Healthcare IT News - Telehealth

APRIL 21, 2021

Cavanaugh previously has served as the deputy administrator and director of the Center for Medicare at the Centers for Medicare & Medicaid Services and as deputy director for programs and policy in the Center for Medicare & Medicaid Innovation. What is happening in healthcare at this unique moment?

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COVID-19 Medicare Medicare Telemedicine 213

Hall Render

NOVEMBER 1, 2024

Health care fraud remains a significant focus for federal and state enforcement agencies, with particular attention placed on the integrity of Medicaid and Medicare billing. He was also ordered to pay $557,000 in restitution to Indiana Medicaid and Medicare.

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Fraud Compliance Medicaid Medicaid 40

Healthcare Compliance Blog

APRIL 27, 2022

A Georgia district court has issued a summary judgment against a state rehabilitation center for 808 false claims billed to Medicaid and Tricare between November 2015 and June 2020. 2, 2015–July 31, 2016, and a range of $11,181–$22,363 for violations committed after Jan. Issue: All submitted claims must be accurate and truthful.

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Medicaid Medicaid Compliance Governance 59

Health Populi

JUNE 18, 2021

workers with private insurance more likely report poor access to health care, greater costs of care, and lower satisfaction with care versus people covered by public health insurance plans — whether Medicaid, Medicare, VHA or military coverage. Health Populi’s Hot Points: U.S. households.

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ACA Health Insurance Medicaid Medicaid 139

Healthcare Compliance Blog

FEBRUARY 2, 2022

The optician fraudulently received approximately $74,000 in Medicaid payments between 2016 and 2019 by billing for the optician services that were not provided. The post New York Optician Convicted of Medicaid Fraud for Nursing Home Residents appeared first on.

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Nursing Homes Fraud Medicaid Medicaid 59

Compliancy Group

JULY 15, 2022

A 2016 hacking incident that hit Oklahoma State University’s Center for Health Sciences has led to an $875,000 HIPAA breach fine settlement to address potential violations. Hackers first gained access to a web server containing the electronic protected health information (ePHI) of as many as 279,865 individuals on March 9, 2016.

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HIPAA Medicaid Medicaid Compliance 97

Healthcare IT News - Telehealth

APRIL 30, 2021

This isn't the first time a version of the CONNECT Act has been introduced in the Senate; Schatz and Wicker unveiled the initial legislation in 2016.

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COVID-19 Medicare Medicare Public Health 218

HIPAA Journal

JULY 15, 2022

The information exposed and potentially obtained by an unauthorized third party included names, Medicaid numbers, healthcare provider names, dates of service, dates of birth, addresses, and treatment information. 164.502(a).

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HIPAA Compliance Medicaid Medicaid 144

Healthcare Law Blog

JANUARY 20, 2023

To add uniformity to this practice, CMS codified this flexibility in the 2016 Medicaid and Children’s Health Insurance Plan (CHIP) managed care final rule by authorizing coverage for “In Lieu of Service or Settings” (ILOS). [i] ILOSs must advance the objectives of the Medicaid program. ILOSs must be medically appropriate.

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Medicaid Medicaid Medicare Medicare 52

HIPAA Journal

FEBRUARY 16, 2022

The PHI of non-dental patients who received healthcare services between December 5, 2016, and August 31, 2020, was also compromised and included names, birthdates, addresses, insurance identification numbers, and Social Security numbers.

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Ransomware Hospitals Licensing HIPAA 132

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.

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Medicare Medicare Medicaid Medicaid 35

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. Indest III, J.D., Board Certified by The Florida Bar in Health Law.

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Fraud Medicaid Medicaid Medicare 40

Healthcare IT News - Telehealth

OCTOBER 19, 2020

Allscripts bought CarePort in 2016 to help bolster its population health management software. Earlier this summer, CarePort launched a tool to help hospitals comply with the Centers for Medicare and Medicaid Services' interoperability final rules.

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Telemedicine Medicaid Medicaid Hospitals 164

The Health Law Firm

JANUARY 31, 2016

The Health Law Firm A nurse practitioner from Corinth, Mississippi, turned herself over to the authorities on Friday, January 8, 2016. Tami Bivens-Johnson was indicted on three counts of Medicaid fraud by an Alcorn County Grand Jury. Her Alleged Crimes Against Medicaid. Schriefer, R.N.,

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Medicaid Medicaid Nurses Fraud 40

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 By George F. Indest III, J.D., million dollars.

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Fraud Medicaid Medicaid 40

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.

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Medicaid Medicaid Governance Fraud 52

The Health Law Firm

MARCH 18, 2016

Board Certified by The Florida Bar in Health Law On March 9, 2016, authorities in Florida arrested a Kissimmee couple accused of Medicaid fraud. are accused of fraudulently billing Medicaid for more than $180,000 worth of mammography services never rendered. Indest III, J.D., and Medisound, Inc.,

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Fraud Medicaid Medicaid 40

The Health Law Firm

SEPTEMBER 19, 2016

Board Certified by The Florida Bar in Health Law On August 11, 2016, a former dentist in Connecticut and his practice were ordered to pay more than $700,000 in restitution and civil penalties for improperly billing the state Medicaid program for pediatric dental cleanings and fluoride treatments. A Scheme to Improperly Bill Medicaid.

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Medicaid Medicaid 40

HIPAA Journal

MARCH 20, 2025

TX Healthcare Provider 3,998,163 Hacking/IT Incident 27 2016 Banner Health AZ Healthcare Provider 3,620,000 Hacking/IT Incident 28 2021 Florida Healthy Kids Corporation FL Health Plan 3,500,000 Hacking/IT Incident 29 2015 Medical Informatics Engineering IN Business Associate 3,500,000 Hacking/IT Incident 30 2016 Newkirk Products, Inc.

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HIPAA Ransomware Compliance Hospitals 111

HIPAA Journal

SEPTEMBER 11, 2023

In 2016, a media outlet reported that members of the health plan were able to access the protected health information (PHI) of other members via the online member portal over a 2-day period in 2014 due to a manual processing error. Care Health Plan it had initiated a compliance review and in February 2016, L.A. OCR informed L.A.

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HIPAA Compliance Medicaid Medicaid 96

The Health Law Firm

MARCH 13, 2017

Board Certified by The Florida Bar in Health Law On December 20, 2016, the owner of Millennium Health Care Services (Millennium) must pay the state nearly $7 million in restitution and will spend 10 years behind bars for his role in a scheme to defraud the Medicaid system, according to Louisiana Attorney General Jeff Landry.

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Medicaid Medicaid Fraud 40

C&M Health Law

JANUARY 18, 2023

On January 4, in its most recent effort to expand federal support for addressing health-related social needs (HRSNs), the Centers for Medicare & Medicaid Services (CMS) issued guidance to clarify an existing option for states to address HRSNs through the use of “in lieu of” services and settings policies in Medicaid managed care.

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Medicaid Medicaid Federal Policy Health Outcomes 52

The Health Law Firm

AUGUST 22, 2016

Board Certified by The Florida Bar in Health Law On July 11, 2016, a federal appeals court stated that a bankruptcy judge did not have the authority to block government health officials from cutting off Medicare and Medicaid payments to a Florida nursing home that was alleged to have violated patient-care regulations. Indest III, J.D.,

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Medicaid Medicaid 40

HIT Consultant

APRIL 17, 2024

Ophelia’s Virtual-First Model Increases Access to Treatment In response to this crisis, Pennsylvania established the COE program in 2016. The COVID-19 pandemic and the rise of synthetic opioids like fentanyl have further exacerbated overdose deaths in recent years.

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US Department of Health and Human Services COVID-19 Licensing Medicaid 97

CMS.gov

OCTOBER 2, 2018

Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Administrator, Centers for Medicare & Medicaid Services. Medicaid & CHIP. Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Between 2013 and 2016, Federal spending on Medicaid grew by over $100 billion.

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Medicaid Medicaid Fraud Health Outcomes 40

The Health Law Firm

JULY 15, 2016

Board Certified by The Florida Bar in Health Law On June 15, 2016, A medical diagnostics company owner found guilty of Medicare and Medicaid fraud for billing $8 million for X-rays whose botched analysis by amateurs led to the death of two patients was sentenced in Maryland federal court to 10 years in prison, the US Department of Justice said.

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Fraud Medicaid Medicaid Medicare 40

Jane Sarashon

JANUARY 19, 2024

Elevance Health, the health plan organization comprising XXX plans serving 117 million members, launched a program to channel mobile phones and data plans into the hands of some Medicaid plan enrollees, explained in the organization’s press release on the program.

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Medicaid Medicaid COVID-19 Health Outcomes 75

Healthcare Law Blog

SEPTEMBER 6, 2023

On September 1, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a long-awaited proposal to establish new federal minimum staffing standards for long-term care facilities. [1] 68754 (October 4, 2016). 55 RN hours per resident per day (the “.55 55 RN HPRD”); and At least 2.45 Nurse Aide (NA) HPRD (the “2.45

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Nursing Homes Nurses Medicaid Medicaid 98

HIT Consultant

SEPTEMBER 18, 2023

The newest value-based payment program purposely designed to address SDOH is the ACO Realizing Equity, Access, and Community Health (ACO REACH) model, launched by the Centers for Medicare & Medicaid Services (CMS). Since 2016, Z codes have been available to capture SDOH data at the point of care delivery.

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Health Outcomes Electronic Medical Records Medicaid Medicaid 88

Healthcare IT News - Telehealth

NOVEMBER 6, 2020

They explained how an initiative launched in 2016, known as the Psychiatric Assessment Officer Telepsychiatry Model , has paid dividends across the health system: lower costs through reduced resource utilization, fewer readmissions and, most importantly, improved patient care through wider accessibility and more empathetic treatment options.

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Hospitals Nurses Licensing Medicaid 153

The Health Law Firm

DECEMBER 24, 2016

Board Certified by The Florida Bar in Health Law On December 7, 2016, Banio Koroma was convicted in a northern Illinois court of falsely certifying elderly patients for in-home care will spend the next three years in prison and be forced to reimburse the government for the $1.5 Indest III, J.D., Paying For His Crimes.

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Fraud Doctors Medicaid Medicaid 40

Jane Sarashon

MARCH 3, 2025

We learned a lot about health equity and disparities during the pandemic: one key driver of health (or social determinant of health, SDoH) which had been one of my talking points since writing about it in the Huffington Post in 2016 was connectivity — the Internet kind of connection. health care.

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Medical Billing Health Insurance Doctors Electronic Medical Records 59

CMS.gov

JUNE 25, 2019

The Medicaid program has grown from $456 billion in 2013 to an estimated $576 billion in 2016, largely fueled by a mostly federally financed expansion of the program to more than 15 million new working age adults.

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Medicaid Medicaid 46

Healthcare IT News - Telehealth

JANUARY 11, 2021

In November, the Centers for Medicare and Medicaid Services took several new steps to help U.S. "During the past few years, we have been working with Brigham and Women's Hospital to provide the remote monitoring technology for Brigham Health Home Hospital, a program they started in 2016," he said.

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Hospitals Medicare Medicare COVID-19 175

Compliancy Group

DECEMBER 20, 2024

OCR investigated the claim and found that from May of 2016 to January of 2019, the ePHI of roughly 1.5 Dr. Gumbs also alleged the complainant was not entitled to the records because the complainant would use the records to commit Maryland Medicaid insurance fraud (dont ask). flat fee to have the records mailed certified to her.

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Ransomware HIPAA Fraud Electronic Medical Records 98

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.,

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Medicare Medicare Medicaid Medicaid 40

Hall Render

AUGUST 8, 2022

The web server contained ePHI, including patients’ names, Medicaid numbers, health care provider names, dates of service, dates of birth, addresses and treatment information. In addition to this breach, the University later reported that a hacker had previously accessed the same web server as early as March of 2016.

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HIPAA Governance Medicaid Medicaid 73