Bill of Health

APRIL 25, 2022

Anticipated efficiencies, real costs: Medicaid managed care organizations and the pharmacy benefit. US Food and Drug Administration-mandated postmarketing studies for high-risk cardiovascular devices approved 2015-2019. A full posting of abstracts/summaries of these articles may be found on our website. Bendicksen L, Kesselheim AS.

COVID-19 147

COVID-19 Medicaid Medicaid FDA 147

The Health Law Firm

NOVEMBER 24, 2014

Through the 2015 Office of the Inspector General (OIG) Work Plan, the agency has revealed how it plans to carry out its mission to ensure the Medicare and Medicaid programs run more efficiently in the 2015 fiscal year. Smith, R.R.T.,

Medicaid 40

Medicaid Medicaid Medicare Medicare 40

HIPAA Journal

MARCH 6, 2023

The Department of Justice has announced one of its first prosecutions under the Medicare Access and CHIP Reauthorization Act of 2015 in a case involving the theft and sale of Medicare Beneficiary Identifiers.

Medicare 103

Medicare Medicare Fraud Medicaid 103

Healthcare Law Blog

MAY 16, 2022

More than 13 million people were enrolled in Medi-Cal in California in September 2021, making it the largest Medicaid program in the nation. In 2015, DHCS launched the WPC Pilots as part of its Medi-Cal 2020 Section 1115 Demonstration.

Medicaid 59

Medicaid Medicaid Nurses Health Care Access 59

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”). In states that have not expanded Medicaid, however, many postpartum women lose coverage.

Medicaid 52

Medicaid Medicaid ACA Public Health 52

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. million from non-extrapolated errors based for PYs 2011–2015, an estimated average of $8.2

Medicare 98

Medicare Medicare Overpayment Overpayments 98

HIPAA Journal

MARCH 20, 2025

The loss/theft of healthcare records and electronic protected health information dominated the breach reports between 2009 and 2015. MN Business Associate 190,000,000 Hacking/IT Incident 2 2015 Anthem Inc. There have been notable changes over the years in the main causes of breaches.

HIPAA 111

HIPAA Ransomware Compliance Hospitals 111

CMS.gov

NOVEMBER 16, 2018

Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report. Director, Medicare-Medicaid Coordination Office, Topic. Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report. Jeremy.Booth@c…. Fri, 11/16/2018 - 18:51. Tim Engelhardt. Innovation models.

Medicare 35

Medicare Medicare Medicaid Medicaid 35

The Health Law Firm

MAY 31, 2016

Board Certified by The Florida Bar in Health Law On May 9, 2016,Michael John Veit, 64, the former chief procurement officer for Arizona's state Medicaid program, was sentenced to 10 years in prison for his role in the fraud scheme that resulted in the theft of 5.9 Indest III, J.D., million dollars. The Original Fraud and Theft Charges.

Fraud 40

Fraud Medicaid Medicaid 40

Healthcare IT Today

OCTOBER 19, 2022

Beyond the fact that DotCom Therapy has been successfully delivering services since 2015, a review of two dozen studies in 2019 found that phone and video therapies were equally effective at treating conditions like anxiety, depression, and post-traumatic stress disorder as in-person therapy.

Medicaid 119

Medicaid Medicaid COVID-19 Telemedicine 119

C&M Health Law

APRIL 21, 2022

Department of Justice (DOJ) to resolve allegations that it had made donations in order to improperly inflate the funding four of its hospitals received from the federal Medicaid program. Florida Medicaid is administered by the state but jointly funded by both the state and federal governments.

Medicaid 52

Medicaid Medicaid Governance Fraud 52

Compliancy Group

DECEMBER 20, 2024

In May of 2015, the NYPD informed Montefiore Medical Center that there was evidence that patient information had been stolen from the hospitals database – leading Montefiore to investigate and discover that the theft had taken place two years earlier. flat fee to have the records mailed certified to her.

Ransomware 98

Ransomware HIPAA Fraud Electronic Medical Records 98

HIT Consultant

NOVEMBER 29, 2022

Beyond the fact that DotCom Therapy has been successfully delivering services since 2015, a review of two dozen studies in 2019 found that phone and video therapies were equally effective at treating conditions like anxiety, depression, and post-traumatic stress disorder as in-person therapy.

Medicaid 98

Medicaid Medicaid Telemedicine Governance 98

The Health Law Firm

NOVEMBER 21, 2014

This Work Plan is the general overview of how the OIG intends to carry out its mission to make the Medicare and Medicaid programs run more smoothly and efficiently in the following year. Smith, R.R.T., A large part of what the OIG does is review and investigate Medicare claims for overpayment.

Overpayment 40

Overpayment Overpayments Medicare Medicare 40

Healthcare IT Today

MAY 15, 2023

“Apixio has been a trusted business partner since our relationship began in 2015,” said Sarah M. With a patented data science infrastructure, Apixio analyzes structured and unstructured data to develop high-fidelity patient health profiles and support value-based care programs. London , Chief Executive Officer at Centene.

Medicare 109

Medicare Medicare Governance Health Insurance 109

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

HIT Consultant

NOVEMBER 11, 2021

Founded in 2015, AppliedVR provides virtual reality-based treatments aimed at comprehensively treating chronic pain. The research, published in the Journal for Medical of Internet Research (JMIR), studied how VR could be used for pain management in safety-net settings for vulnerable populations like Medicaid patients.

FDA 98

FDA COVID-19 Medicaid Medicaid 98

The Health Law Firm

NOVEMBER 17, 2015

The United States Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its 2016 Annual Work Plan (Work Plan) on November 2, 2015, with an effective date of October 1, 2015.

Fraud 40

Fraud Medicaid Medicaid Medicare 40

American Medical Compliance

JANUARY 9, 2024

Through Medicare, Medicaid, and the Children’s Health Insurance Program, the federal government and state governments offer health care coverage to nearly 100 million individuals. trillion in 2015. This type of theft is just one example of healthcare fraud.

Fraud 52

Fraud Medicare Medicare Compliance 52

HIPAA Journal

JANUARY 23, 2024

Carreyrou published the story in 2015 that revealed the company was using third-party technology rather than its own, as its own technology was inefficient. The HHS-OIG has the authority under 1128(a) of the Social Security Act to exclude individuals from participation in Medicare, Medicaid, and other Federal health care programs.

Fraud 91

Fraud FDA Medicaid Medicaid 91

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

Medisys Compliance

APRIL 25, 2024

Introduction The ever-evolving world of healthcare billing can feel complex, and with the introduction of MACRA (Medicare Access and CHIP Reauthorization Act) in 2015, cardiology practices have faced some adjustments. Reporting accurate data for cardiology-specific quality measures is crucial.

Medical Billing Outsourcing 64

Medical Billing Outsourcing Medical Billing Medicare Medicare 64

Hall Render

MARCH 4, 2025

Prior OIG Guidance According to the OIGs 2008 Memo entitled OIG Supplemental Compliance Program Guidance for Nursing Facilities (OIG 2008 Memo), contracts for physician services as medical director and quality assurance services must not offer anything of value in exchange for referrals of patients for Medicare or Medicaid services.

Compliance 52

Compliance Nursing Homes Nurses Medicare 52

Jane Sarashon

DECEMBER 30, 2024

My favorite example of this discovery happened at CES in 2015: that would make it a decade ago. Health Populi’s Hot Points: I leave time in my frenetic schedule at CES for serendipity to kick in. Every year, keeping eyes and ears wide open, I spot something adjacent or somehow influential on health or well-being.

FDA 52

FDA Medicare Medicare Medical Billing 52

HIT Consultant

OCTOBER 6, 2021

It doesn’t even take you to the Centers for Medicare & Medicaid Services (CMS) website. since 2015, according to a recent report. – About 23 percent of caregivers say caregiving has made their own health worse , up from 17 percent in 2015. Try Googling the word “caregiving.” In addition, President Biden’s $1.9

COVID-19 98

COVID-19 Doctors Health Outcomes Licensing 98

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. The new requirement takes effect on June 1, 2015.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

The Health Law Firm

NOVEMBER 4, 2015

entered into a settlement with the Department of Justice (DOJ) on Monday, October 19, 2015, agreeing to pay $256 million to resolve allegations of False Claims Act (FCA) violations. Indest III, J.D., Board Certified by The Florida Bar in Health Law Millennium Health (Millennium), formerly Millennium Laboratories, Inc.,

Medicaid 40

Medicaid Medicaid Medicare 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.

HIPAA 56

HIPAA Medicaid Medicaid Compliance 56

Health Care Performance

JULY 20, 2022

A New York ENT physician was convicted of filing false claims with Medicare and Medicaid. The physician submitted claims totaling about $585,000 to Medicare and Medicaid and was paid roughly $191,000. million in fraudulent payments between 2015 and 2021. Well, it turns out that the scheme was, shall we say, creative.

Fraud 52

Fraud Compliance Medicaid Medicaid 52

The Health Law Firm

MARCH 8, 2016

Board Certified by The Florida Bar in Health Law On February 26, 2016, The Centers for Medicare & Medicaid Services (CMS) extended the deadline for eligible hospitals/professionals and critical access hospitals to apply for a hardship exception from the 2015 Medicare Electronic Health Records Incentive Program. Indest III, J.D.,

Medicare 40

Medicare Medicare Medicaid Medicaid 40

The Health Law Firm

SEPTEMBER 12, 2016

In 2015, the Centers for Medicare and Medicaid Services (CMS) estimated that nearly $60 billion in taxpayer money was lost to fraud, abuse, waste, and improper payments. Medicare Strike Force Enhanced to Reduce Billion-Dollar Losses.

Medicare 40

Medicare Medicare Fraud Medicaid 40

Healthcare IT Today

DECEMBER 17, 2023

Though this is a significant increase from 2012, numbers haven’t budged much since 2015. Pair Team expanded into seven more California counties ; the company provides virtual primary care for Medicaid beneficiaries. Home care EMR software maker Smartcare Software rebranded as Aaniie.

Hospitals 95

Hospitals Nurses Compliance Regulatory Compliance 95

The Health Law Firm

JUNE 4, 2014

The Health Law Firm On June 1, 2015, doctors and other health care providers will be under tighter restrictions when prescribing to Medicare Part D patients. By Lance O. Leider, J.D.,

Medicare 40

Medicare Medicare Medicaid Medicaid 40

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

HIT Consultant

DECEMBER 20, 2021

Founded in 2015, Equality Health is a population health risk management company that improves care delivery for underserved populations. Reimagining the New Frontier of Value-Based Care.

ACA 52

ACA Medicaid Medicaid Medicare 52

Health Populi

AUGUST 5, 2019

” All 50 state Medicaid agencies have adopted some coverage for telehealth, with 10 states not advancing coverage since 2017. There’s a move among state Medicaid programs to migrate from traditional hub-and-spoke models of care, with 29 states not specifying a specific patient setting for payment.

Telemedicine 82

Telemedicine Doctors Medicaid Medicaid 82

Compliancy Group

NOVEMBER 16, 2022

In 2015, legislation known as the Medicare Access and CHIP Reauthorization Act (MACRA) was enacted. Under MACRA, the Centers for Medicare and Medicaid Services created regulations for healthcare providers’ use of health information technology. healthcare system since 2010’s Affordable Care Act.

Medicare 52

Medicare Medicare HIPAA Medicaid 52