Healthcare IT Today

OCTOBER 12, 2023

The Centers for Medicare & Medicaid Services (CMS) have taken a bold step by mandating a standard for prior authorization. The federal government has been haranguing vendors and clinicians to make interoperable systems since the HITECH act was passed in 2009. The release of FHIR in the mid-2010 decade changed everything.

Electronic Medical Records 111

Electronic Medical Records Doctors Governance Medicaid 111

Healthcare IT News - Telehealth

JUNE 12, 2024

Centers for Disease Control said it measured 39% more SUD cases between 2018 and 2021, according to the company. million lives across Medicaid and commercial contracts," Abhinav Shashank, cofounder and CEO at Innovaccer, said in the announcement. "Pediatric Associates has an impressive track record in managing over 1.5

Hospitals 146

Hospitals COVID-19 Medicaid Medicaid 146

Hall Render

AUGUST 8, 2022

In January 2018, the University notified OCR of a breach of ePHI that affected 279,865 individuals and occurred in November 2017. The web server contained ePHI, including patients’ names, Medicaid numbers, health care provider names, dates of service, dates of birth, addresses and treatment information.

HIPAA 73

HIPAA Governance Medicaid Medicaid 73

HIT Consultant

AUGUST 5, 2022

Predictions regarding Home Care and Medicaid Outlook: As a general observation, Stout thinks that many states will increase reimbursement rates and funding for Medicaid recipients, who have often had difficulty accessing quality home care due to providers declining to participate in government-funded programs.

Telemedicine 93

Telemedicine Medicaid Medicaid Malpractice 93

HIT Consultant

MARCH 20, 2024

The Centers for Medicare and Medicaid Services (CMS) estimated that for payment year 2018 alone , it will recover $428.4 Errors identified in already completed audits will be extrapolated more aggressively for audits going back to 2018, and then going forward for new audits. million (net) and $4.7

Overpayment 52

Overpayment Overpayments Medicare Medicare 52

McGuire Wood

OCTOBER 2, 2023

times the amount the government believed was due to improper billing, after a voluntary disclosure to the Department of Justice (DOJ). According to the DOJ press release, from January 2013 to July 2018, Oliver Street, doing business as U.S. This settlement includes more than $5.928 million in restitution, essentially a payment of 1.49

Fraud 52

Fraud Governance Compliance Medicare 52

Hall Render

JUNE 15, 2022

Becerra , the Supreme Court ruled the payment cuts made by the Department of Health and Human Services’ (“HHS”) Centers for Medicare & Medicaid Services (“CMS”) for 340B eligible outpatient drugs were not permissible under the governing statute. for 340B eligible hospitals.

Medicare 45

Medicare Medicare Hospitals Governance 45

HIT Consultant

MARCH 7, 2023

According to the AMA , studies conducted in 2018 showed that “most patients only take their medicine as prescribed about half the time and are often reluctant to tell their doctor, while a quarter of new prescriptions are never filled.” It also costs $290 billion annually in increased medical costs.

Doctors 95

Doctors Medicaid Medicaid Governance 95

MedTrainer

NOVEMBER 29, 2023

For healthcare compliance programs in Indiana to be successful, organizations must have methods in place for tracking and applying regulatory standards, while ensuring all staff are up to date with changes by governing bodies. This article provides an overview of the important aspects to healthcare compliance specific to Indiana State.

Compliance 52

Compliance Licensing Governance Public Health 52

Healthcare IT News - Telehealth

MARCH 18, 2022

Norden is particularly passionate about funding companies focused on the Medicaid population – a traditionally tricky and often ignored area. Notably, since 2018, mental health has been the top clinical indication to receive investment, growing from $1.4 billion that year to $5.1 billion in 2021, according to Rock Health.

Medicaid 216

Medicaid Medicaid COVID-19 Telemedicine 216

Health Populi

AUGUST 24, 2018

The line chart come from a new study into Multimorbidity Trends in United States Adults, 1988-2014 , published in the July-August 2018 issue of the Journal of the American Board of Family Medicine. We need all hands on deck: in the kitchen, grocery stores and retailers, schools, doctors’ offices, and government agencies.

Public Health 72

Public Health Doctors Medicaid Medicaid 72

Health Populi

NOVEMBER 1, 2018

And maintaining good mental health and staying on-track with health goals come close to managing uncovered costs, Oliver Wyman’s 2018 consumer survey learned. But this time around, polling health-insured consumers in July 2018, Oliver Wyman perceives a change in consumers’ “willingness to try new kinds of health services.”

Health Insurance 73

Health Insurance Doctors Medicaid Medicaid 73

Pharmacy Law Blog

MARCH 13, 2018

The federal judge refused the dismissal on the grounds that the government had sufficiently backed its allegations against both the company and its owner. The government had also adequately backed its allegations that RS knew it had been overpaid but had made no attempt to refund the difference to Tricare, according to the judge.

Fraud 52

Fraud Governance Licensing FDA 52

Kaiser Health News

FEBRUARY 8, 2022

The federal government has penalized 764 hospitals — including more than three dozen it simultaneously rates as among the best in the country — for having the highest numbers of patient infections and potentially avoidable complications. Other hospitals declined to comment or did not respond to emails.

Medicare 121

Medicare Medicare Hospitals COVID-19 121

Healthcare IT News - Telehealth

JUNE 3, 2021

He earned a HIMSS Davies Award of Excellence in 2018. Before that she served as director of the State Innovation Models Initiative at the Centers for Medicare and Medicaid Services. Before that, he spent 17 years as CEO of HealthPartners, a cooperatively governed health plan and care system in Minnesota. Dr. Stephanie Lahr.

COVID-19 105

COVID-19 Department of Veterans Affairs COVID-19 Vaccine Nurses 105

HIT Consultant

AUGUST 15, 2022

– Government support and benefit flexibility (e.g., – Innovation-driven initiatives from the Centers for Medicare & Medicaid Services (CMS). Key trends are influencing this growth, including: – An aging population. – Continued increase in overall Medicare costs. Case in Point.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

CMS.gov

OCTOBER 31, 2018

Wed, 10/31/2018 - 17:03. Administrator, Centers for Medicare & Medicaid Services`. Medicaid & CHIP. We’ve heard loud and clear that states want room to explore new ways of delivering care and designing programs to help their Medicaid beneficiaries live healthier, more independent lives. Jeremy.Booth@c…. Seema Verma.

Medicaid 51

Medicaid Medicaid Medicare Medicare 51

Med Law Blog

MAY 1, 2023

Tenet went through its own bankruptcy difficulties and, in 2018, sold its remaining Philadelphia assets, i.e. Hahnemann Hospital and St. Hahnemann was acquired by AHERF, the forerunner of Allegheny Health Network, in 1993. Tenet Healthcare bought Hahnemann out of the AHERF bankruptcy in 1998.

Nursing Homes 52

Nursing Homes Malpractice Hospitals Nurses 52

AIHC

APRIL 5, 2022

Audit Coding, Billing and Documentation for Accuracy Insurance carriers and government contractors have the authority to review any claims at any time. Prior to appealing a Medicare, Medicaid, TriCare or other Federal Program claim, you should verify that your organization is compliant in this area ( click here ).

Fraud 52

Fraud Medicare Medicare Compliance 52

Health Populi

JUNE 20, 2019

In fact, Kroger Health is the umbrella under which all of the food chain’s health and wellness assets fit: Kroger struck a deal with GoodRx in December 2018 to expand its prescription drug discount program. Intriguingly, government agencies tie at one in five people for both being on my side and working against me.

Doctors 73

Doctors Governance FDA Medicaid 73

Health Law Gurus

MAY 22, 2019

The Centers for Medicare and Medicaid Services (CMS) is launching new value-based programs with great fervor as a central strategy to bend the healthcare cost curve. Apple hired their first 50 physicians in 2018. CMS is now acting to maximize the sharing and transparency of healthcare data directly to consumers. Sound far-fetched?

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

JULY 14, 2023

On Friday, June 20, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update (“PPS Rule”), which has since been published in the Federal Register and is currently open for comment. Physical Therapy 3.30

Medicare 52

Medicare Medicare Payment Systems Governance 52

Health Populi

MARCH 1, 2018

This report was published just-in-time as we convene to meet at HIMSS 2018, the largest annual health technology conference. Last year I gave a talk about social determinants of health at HIMSS, which hadn’t been a topic that was much-discussed in previous years’ meet-ups.

Health Insurance 82

Health Insurance Medicaid Medicaid Public Health 82

Hall Render

FEBRUARY 23, 2024

CT’s Medicaid reimbursement rates lower than peer states: report Better safety training, reporting, escorts for CT home health care workers focus of new legislation D.C. Mary’s unveils new name, but mission remains unchanged UCHealth sues thousands of patients every year. What they say sets them apart.

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

CMS.gov

JULY 18, 2018

Thu, 07/19/2018 - 00:03. Administrator, Centers for Medicare & Medicaid Services. We see health IT systems that work seamlessly with each other, and a government that supports secure data sharing and emerging technologies so that healthcare in America is better and less expensive. CMS Doubling Down on Health IT; Patients.

Medicare 35

Medicare Medicare Governance Medicaid 35

Health Populi

SEPTEMBER 17, 2020

In fact, the number of uninsured Americans rose by 2 million people in 2018 , and by 1.9 In addition, people living in states that failed to expand Medicaid as part of the Affordable Care Act provisions were also at greater risk of inadequate coverage. million people in 2017.

COVID-19 62

COVID-19 Health Insurance Public Health Health Care Access 62

CMS.gov

OCTOBER 2, 2018

Tue, 10/02/2018 - 13:57. Administrator, Centers for Medicare & Medicaid Services. It’s no secret that the government often moves more slowly than private industry — some of our payment policies haven’t been updated in decades. Modernizing Medicare to Take Advantage of the Latest Technologies. Jeremy.Booth@c…. Seema Verma.

Medicare 44

Medicare Medicare Payment Systems FDA 44

Healthcare Law Blog

NOVEMBER 21, 2022

Pharmaceutical manufacturers are challenging the breadth of the Federal Anti-Kickback Statute (“AKS”) in federal court, arguing that the government is harming the very vulnerable patients it aims to serve by prohibiting cost-sharing subsidies for life-saving oncology drugs. 10, 2018). [5] Doshi et al., of Clinical Oncology 5 (Feb.

Medicare 52

Medicare Medicare Governance Medicaid 52

Compliancy Group

AUGUST 23, 2023

In a shocking turn of events, a dental office manager from Worcester has been sentenced for participating in a scheme to defraud the Massachusetts Medicaid program, MassHealth. Deceiving MassHealth: The Disturbing Truth Behind Dental Services From 2014 to 2018, a shocking scheme unfolded within the realm of dental services.

Fraud 52

Fraud Medicaid Medicaid Governance 52

Pharmacy Law Blog

MAY 14, 2018

This will then result in your exclusion from the Medicare and Medicaid Programs, and you debarment/exclusion from all government contracting or employment. Copyright © 2018 The Health Law Firm. You do not have to report a pending DOH investigation against you to anyone. a Florida professional service corporation, since 1999.Copyright

Licensing 40

Licensing Nurses Medicaid Medicaid 40

Pharmacy Law Blog

MAY 7, 2018

This will then result in your exclusion from the Medicare and Medicaid Programs, and you debarment/exclusion from all government contracting or employment. Copyright © 2018 The Health Law Firm. You do not have to report a pending DOH investigation against you to anyone. a Florida professional service corporation, since 1999.Copyright

Licensing 40

Licensing Nurses Medicaid Medicaid 40

HIT Consultant

NOVEMBER 22, 2021

July 1, 2021 was the enforcement date for the Centers for Medicare and Medicaid Services (CMS) Interoperability and Patient Access final rule. In some cases, even as the national conversation about data blocking started in Congress, payers started to build out an FHIR infrastructure as early as 2018.

Compliance 52

Compliance Medicaid Medicaid Medicare 52

Health Populi

MAY 6, 2018

Universal health care was covered in a section on 28 April 2018, and coverage on financial inclusion was bundled into the 5th May edition. Two weeks in a row, The Economist , the news magazine headquartered in London, included two special reports stapled into the middle of the magazines.

Medicaid 54

Medicaid Medicaid Medicare Medicare 54

Healthcare IT News - Telehealth

DECEMBER 16, 2020

The virtual trial, to be sure, is not a new concept: One team of researchers counted more than 1,100 trials listed on ClinicalTrials.gov employing connected digital products for remote data collection in both 2017 and 2018, the organization observed. " Healthcare organizations also need to convene regional collaborations, HRI said.

COVID-19 218

COVID-19 Hospitals Doctors Health Insurance 218

Healthcare Law Blog

AUGUST 3, 2022

is a reminder that the government will use the FCA to target medical device manufacturers for off-label use of medical devices, even where healthcare providers have decided the use is safe and effective. The government is attempting to prove materiality using Medicare’s coverage requirement that procedures must be “reasonable and necessary.”

Governance 52

Governance FDA Medicare Medicare 52

Healthcare Law Blog

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). Enrollee Participation in Plan Governance (§ 422.107).

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

AIHC

AUGUST 8, 2023

The “Cobra” - In the late 1800s-early 1900s when India was ruled by the British government, there was a problem with venomous cobras invading major cities. The British government decided to take action and offered citizens a bounty to redeem for dead cobras. The government eventually found out and stopped the financial incentives.

COVID-19 40

COVID-19 Governance Hospitals Medicaid 40