Medisys Compliance

JANUARY 20, 2022

The Centers for Medicare & Medicaid Services (CMS) recognizes that CCM services are critical components of primary care that promote better health and reduce overall health care costs. Billing Guidelines for Medicare Chronic Care Management. Practitioner and Patient’s Eligibility.

Medicare 52

Medicare Medicare Medical Billing Outsourcing Medical Billing 52

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

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. MACRA replaced the previously used Sustainable Growth Rate (SGR) formula for Medicare physician payments.

Medical Billing Outsourcing 64

Medical Billing Outsourcing Medical Billing Medicare Medicare 64

Bill of Health

NOVEMBER 17, 2022

Medicare’s National Coverage Determination for Aducanumab – A One-Off or a Pragmatic Path Forward? Association Between US Drug Price and Measures of Efficacy for Oncology Drugs Approved by the US Food and Drug Administration From 2015 to 2020. Medicaid Spending on Antiretrovirals from 2007-2019. N Engl J Med.

FDA 190

FDA World Health Medicaid Medicaid 190

Health Care Law Brief

APRIL 3, 2023

On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ( Rate Announcement ). 1395w-23): Medicare Advantage Organizations (MAOs) are paid a base rate by CMS. Risk Adjustment.

Medicare 52

Medicare Medicare Overpayments Overpayment 52

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 58

HIPAA Medicaid Medicaid Compliance 58

HIT Consultant

JUNE 25, 2024

Researchers analyzed data from over 22,000 patients with newly diagnosed HCC between 2015 and 2018. The registry offers a de-identified dataset encompassing Medicare, Medicaid, commercially insured, and Medicare Advantage patients.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

The Health Law Firm

SEPTEMBER 12, 2016

The health care industry has found a similar success in recent years, as federal agents use data mining, predictive analytics, and other modeling approaches to catch Medicare fraud. Medicare Strike Force Enhanced to Reduce Billion-Dollar Losses.

Medicare 40

Medicare Medicare Fraud Medicaid 40

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.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

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. That is how you collect $4.1

Fraud 52

Fraud Compliance Medicaid Medicaid 52

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-19 148

COVID-19 Medicaid Medicaid FDA 148

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

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

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 103

Medicare Medicare Governance Health Insurance 103

CMS.gov

MARCH 2, 2018

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program. Jeremy.Booth@c…. Fri, 03/02/2018 - 16:30. Kate Goodrich, M.D., Director, CMS Center for Clinical Standards and Quality & CMS Chief Medical Officer. Billing & payments. Initiatives. Leadership.

Medicare 20

Medicare Medicare Patient Advocacy Medicaid 20

Med-Net Compliance

SEPTEMBER 20, 2022

million scheme to defraud Medicare by billing for services under another doctor’s name after Medicare revoked his privileges to participate in the program. According to court documents and evidence presented at trial, the podiatrist was revoked from participating in the Medicare program in January 2015.

Fraud 59

Fraud US Department of Health and Human Services Medicare Medicare 59

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 110

Medicaid Medicaid COVID-19 Telemedicine 110

Compliancy Group

OCTOBER 5, 2023

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law to improve patient healthcare outcomes. Under MACRA, the Centers for Medicare and Medicaid Services (CMS) created regulations to encourage healthcare providers to use secure health information technology. What Are the MIPS Rules for 2023?

HIPAA 52

HIPAA Medicare Medicare Compliance 52

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. A large part of what the OIG does is review and investigate Medicare claims for overpayment.

Overpayments 40

Overpayments Overpayment Medicare Medicare 40

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

Healthcare IT News - Telehealth

JULY 1, 2020

The VUC system had been in place since 2015, explained the team in the manuscript, with the goal of providing rapid access to care for low-risk clinical conditions.

COVID-19 213

COVID-19 Medicaid Medicaid Medicare 213

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. Most health care providers are already enrolled in Medicare. Leider, J.D.,

Medicare 40

Medicare Medicare Medicaid Medicaid 40

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

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

MedTrainer

JANUARY 12, 2024

Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation. MACRA (2015): The Medicare Access and CHIP Reauthorization Act (MACRA) introduced the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).

Compliance 52

Compliance HIPAA Telemedicine ACA 52

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

Provider Trust

JULY 26, 2023

The Centers for Medicare and Medicaid Services (CMS) conducted multiple reviews of Medicaid Advantage provider directories between February 2016 and July 2018. Their report from the third round of reviews found that of the 108 providers selected from 52 Medicare Advantage Organizations (MAO) directories, 48.7%

Medicaid 52

Medicaid Medicaid Compliance Medicare 52

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

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 83

Fraud FDA Medicaid Medicaid 83

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

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

Hall Render

APRIL 6, 2022

However, some of the defendant’s customers typically paid less than the retail price for their medications through several discount programs that the defendant offered between 2006 and 2015. Subsequently, it was incorporated into the CMS’s Medicare Prescription Drug Benefit Manual (“Manual”) in December of 2006.

Medicare 72

Medicare Medicare Medicaid Medicaid 72

MedTrainer

MARCH 3, 2021

The Physician Quality Reporting System (PQRS) was first introduced over a decade ago by the Centers for Medicare and Medicaid Services (CMS) as a quality reporting program. In 2015, the reporting program shifted from a voluntary program to a mandatory one in which penalties would be assessed for failure to participate.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

HIT Consultant

APRIL 12, 2022

Second, the number of unpaid family caregivers in the United States increased by nearly 10 million people between 2015 and 2020 to 54 million. Through interpersonal communication and technology, DUOS identifies and addresses the individual needs of older adults by leveraging Medicare benefits, trusted partners, and local service providers.

Medicare 52

Medicare Medicare COVID-19 Health Insurance 52

CMS.gov

NOVEMBER 16, 2018

2018 Medicare Fee-For-Service improper payment rate is lowest since 2010. Administrator, Centers for Medicare & Medicaid Services. 2018 Medicare Fee-For-Service improper payment rate is lowest since 2010 Significant progress in saving $4.59B in estimated improper payments for the Medicare Fee-For-Service program.

Medicare 20

Medicare Medicare Overpayments Overpayment 20

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. Pennsylvania-based WellSpan Health selected Arcadia data analytics to supports its Medicare Shared Savings Program.

Hospitals 115

Hospitals Nurses Compliance Regulatory Compliance 115