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.,

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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.

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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.

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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”). This option is available for five years and ends on March 31, 2027.

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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.

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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.

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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.

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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.

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Hall Render

MARCH 4, 2025

SNF services covered by the Medicare Part A Skilled Nursing Prospective Payment System (PPS) payment are not designated health services (DHS) for purposes of the PSL. When the services are DHS for purposes of the PSL (e.g.,

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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.

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Health Populi

JUNE 18, 2020

Kesselheim, are affiliated with the London School of Economics and Brigham and Women’s Hospital in Boston, note that 1% of medicines dispensed under Medicare Part D and Medicaid accounted for nearly $1 in $3 of drug spending in each program in 2015. bn between 2019 and 2015 (Part D) and from $4.8 bn for Medicaid.

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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.

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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.

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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.

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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.

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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.,

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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.

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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.

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Medical Billing Outsourcing Medical Billing Medicare Medicare 64

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.

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American Medical Compliance

JANUARY 9, 2024

When someone uses your personal information, such as your name, Social Security number, or Medicare number, to make false claims to Medicare and other health insurers without your consent, it is known as medical identity theft. trillion in 2015. This wastes taxpayer money and interferes with your medical care.

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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.

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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.

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HIT Consultant

APRIL 20, 2022

Since the passage of the Medicare Improvements for Patients & Providers Act in 2008, the U.S. 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. Tom Zaubler, MD, Chief Medical Officer of NeuroFlow.

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HIPAA Journal

OCTOBER 21, 2022

However, in 2015, Congress partially relented its stance by passing the Medicare Access and CHIP Reauthorization Act which requires the Centers for Medicare and Medicaid to remove Social Security Numbers from Medicare cards and replace them with Medicare Beneficiary Numbers. billion and $11.5

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HIPAA Compliance Medicare Medicare 107

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.

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Fraud US Department of Health and Human Services Medicare Medicare 59

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

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Fraud Compliance Medicaid 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.

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Nursing Homes Nurses Compliance 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.

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Fraud FDA Medicaid Medicaid 91

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

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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.

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Medicare Medicare Medicaid Medicaid 72

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.

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HIPAA Medicaid Medicaid Compliance 56

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.

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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.,

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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.

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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.

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HIT Consultant

DECEMBER 30, 2021

A few years ago, Pew Research projected that 10,000 men and women would be retiring each day which would double Medicare and Medicaid costs by 2020. Well, 2020 happened and if there was the beginning of a Baby Boomer Medicare surge, nobody even noticed it.

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Healthcare IT Today

APRIL 10, 2023

Uncle Roy spent years on dialysis and passed away after having a stroke in 2015. Notably, our payer clients have measured drastic savings to medical costs by preventing hospitalizations and ED visits, and we’ve helped Medicare Advantage plans achieve higher Star ratings.

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