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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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.,

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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.

Medicare 52

Medicare Medicare Overpayments Overpayment 52

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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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

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. 2022 Oct 5;379:e071752. Dhruva SS, Ramachandran R, Ross JS. N Engl J Med.

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FDA World Health Medicaid Medicaid 190

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

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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Medicare Medicare Fraud Medicaid 40

The Health Law Firm

JANUARY 14, 2016

Board Certified by The Florida Bar in Health Law President Obama executed a new law on December 28, 2015, which will significantly impact Medicare. The recently enacted law, the Patient Access and Medicare Protection Act, includes a number of Medicare provisions not included in the Consolidated Appropriations Act.

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Medicare Medicare 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.

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Medicare Medicare Medicaid Medicaid 40

McGuire Wood

OCTOBER 19, 2022

Frontpoint is a home health and hospice platform focused primarily on servicing Medicare Advantage patients in the Texas market. Founded in 2015, the firm typically invests between $10 million and $30 million per transaction.

Medicare 52

Medicare Medicare 52

The Health Law Firm

JUNE 22, 2015

Board Certified by the Florida Bar in Health Law and Shelby Root The largest criminal health care fraud takedown in the history of the US Justice Department, in terms of both loss amount and arrests, took place June 18, 2015. Indest III, J.D.,

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Fraud Medicare Medicare Licensing 40

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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Medicare Medicare Medicaid Medicaid 52

Med-Net Compliance

JULY 27, 2022

On behalf of the agencies, they certified to Medicare that they would not pay kickbacks in exchange for Medicare beneficiary referrals to the agencies. In total, the agencies submitted over 8,000 claims to Medicare for the cost of home healthcare and hospice services. Of that amount, Medicare paid the agencies at least $2?million

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Medicare Medicare Nurses Fraud 59

CMS.gov

JANUARY 6, 2020

In 2015, Congress passed the Medicare Access and CHIP Reauthorization Act – or MACRA. In an attempt to streamline multiple quality programs for physicians, the law created the Merit Based Incentive Payments System (MIPS).

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Payment Systems Medicare Medicare 62

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

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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Medicare Medicare HIPAA Medicaid 52

HIT Consultant

JULY 31, 2023

Founded by Chief Medical Officer Dr. Somi Javaid in 2015, HerMD has been revolutionizing the future of women’s healthcare through an integrated, evidence-based model delivering comprehensive women’s healthcare all under one roof. All appointments last between 20 and 60 minutes and all medical services are insurance and Medicare based.

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Medicare Medicare 52

The Health Law Firm

DECEMBER 15, 2015

Board Certified by The Florida Bar in Health Law On Thursday, December 10, 2015, 24-year-old, Daniel Suarez, was sentenced to nine years in prison and ordered to pay nearly $21 million in restitution by US District Judge Donald Middlebrooks, for his alleged leading role in a Medicare fraud scheme in Miami, Florida. Indest III, J.D.,

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Fraud Medicare Medicare 40

HIT Consultant

JUNE 21, 2023

Additionally, Aledade is continuing its momentum by welcoming two new members of its Board of Directors and a senior executive to lead its Medicare Advantage business. From 2011 to 2015, Paul served as chief marketing officer of Booking.com. Dr. Efrem Castillo joins Aledade as senior vice president for Medicare Advantage.

Medicare 52

Medicare Medicare 52

The Health Law Firm

AUGUST 18, 2015

Board Certified by The Florida Bar in Health Law On July 14, 2015, Ann Maxwell, Assistant Inspector General for Evaluation and Inspections of the Office of Inspector General (OIG), US Department of Health and Human Services (HHS), gave testimony to Congress on the Medicare Part D Program. Indest III, J.D.,

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US Department of Health and Human Services Medicare Medicare Fraud 40

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

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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Medicare Medicare Governance Health Insurance 103

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

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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Overpayments Overpayment Medicare Medicare 40

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

OCTOBER 8, 2015

million scheme to defraud Medicare will spend the next five years behind bars. The pair pleaded guilty on June 24, 2015, before United States District Judge Paul G. Indest III, J.D., Board Certified by The Florida Bar in Health Law An Orlando health care clinic owner who engaged in a $2.4 Byron of the Middle District of Florida.

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Fraud 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.

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HIPAA Medicaid Medicaid Compliance 58

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

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. Fraudulent documentation was submitted in response to Medicare audits.

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Fraud Compliance Medicaid Medicaid 52

Healthcare IT Today

JULY 10, 2023

Company Adds Two Board Members and a Senior Executive to Lead its Medicare Advantage Business Aledade , the largest network of independent primary care practices in the country, today announced the closing of a $260 million Series F funding round to enhance and acquire services and technology to support its practices.

Medicare 52

Medicare Medicare Health Outcomes 52

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

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.

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Overpayments Overpayment ACA Medicare 52

Healthcare IT Today

AUGUST 26, 2022

When VBC programs were expanded as part of the Affordable Care Act in 2010 and the Medicare Access and CHIP Reauthorization Act (MACRA) in 2015, there was hope that the existing fee-for-service model would begin to decline.

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Health Outcomes Medicare Medicare 104

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).

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Compliance HIPAA Telemedicine ACA 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.

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COVID-19 Medicaid Medicaid Medicare 213

Bill of Health

APRIL 25, 2022

US Food and Drug Administration-mandated postmarketing studies for high-risk cardiovascular devices approved 2015-2019. Clin Pharmacol Ther. 2022 Mar 16. Epub ahead of print. Hidano D, Dhruva SS, Redberg RF. JAMA Intern Med. 2022 Mar 14:e220184. Epub ahead of print.

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