Health Populi

DECEMBER 7, 2018

National health care spending growth slowed in 2017 to the post-recession rate of 3.9%, down from 4.8% to $10,739 in 2017, and the share of GDP spent on medical care held steady at 17.9%. These annual numbers come out of the annual report from the Centers for Medicare and Medicaid Services, published yesterday in Health Affairs.

Health Insurance 54

Health Insurance Medicaid Medicaid Medicare 54

Bill of Health

JULY 28, 2023

US Food and Drug Administration Review Time of Supplemental New Indication Approvals of Drugs and Biologics, 2017 to 2019. Inflationary Rebates For Generic Drugs Sold Through Medicaid Saved Billions During 2017-20. J Diabetes Sci Technol. 2023 Jun 5:19322968231178016. Epub ahead of print. Dhodapkar MM, Ross JS, Ramachandran R.

Medicaid 130

Medicaid Medicaid Governance 130

Bill of Health

MARCH 24, 2023

Assessment of FDA-Approved Drugs Not Recommended for Use or Reimbursement in Other Countries, 2017-2020. Market dynamics of authorized generics in Medicaid from 2014 to 2020. Pham C, Le K, Draves M, Seoane-Vazquez E. JAMA Intern Med. 2023 Feb 13:e226787. Epub ahead of print. Rome BN, Gunter SJ, Kesselheim AS. Health Serv Res.

Medicare 147

Medicare Medicare Medicaid Medicaid 147

Med-Net Compliance

AUGUST 5, 2022

New York Attorney General Letitia James announced the indictment of a physician and his company for defrauding Medicaid by forcing patients to get unnecessary and invasive medical tests. From January 2006 to August 2017, the physician allegedly gave?gift

Medicaid 59

Medicaid Medicaid Fraud 59

Healthcare Compliance Blog

JANUARY 25, 2022

A Missouri woman who had previously pled guilty to Medicare and Medicaid fraud was sentenced in Federal Court to three years imprisonment and ordered to pay $7,620,779 in restitution. Between 2017 and 2019, the Missouri woman owned and managed several durable medical equipment (DME) companies. General Legal Duties and Antitrust Laws.

Fraud 59

Fraud Medicaid Medicaid Medicare 59

HIT Consultant

APRIL 12, 2023

Founded in 2017, 1upHealth’s FHIR®-native platform designed for interoperability and modern computing is used by over 75 enterprise organizations including leading national and regional health plans, the highest performing CMS ACOs, international clinical research organizations, and over 20 state Medicaid agencies.

Medicaid 98

Medicaid Medicaid 98

Healthcare IT News - Telehealth

AUGUST 30, 2021

In 2017, the health system – which has 100 continuing care locations, including home care, hospice, PACE programs and senior living facilities – was in a bind, facing double-digit hospital readmissions of 16% across its high-risk Medicare population. Trinity Health has 94 hospitals across 24 states. THE PROBLEM.

Patient Satisfaction 195

Patient Satisfaction Nurses Medicare Medicare 195

Health Populi

MARCH 8, 2018

Amazon is planning to extend Prime subscriptions to people enrolled in Medicaid for the discount price of $5.99 Medicaid enrollees who want to take advantage of the deal must provide Amazon with a scan or image of the card they use for their benefit (either Medicaid or EBT). a month instead of the recent price increase to $12.99/month

Medicaid 48

Medicaid Medicaid 48

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”). In states that have not expanded Medicaid, however, many postpartum women lose coverage.

Medicaid 52

Medicaid Medicaid ACA Public Health 52

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).

HIPAA 144

HIPAA Compliance Medicaid Medicaid 144

Healthcare IT News - Telehealth

JULY 19, 2019

Expansion of telehealth coverage and reimbursement at the state level has grown since 2017, according to the latest American Telemedicine Association. "The progress at the Federal level helps drive state action."

Telemedicine 153

Telemedicine Medicaid Medicaid HIPAA 153

HIT Consultant

MARCH 22, 2022

What You Should Know: – Cityblock Health, a value-based healthcare provider for Medicaid, dually-eligible and lower-income Medicare beneficiaries appoints co-founder Dr. Toyin Ajayi to CEO. Since launching in 2017, Cityblock has established itself as an industry leader in value-based care for marginalized populations.

Medicaid 98

Medicaid Medicaid Medicare Medicare 98

HIPAA Journal

JUNE 9, 2023

Prior to the Supreme Court ruling, there was no distinction between an identity thief stealing an individual’s identity and running up huge debts, a lawyer rounding up bills and only charging full hours, a waitress overcharging customers, and a doctor overbilling Medicaid. The Supreme Court decision related to the latter.

Fraud 107

Fraud Medicaid Medicaid Doctors 107

HIT Consultant

NOVEMBER 4, 2021

– Since its 2017 founding, Papa and its Papa Pals have served members in all 50 states, across Medicare Advantage, Medicaid, and employer health plans.

Medicaid 97

Medicaid Medicaid Health Outcomes Medicare 97

Healthcare IT Today

APRIL 25, 2023

1upHealth’s FHIR®-native platform designed for interoperability and modern computing is used by over 75 enterprise organizations including leading national and regional health plans, the highest performing CMS ACOs, international clinical research organizations, and over 20 state Medicaid agencies.

Medicaid 107

Medicaid Medicaid Health Analytics Governance 107

Compliancy Group

JULY 15, 2022

The information accessed included patient names, Medicaid numbers, healthcare provider names, dates of service, dates of birth, addresses, and treatment information. At that time, it was believed that the incident started in November 2017, but later forensic analysis revealed the earlier breach date.

HIPAA 97

HIPAA Medicaid Medicaid Compliance 97

The Health Law Firm

AUGUST 14, 2017

Board Certified by The Florida Bar in Health Law On August 3, 2017, the Centers for Medicare & Medicaid Services (CMS) approved a five-year extension of Florida’s Managed Medical Assistance (MMA) section 1115 demonstration. Tools For More Effective Medicaid Programs. Indest III, J.D.,

Medicaid 40

Medicaid Medicaid Medicare Medicare 40

Healthcare IT News - Telehealth

JUNE 18, 2019

The challenge is particularly severe for the Medicaid population, with fewer than 25 percent of physicians in north Texas now accepting Medicaid, he added. Acute Care Transitions partnered with CirrusMD in 2017 to create a virtual care offering for patients. MEETING THE CHALLENGE.

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Telemedicine Doctors Medicaid Medicaid 161

The Health Law Firm

NOVEMBER 8, 2017

Board Certified by The Florida Bar in Health Law A Michigan dentist accused of Medicaid fraud was recently captured in the Dominican Republic after evading charges for months, state authorities announced. By George F. Indest III, J.D., 27 Charges. 27 Charges. million over a three year period of time.

Fraud 40

Fraud Medicaid Medicaid 40

HIT Consultant

FEBRUARY 15, 2022

billion in 2017, is projected to reach more than $8.5 Medicaid, Medicare Advantage). public Medicaid, private PPO, Medicare Advantage). Medicaid seniors), delivered in the way the cohort prefers (e.g., Cogan joined SPH Analytics in 2017 as Chief Commercial Officer. . billion by 2025. – Geographic location.

Medicare 98

Medicare Medicare Medicaid Medicaid 98

HIPAA Journal

MARCH 20, 2025

387,000 Settlement 2017 The Center for Childrens Digestive Health $31,000 Settlement 2016 Lincare, Inc. 1,100,000 2017 Vermont SAManage USA, Inc. Dominion National Insurance Company, and Dominion Dental Services USA, Inc. CA Healthcare Provider 2,364,359 Hacking/IT Incident 57 2024 Medical Management Resource Group, L.L.C.

HIPAA 111

HIPAA Ransomware Compliance Hospitals 111

Healthcare IT Today

JULY 14, 2022

Is the algorithm in question used for Medicare, Medicaid, or ACA populations? Sachin Patel joined Apixio in 2017 as Chief Financial Officer and later served as President and Chief Financial Officer before taking his current role as Chief Executive Officer. Health coverage program. ” About Sachin Patel.

ACA 142

ACA Hospitals Medicaid Medicaid 142

Health Populi

FEBRUARY 14, 2018

Focusing in on the health insurance line item, 44% will be covered by private/commercial payors and 51% by Medicare and Medicaid (the remaining 5% of insurance costs will lie with other third-party payors and programs). per year, 2017-26, expected to hit $5.7 What are those “fundamentals” pushing up healthcare spending?

Health Insurance 79

Health Insurance Medicare Medicare Medicaid 79

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.

Medicaid 40

Medicaid Medicaid Fraud Health Outcomes 40

Health Law Advisor

FEBRUARY 2, 2023

On February 1, 2023, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining its audit methodology and related policies for its Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program. The final rule codifies long-awaited regulations first proposed by CMS in 2018.

Medicare 98

Medicare Medicare Overpayments Overpayment 98

HIT Consultant

AUGUST 17, 2021

In 2018, 36% of spending was via alternative payment models and by 2025, CMS has targeted 100% of Medicare and 50% of Commercial and Medicaid spending.4 Founded in 2017, ClosedLoop’s healthcare data science platform is purpose-built and dedicated to healthcare.

COVID-19 98

COVID-19 Medicaid Medicaid Health Outcomes 98

Healthcare IT Today

JUNE 21, 2023

Inflation will push Payers back into the Public Marketplace whether Statewide and Federal Health Exchanges, Medicaid and Medicare Before the pandemic, many payers left statewide health exchanges as they found more ways to become profitable outside of the public market. In the same time period we have seen a large surge in Medicaid enrollment.

COVID-19 72

COVID-19 Medicare Medicare Medicaid 72

Healthcare Compliance Blog

MARCH 28, 2022

An Illinois licensed practical nurse (LPN) was convicted and sentenced for failing to administer lifesaving measures to a resident in a nursing home in 2017. The woman, 45, pleaded guilty to an amended charge of Reckless Conduct (Class A Misdemeanor).

Nurses 59

Nurses Nursing Homes Licensing Fraud 59

The Health Law Firm

MARCH 6, 2017

The Health Law Firm On January 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that revises the conditions of participation (CoPs) that home health agencies (HHAs) must meet to participate in the Medicare and Medicaid. The provisions of this rule will go into effect on July 13, 2017.

Medicaid 40

Medicaid Medicaid Medicare Medicare 40

HIT Consultant

MAY 23, 2024

Leading the Charge in Telehealth Addiction Treatment Since its inception in 2017, Boulder Care has established itself as a pioneer in telehealth care for addiction treatment. Focus on Medicaid Populations Boulder Care specifically targets underserved communities, including those covered by Medicaid.

Medicaid 52

Medicaid Medicaid Patient Satisfaction Health Services Administration 52

Healthcare Compliance Blog

MARCH 31, 2022

The agencies received millions of dollars in funding from Medicaid, which is funded in part by the federal government, and much of that money was meant to pay the wages and benefits of their aides. Under the Wage Parity Law, which is funded by Medicaid, aides are to be paid a minimum amount in total compensation.

Medicaid 59

Medicaid Medicaid Governance Fraud 59

Pharmacy Law Blog

MARCH 13, 2018

On December 4, 2017, a Florida federal judge refused to dismiss the federal government’s False Claims Act (FCA) suit against a compounding pharmacy. She accused RS and Gobea of charging Tricare, Medicare and Medicaid excessively high rates for certain compounded drugs. December 4, 2017). December 4, 2017). By George F.

Fraud 52

Fraud Governance Licensing FDA 52

HIT Consultant

FEBRUARY 1, 2023

What You Should Know: – Based on prevalence estimates from PINC AI™ data during 2017-2022, an estimated 66 million emergency department (ED) outpatient visits and 760,000 inpatient admissions in the U.S. during 2017-2022, creating a substantial economic burden for affected hospitals. – Patients with an OUD diagnosis had 32.5

Hospitals 52

Hospitals Medicaid Medicaid Health Outcomes 52

Healthcare IT News - Telehealth

JUNE 3, 2021

This helped the organization achieve HIMSS Stage 7 in 2017 – the first academic hospital in Canada to do so. Before that she served as director of the State Innovation Models Initiative at the Centers for Medicare and Medicaid Services. He earned a HIMSS Davies Award of Excellence in 2018. Isaiah Nathaniel. Philadelphia.

COVID-19 116

COVID-19 Department of Veterans Affairs COVID-19 Vaccine Nurses 116

Natalia Mazina

AUGUST 6, 2022

This allegedly fraudulent scheme resulted in the submission of false claims to federal health care programs, including Medicare and Medicaid. More information on the case: United States et al. Habana Hospital Pharmacy, Inc. 17-CV-80871-KAM, S.D.Fla.,

Medicaid 52

Medicaid Medicaid Governance Medicare 52

HIT Consultant

OCTOBER 31, 2023

What You Shoud Know: – Medicaid prospective payment rate for Michigan’s federally qualified health centers (FQHCs) has not kept pace with the actual costs incurred to provide healthcare, resulting in a substantial reimbursement gap of $97.95 and indirect costs rising by 26.2%.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare Compliance Blog

JUNE 9, 2022

Between 2017 and 2019, the man, through a group of pain clinics he controlled, caused the submission of false claims for payment to Medicare. Providers must ensure that the claims they submit to Medicare and Medicaid are true and accurate. He is awaiting sentencing on those charges.

US Department of Health and Human Services 59

US Department of Health and Human Services Overpayments Overpayment Medicare 59