CMS.gov

NOVEMBER 16, 2018

Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report. Director, Medicare-Medicaid Coordination Office, Topic. Medicare Parts A & B. Washington Managed Fee-for-Service Demonstration: 2015 and 2016 Medicare Actuarial Savings Report. Jeremy.Booth@c…. Tim Engelhardt.

Medicare 35

Medicare Medicare Medicaid Medicaid 35

Med Law Blog

FEBRUARY 8, 2024

Penn State Health has agreed to pay $11,712,336 to settle allegations of civil liability from submitting improper claims to Medicare for Annual Wellness Visit services.

Medicare 59

Medicare Medicare 59

Healthcare It News

MARCH 18, 2022

Virtual visits were selected five times more often for anxiety and depression complaints than in-person – and this was for pre-pandemic encounters between 2015 and 2017. Compared with Medicare or other populations, Medicaid patients often have more complex social determinants of health and can cycle in and out of beneficiary status.

Medicaid 362

Medicaid Medicaid COVID-19 Telemedicine 362

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 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

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

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.

Ransomware 98

Ransomware HIPAA Fraud Electronic Medical Records 98

HealthIT Answers

MAY 12, 2024

Hacker - At least two-thirds of Medicare enrollees have two or more chronic health conditions, federal data shows. That makes them eligible for a federal program that, since 2015, has rewarded doctors for doing more to manage their health outside office visits. By Phil Galewitz & Holly K.

Doctors 59

Doctors Medicare Medicare 59

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.,

Compliance 52

Compliance Nursing Homes Nurses Medicare 52

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.

Medicare 40

Medicare Medicare 40

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).

Payment Systems 62

Payment Systems Medicare Medicare 62

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

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.,

Fraud 40

Fraud Medicare Medicare Licensing 40

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

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

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.

COVID-19 147

COVID-19 Medicaid Medicaid FDA 147

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

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

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.,

Fraud 40

Fraud Medicare Medicare 40

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.

Health Outcomes 110

Health Outcomes Medicare Medicare 110

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.,

US Department of Health and Human Services 40

US Department of Health and Human Services Medicare Medicare Fraud 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

Health Populi

JUNE 1, 2021

While Apple product purchases in 2015 were. We can look to Medicare Advantage programs in the current landscape of health care payment: these plans and “payviders” have an incentive to adopt useful tech that helps people care for themselves at home and on-the-go, and there are examples of plans doing just that.

COVID-19 138

COVID-19 Elder Care Telemedicine Doctors 138

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

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

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.

Fraud 40

Fraud Medicare Medicare 40

Health Populi

MAY 20, 2021

now, looking at health citizens’ trust in five segments of the health care industry between 2015 and 2021. to approve Medicare’s negotiation of drug prices with pharmaceutical companies]. to approve Medicare’s negotiation of drug prices with pharmaceutical companies]. Let’s focus in on the U.S.

COVID-19 127

COVID-19 COVID-19 Vaccine Health Insurance Medicare 127

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

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

Medicare 59

Medicare Medicare Nurses Fraud 59

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

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.

Fraud 52

Fraud Medicare Medicare Compliance 52

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

HIPAA 107

HIPAA Compliance Medicare Medicare 107

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

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

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

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

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