been used since 2015 as a metric to determine negative Medicare payment adjustments to providers who do not meet quality standards. I will discuss below some of the most useful applications of such exemplary registries. Provide real-world data for regulators.

FDA 60

FDA Medicare Medicare Governance 60

Healthcare IT News - Telehealth

DECEMBER 16, 2020

As the pandemic experience varies at different times across different regions of the country, local partnerships between healthcare providers, payers, community groups and government agencies can help power a more informed response, it added. “A CEO flight simulator relies on advanced analytics and modeling,” the report read.

COVID-19 218

COVID-19 Hospitals Doctors Health Insurance 218

MedTrainer

OCTOBER 11, 2024

As you may have discovered (hopefully not the hard way), meeting the basic requirements set forth by the Centers for Medicare and Medicaid (CMS) and OSHA should be a bare minimum. To truly be prepared with a multi-hazard approach, you should conduct risk assessments and use all the tools and resources available to you.

Compliance Officers 52

Compliance Officers Compliance Medicaid Medicaid 52

Verisys

NOVEMBER 14, 2023

A healthcare facility’s accountability and overall reputation are dependent upon rigorous credentialing processes compliant with governing regulatory bodies, such as the National Committee for Quality Assurance. It is critical for hospitals and health systems to know that everyone on the staff is compliant and in good standing at all times.

Licensing 52

Licensing Medicaid Medicaid Governance 52

Verisys

JANUARY 18, 2022

A healthcare facility’s accountability and overall reputation are dependent upon rigorous credentialing processes compliant with governing regulatory bodies, such as the National Committee for Quality Assurance. ISO 9001:2015 (quality management). Utilization Review Accreditation Commission (URAC) accredited.

Licensing 52

Licensing Medicaid Medicaid Governance 52

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”). 2] Black women have a maternal mortality rate 3.3 31, 2022). [2] 2] Emily E. Peterson, et.

Medicaid 52

Medicaid Medicaid ACA Public Health 52

AIHC

NOVEMBER 6, 2023

government introduced the 21st Century Cures Act, which builds upon the HITECH Act and aims to promote innovation in HIT and improve patient access to healthcare services. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) is the government enforcement agency over both HIPAA and HITECH. In 2020, the U.S.

HIPAA 52

HIPAA Compliance Governance Health Insurance 52

The Digital Health Corner

JUNE 14, 2017

According to most recent statistics from the Office of the National Coordinator, use of EHRs has increased from 20% in 2004 to 87% in 2015. I’d like to discuss what I believe are five areas of significant opportunity for quality technologies. EHRs were designed as documentation centers for billing and regulatory purposes.

Patient Satisfaction 87

Patient Satisfaction Hospitals FDA Governance 87

Healthcare Law Blog

NOVEMBER 21, 2022

Pharmaceutical manufacturers are challenging the breadth of the Federal Anti-Kickback Statute (“AKS”) in federal court, arguing that the government is harming the very vulnerable patients it aims to serve by prohibiting cost-sharing subsidies for life-saving oncology drugs. and $500.39. [4].

Medicare 52

Medicare Medicare Governance Medicaid 52

Hall Render

JULY 25, 2023

At first glance, different outcomes based on the same type of APP support program suggest contradictory views from the government. The settlement arose out of a case initially filed in 2015 by a whistleblower who worked at the hospital involved in the settlement.

Compliance 40

Compliance Hospitals Governance Doctors 40

Hall Render

JANUARY 21, 2022

In 2015, the plaintiff’s application for reappointment and for medical staffing privileges was rejected by the Hospital. Plaintiff alleged that his application for reappointment and for medical staff privileges was rejected in retaliation for his “whistleblowing” to the federal government. JCC vote) took place.

Hospitals 40

Hospitals Medicare Medicare Governance 40

MedTrainer

MARCH 28, 2024

Establishes a governance structure, reviews compliance reports, and ensures the organization operates ethically and within legal boundaries. Law by law, regulations were added, increasing the complexity of maintaining compliance for healthcare organizations. Cons: Limited focus on other aspects of compliance beyond their specific areas.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

Provider Trust

JULY 26, 2022

This resulted in the practice submitting at least $147,000 in fraudulent claims for reimbursement to Medicare and numerous private insurance companies. In order for a person to perform certain services, state laws govern whether a state-issued license or certification is required. So, how could this situation have been avoided?

Licensing 52

Licensing Fraud Compliance Nurses 52

Redox

DECEMBER 4, 2020

Immunization information systems (IIS) have received special focus as part of government health initiatives (Meaningful Use 1 and 2), so every state has one or more: More accurate information about the number of distinct IIS in the US: [link] — Lisa Bari (she/her/hers) (@lisabari) November 17, 2020. The government thought the same.

Public Health 52

Public Health Governance Doctors Medicare 52

Health Law RX

JULY 18, 2023

This partnership will involve, among other things, referring violations to other agencies for other regulatory considerations, such as the HHS Office for Civil Rights, the Federal Trade Commission, the Centers for Medicare and Medicaid Services, or the Department of Justice. What would such collaboration look like?

Fraud 52

Fraud Compliance Medicaid Medicaid 52

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. Cliff ERS, Kesselheim AS, Rome BN, Feldman WB.

Pharmaceutical Industry 162

Pharmaceutical Industry Medicare Medicare Medicaid 162

Health Blawg

MARCH 5, 2018

He’s the co-author of O’Reilly’s first health IT book, Hacking Healthcare, and the 2015 recipient of the Healthcare Data Liberator of the Year award. News, NPR, Government Health IT, and Modern Healthcare. News, NPR, Government Health IT, and Modern Healthcare.

Governance 113

Governance Medicare Medicare Hospitals 113

Health Blawg

MARCH 5, 2018

He’s the co-author of O’Reilly’s first health IT book, Hacking Healthcare, and the 2015 recipient of the Healthcare Data Liberator of the Year award. News, NPR, Government Health IT, and Modern Healthcare. News, NPR, Government Health IT, and Modern Healthcare.

Governance 60

Governance Ransomware Medicare Medicare 60

Health Blawg

MARCH 5, 2018

He’s the co-author of O’Reilly’s first health IT book, Hacking Healthcare, and the 2015 recipient of the Healthcare Data Liberator of the Year award. News, NPR, Government Health IT, and Modern Healthcare. News, NPR, Government Health IT, and Modern Healthcare.

Governance 60

Governance Ransomware Medicare Medicare 60

Health Blawg

MARCH 5, 2018

He’s the co-author of O’Reilly’s first health IT book, Hacking Healthcare, and the 2015 recipient of the Healthcare Data Liberator of the Year award. News, NPR, Government Health IT, and Modern Healthcare. News, NPR, Government Health IT, and Modern Healthcare.

Governance 60

Governance Ransomware Medicare Medicare 60

Health Blawg

MARCH 5, 2018

He’s the co-author of O’Reilly’s first health IT book, Hacking Healthcare, and the 2015 recipient of the Healthcare Data Liberator of the Year award. News, NPR, Government Health IT, and Modern Healthcare. News, NPR, Government Health IT, and Modern Healthcare.

Governance 60

Governance Medicare Medicare Hospitals 60

Health Blawg

MARCH 5, 2018

He’s the co-author of O’Reilly’s first health IT book, Hacking Healthcare, and the 2015 recipient of the Healthcare Data Liberator of the Year award. News, NPR, Government Health IT, and Modern Healthcare. News, NPR, Government Health IT, and Modern Healthcare.

Governance 60

Governance Medicare Medicare Hospitals 60

Healthcare IT Today

DECEMBER 22, 2023

A STAT investigation found that clinical employees were pressured to follow an algorithm that predicts a patient’s length of stay under the guise of denying payments to people in Medicare Advantage plans. Internal documents showed that a quota was in place to limit patient rehab stays to within 1% of the days projected by the algorithm.

US Department of Health and Human Services 122

US Department of Health and Human Services Nurses Informed Consent Doctors 122

Hall Render

JANUARY 3, 2025

in Medicare fraud settlement 10 behavioral health policy changes taking effect in 2025 An uncertain era for Stark law: 12 updates in 2024 CMS launches campaign to support nursing home staffing rule CMS taps 4 states for behavioral innovation model: 5 things to know Epic files to dismiss antitrust lawsuit Healthcare company to pay $15.2

Nursing Homes 40

Nursing Homes Fraud Nurses Hospitals 40

Hall Render

DECEMBER 22, 2023

health care spending hits $4.5 approval for obstetrics services in Prince George’s County Maryland health system gets state OK for $300M labor, delivery unit Maryland hospitals must pay back millions to poor patients.

Nursing Homes 40

Nursing Homes Nurses COVID-19 Hospitals 40