Healthcare IT News - Telehealth

JUNE 26, 2020

Throughout 2018 and 2019, Northwell Health piloted small-scale programs in partnership with the Gary and Mary West Health Institute Collaboration to bring medical services virtually to the homes of their patients. "I know their baseline and when they call, I send the [mobile telemedicine technicians] there."

COVID-19 199

COVID-19 Telemedicine Medicaid Medicaid 199

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. The post Georgia Rehabilitation Center Submitted 808 False Claims to Medicaid/Tricare appeared first on Med-Net.

Medicaid 59

Medicaid Medicaid Compliance Governance 59

Healthcare Law Blog

MAY 16, 2022

More than 13 million people were enrolled in Medi-Cal in California in September 2021, making it the largest Medicaid program in the nation. In 2018, DHCS also launched the HHP pilot. In 2015, DHCS launched the WPC Pilots as part of its Medi-Cal 2020 Section 1115 Demonstration.

Medicaid 59

Medicaid Medicaid Nurses Health Care Access 59

Healthcare IT News - Telehealth

MAY 13, 2020

"For example, the Centers for Medicare and Medicaid Services declared it would reimburse for telemedicine visits in both rural and urban communities, and services could be delivered into patients' homes," study authors wrote. The shift to telemedicine was made simpler, researchers note, by regulatory and reimbursement changes.

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Telemedicine COVID-19 HIPAA Medicare 218

Healthcare IT News - Telehealth

OCTOBER 19, 2020

In the suit, the EHR giant argues that it has used the CarePort trademark since 2013 and that in 2018 the telemedicine company changed its name from ER at Home to CarePortMD. In 2018, CarePort Health took over management of AllScripts' Care Management technology to aid with acute-case management and post-acute referrals.

Telemedicine 135

Telemedicine Medicaid Medicaid Hospitals 135

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. This total includes $41.1

Medicare 98

Medicare Medicare Overpayments Overpayment 98

Healthcare Law Blog

FEBRUARY 1, 2023

On January 30, 2023 , the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”). One thing that is certain, CMS can expect further challenges to its RADV audit methodology. See also Ratanasen v.

Medicare 105

Medicare Medicare Overpayments Overpayment 105

Healthcare IT News - Telehealth

APRIL 9, 2019

The ability of such analytics to both assess patients in the moment and point toward their potential future condition had health systems investing more than $566 million in the technology during 2018, the report notes.

Hospitals 166

Hospitals Medicaid Medicaid Medicare 166

Bill of Health

OCTOBER 17, 2024

SB 1223 amended the California Consumer Privacy Act of 2018 to include neural data as sensitive personal information, whose collection and use companies can be directed to limit. AB 3030 requires that health care providers disclose when they have used generative AI to create communications with patients.

Medicare 150

Medicare Medicare Health Insurance Licensing 150

Healthcare IT News - Telehealth

APRIL 24, 2020

The Alliance for Integrated Care of New York (AICNY) oversees the healthcare needs of roughly 6,200 dually eligible Medicare and Medicaid beneficiaries with intellectual and developmental disabilities (IDD). Over three quarters of 2018, AICNY inpatient expenditures saw a 6% reduction. THE PROBLEM. ” PROPOSAL. MARKETPLACE.

Telemedicine 173

Telemedicine COVID-19 Medicaid Medicaid 173

HIPAA Journal

JULY 15, 2022

OCR launched a HIPAA investigation after receiving a breach report on January 5, 2018, in response to the hacking of an OSU-CHS web server. OSU-CHS determined that malware had been installed on the server which allowed the hacker(s) to access the electronic protected health information of 279,865 individuals.

HIPAA 132

HIPAA Compliance Medicaid Medicaid 132

Healthcare IT News - Telehealth

JANUARY 5, 2021

In 2018 and 2019, 36% of the organization's transplanted population were Medicaid and others were in rural areas with poor access to local care, necessitating travel to the center for routine or acute care and follow-up. THE PROBLEM.

COVID-19 191

COVID-19 Electronic Medical Records Telemedicine Patient Satisfaction 191

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. The university announced the HIPAA breach on January 5, 2018.

HIPAA 97

HIPAA Medicaid Medicaid Compliance 97

Kaiser Health News

MARCH 15, 2022

But the new benefit for people enrolled in Medi-Cal, the state’s Medicaid health insurance program, has been delayed twice as the state and doulas — nonmedical workers who help parents before, during, and after birth — haggle over how much they should get paid.

Medicaid 90

Medicaid Medicaid Health Insurance Public Health 90

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

Health Populi

DECEMBER 4, 2019

With new rules emanating from the White House this month focusing on health care price transparency, health care costs are in the spotlight at the Centers for Medicare and Medicaid Services. Read my post on getting transparent about transparency in Medecision’s blog here for more details and a deeper dive into this important issue.

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Medicaid Medicaid Medicare Medicare 83

HIT Consultant

JUNE 12, 2024

Additionally, the Centers for Disease Control and Prevention reported a 39% increase in SUD cases in emergency departments (ED) from 2018 to 2021, exacerbating issues of overcrowding and overspending. Department of Health and Human Services revealed that in 2022, 17% of people aged 12 or older reported a substance use disorder (SUD).

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Medicaid Medicaid Medicare Medicare 98

Health Populi

JUNE 27, 2022

The second bar chart illustrates the per member/per month (PMPM) spend for commercially insured workers, showing growth of over 7% from 2018 to 2019, and nearly 7% drop from 2019 to 2020 in the first year of the pandemic. But flat growth is expected for 2022, Castlight forecasts.

COVID-19 125

COVID-19 Health Insurance Medicaid Medicaid 125

CMS.gov

OCTOBER 2, 2018

Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Tue, 10/02/2018 - 15:36. Administrator, Centers for Medicare & Medicaid Services. Medicaid & CHIP. Better Data Will Serve as the Foundation in Modernizing the Medicaid Program. Jeremy.Booth@c…. Seema Verma.

Medicaid 40

Medicaid Medicaid Fraud Health Outcomes 40

HealthStream

DECEMBER 19, 2019

Leaders are looking to optimize software solutions which provide methods to improve efficient communication and required payer ongoing verifications, as well as integration with the Council for Accountable Quality Healthcare (CAQH), State Medicaid, and Medicare enrollment.

Medicaid 40

Medicaid Medicaid Medicare Medicare 40

Healthcare Law Blog

DECEMBER 27, 2022

The Centers for Medicare and Medicaid Services (“CMS”) has issued a proposed rule which would amend the existing regulations for reporting and returning identified overpayments (the “Proposed Rule”). 2018), rev’d in part on other grounds sub nom. FOOTNOTES. [1] 1] See UnitedHealthcare Ins. Azar , 330 F. 3d 173 (D.D.C. Becerra , 16 F.4th

Overpayments 98

Overpayments Overpayment Medicare Medicare 98

HIT Consultant

MARCH 30, 2023

The platform allows connectivity to the key services providers require to address patient needs including prescription delivery, stress-free rides, and soon, the delivery of healthy food and over-the-counter medicine for those who need it most—including Medicare Advantage and Medicaid beneficiaries.

Medicaid 98

Medicaid Medicaid Medicare Medicare 98

Healthcare IT News - Telehealth

MARCH 4, 2019

As a federally qualified health center, Vista Community Clinic is a safety net for its neighborhood, managing an uninsured or underinsured patient population – in this case, 58 percent Medicaid, 2 percent Medicare and 32 percent uninsured. THE PROBLEM.

Telemedicine 152

Telemedicine Medicaid Medicaid Medicare 152

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 98

Telemedicine Medicaid Medicaid Malpractice 98

Health Populi

AUGUST 24, 2020

Four in five large employers believe virtual health will play a significant role in how care is delivered int he future, up from 64% in 2019 and 52% in 2018. On the payor front, large U.S. Furthermore, nine in ten companies plans to offer virtual care for telemental health, a fast-growing aspect of virtual care.

COVID-19 154

COVID-19 Telemedicine Doctors Medicare 154

HIT Consultant

APRIL 3, 2023

Progress toward VBC adoption hasn’t achieved its potential yet, hovering around 60% of all payment models from 2018 to 2021, with the remaining 40% comprised of traditional fee for service (FFS).

Medicaid 98

Medicaid Medicaid Medicare Medicare 98

Health Populi

JANUARY 16, 2020

“All healthcare is social,” Dr. Sachin Jain, CEO and President of CareMore Health, wrote about the latter in Forbes in April 2018 — and his essay is worth reading if you missed it the first time around. And so the modern house call enables more social care, the CareMore model shows us.

Doctors 159

Doctors Hospitals Nurses Medicaid 159

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 . – The latest round of funding positions ClosedLoop to extend its lead in delivering artificial intelligence (AI) solutions that tackle some of healthcare’s biggest challenges.

COVID-19 98

COVID-19 Medicaid Medicaid Health Outcomes 98

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”). Additional Opportunities for Integration through State Medicaid Agency Contracts.

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

Healthcare IT Today

AUGUST 14, 2024

The Centers for Medicare and Medicaid Services reported more than 45% of provider office locations listed in online directories contained at least one error. A study ( “What Physicians are Saying About Directories” American Medical Association, 2018. However, much of this provider data has a short shelf life.

Fraud 80

Fraud Hospitals Medicaid Medicaid 80

HIT Consultant

AUGUST 7, 2024

Despite the Challenges, CHCs Remain a Beacon of Hope This news comes amidst a backdrop of rising mental health and substance use treatment needs, fluctuating Medicaid enrollment patterns, and persistent funding gaps. In 2024, 67% of CHCs reported screening all patients, compared to only 40% in 2018.

Medicaid 52

Medicaid Medicaid Nurses Public Health 52

HIT Consultant

MARCH 15, 2023

A June 2022 report from Medicaid and CHIP Payment and Access Commission (MACPAC) further illuminated the issue, explicitly citing an extension of the financing through state Medicaid programs to drive health IT adoption as a decisive step to addressing gaps in access, outcomes data, and oversight.

Medicaid 98

Medicaid Medicaid Doctors 98

Healthcare Compliance Blog

MAY 11, 2022

The South Carolina Attorney General announced that his office’s Medicaid Fraud Control Unit (SCMFCU) had arrested a 57-year-old woman on two counts of Exploitation of a Vulnerable Adult and two counts of Breach of Trust with Fraudulent Intent, value of $10,000 or more.

Fraud 59

Fraud Nursing Homes Medicaid Medicaid 59

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. In 2018, CMS chief Seema Verma pushed forward the organization’s goal to advance true interoperability. The release of FHIR in the mid-2010 decade changed everything.

Electronic Medical Records 122

Electronic Medical Records Doctors Governance Medicaid 122

Health Populi

MAY 17, 2018

One-third of Americans are following a specific eating pattern, including intermittent fasting, paleo gluten-free, low-carb, Mediterranean diet, and Whole 30, among dozens of other food-styles in vogue in 2018. IFIC surveyed 1,009 American online adults ages 18 to 80 in March 2018.

Doctors 74

Doctors Medicaid Medicaid Nurses 74

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

Med-Net Compliance

JULY 20, 2022

A federal jury convicted a New York ENT doctor for defrauding Medicare and Medicaid by causing the submission of false and fraudulent claims for surgical procedures that were not performed. Specifically, between January 2014 and February 2018, the doctor billed Medicare and Medicaid approximately $585,000 and was paid approximately $191,000.

Fraud 59

Fraud Doctors Medicare Medicare 59