Healthcare IT News - Telehealth

FEBRUARY 3, 2023

An excepted benefit allows employers to finance additional medical care, like vision or dental coverage, according to the Centers for Medicare & Medicaid Services FAQs for insurance agents and brokers, requiring Congress to amend previous public health and funding laws. In an announcement about the bipartisan bill, Rep.

COVID-19 180

COVID-19 Public Health Medicare Medicare 180

Bill of Health

DECEMBER 6, 2023

To tackle this issue, federal and state governments should strengthen the regulation of insurance networks and insurers should address underlying causes of inadequate networks. The Consolidated Appropriations Act of 2023 requires Medicaid plans to publish and update accurate and searchable provider directories.

Governance 147

Governance Medicaid Medicaid Medicare 147

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 hearing is scheduled for May 2, 2022. The court has ordered the parties involved to appear within 30 days for a hearing on the issue of damages.

Medicaid 59

Medicaid Medicaid Compliance Governance 59

C&M Health Law

APRIL 21, 2022

On April 6, 2022, BayCare Health System Inc. 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. BayCare) entered into a $20 million settlement under the False Claims Act with the U.S.

Medicaid 52

Medicaid Medicaid Governance Fraud 52

Jane Sarashon

DECEMBER 13, 2021

This feels especially apt right “now” as we enter 2022, Year 3 of the COVID-19 pandemic, with people mentally stressed, anxious, and shrugging off the Omicron variant – while taking on more DIY life-flows, self-care and desire for (more) control. We start at a macro bird’s-eye view with Gartner’s top US consumer and cultural trends for 2022.

COVID-19 64

COVID-19 Public Health Governance Medicaid 64

HIT Consultant

AUGUST 5, 2022

in Q2 2022, which was in line with the S&P 500 decline of 16.4%. – Healthcare & Life Science M&A activity plummeted to 338 deals in Q2 2022 versus 535 in Q2 2021 and a record 565 deals in Q4 2021. The key trends highlighted in the Quarterly Update Q2 2022 report from Stout are as follows: 1. from $34.61

Telemedicine 98

Telemedicine Medicaid Medicaid Malpractice 98

Healthcare IT News - Telehealth

SEPTEMBER 28, 2021

Centers for Medicare and Medicaid Services proposed for the first time a set of CPT codes for remote therapeutic monitoring. It's important that the federal government set policies that align incentives with the outcomes we hope to see for patients: higher quality care at lower overall costs.

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COVID-19 Medicare Medicare Hospitals 218

Healthcare Law Blog

FEBRUARY 3, 2023

Part 521 governing the implementation and operation of effective compliance programs for certain “required providers,” including, now for the first time, Medicaid managed care organizations (MMCOs). [1] New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R.

Medicaid 52

Medicaid Medicaid Compliance Overpayments 52

Healthcare IT News - Telehealth

JUNE 19, 2023

Based on his success in building chronic care business for seniors, Sinclair’s role was broadened to focus on all government lines of business (Medicare Advantage, Managed Medicaid and Marketplace) and all virtual care offerings (urgent care, mental health, chronic care, specialty care and primary care).

Medicare 172

Medicare Medicare Telemedicine Medicaid 172

AIHC

DECEMBER 27, 2024

13] Beyond Federal law, state laws and Title IX policies that govern teaching hospitals at associated universities address consent. 2022 Jan;52(1):28-31. In order to address concerns about these unauthorized practices, an increasing number of states have passed laws protecting the bodily autonomy of patients. Hastings Cent Rep.

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Informed Consent Bioethics ADA Nurses 98

HIT Consultant

MARCH 8, 2022

Under the PHE, states must keep Medicaid enrollees continuously covered, irrespective of their circumstances. . By December 2021, enrollment in Medicaid and CHIP (Children’s Health Insurance Program) grew to a record high of more than 83 million individuals, primarily due to the continuous coverage requirements of the PHE.

Public Health 98

Public Health Medicaid Medicaid COVID-19 98

Healthcare Law Blog

OCTOBER 2, 2023

The government buys billions of dollars in healthcare-related goods and services every year, and no government procurement is perfect. If the answer is “yes”—or even “maybe”—healthcare companies may file a bid protest at the Government Accountability Office (“GAO”) or the U.S. B-417836, 2020 CPD ¶ 47 ( Nov.

Governance 52

Governance Department of Veterans Affairs Medicaid Medicaid 52

Healthcare IT News - Telehealth

SEPTEMBER 9, 2024

Meanwhile, the American Telemedicine Association is pleading with the Centers for Medicare and Medicaid Services for expanded flexibilities and further guidance on payment and coverage. For the 15 or so years leading up to 2022, we enjoyed very low, even negative, interest rates. The government must take the lead.

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Telemedicine Licensing Health Outcomes Governance 188

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 31, 2023

billion in the first three quarters of 2022. [ii] v] In November 2022, Colorado voted to decriminalized psilocybin mushrooms. In December 2022, the U.S. Part 2, which governs the medical records of federally assisted substance use treatment programs. Finance (July 18, 2022). 2, 2021).

COVID-19 105

COVID-19 Medicare Medicare Medicaid 105

Kaiser Health News

APRIL 16, 2024

District Court for the Southern District of Florida, two such call centers paid tens of thousands of dollars a day to buy names of people who responded to misleading advertisements touting free government “subsidies” and other rewards.

ACA 140

ACA Health Insurance Governance Medical Billing 140

Med-Net Compliance

OCTOBER 21, 2022

The Office of Inspector General (OIG) has recently posted the False Claims Act (FCA) settlements for FY 2022 Q1–Q4 on the risk spectrum. The government’s primary civil tool for addressing healthcare fraud is the FCA. Issue: Providers must ensure that the claims they submit to Medicare and Medicaid are true and accurate.

Fraud 59

Fraud Compliance Medicare Medicare 59

Healthcare Law Blog

FEBRUARY 24, 2023

Earlier today, the Department of Labor, the Treasury, and the Department Health and Human Services Centers for Medicare and Medicaid Services (the “Departments”) issued a new directive to Certified Independent Dispute Resolution (IDR) Entities regarding issuing payment determinations for certain pending out-of-network (OON) disputes.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIPAA Journal

MARCH 6, 2023

Cedar Park, TX-based Dental Health Management Solutions (DHMS), a provider of dental services to the government/military and private patients has recently announced – via its legal counsel – that the protected health information of certain patients was exposed in a 2021 hacking incident.

Electronic Medical Records 98

Electronic Medical Records HIPAA Licensing Nurses 98

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 a 2022 American Medical Association physician survey , 88% of providers said that the burden of doing prior authorization was high or extremely high. But that is an ideal far off in the future.

Electronic Medical Records 117

Electronic Medical Records Doctors Governance Medicaid 117

MRO Compliance

JUNE 1, 2022

This review is part of the Star rating system, which according to RAC Monitor was developed by the Centers for Medicare & Medicaid Services (CMS) to rate health plan performance for Medicare Advantage programs and Medicare risk adjustment initiatives. HEDIS works as a government rating tool. What is a HEDIS audit?

Medicare 130

Medicare Medicare Compliance Medicaid 130

Healthcare IT News - Telehealth

APRIL 13, 2023

They are asking providers to identify cancer patients and families who may qualify as ACP program enrollees, which includes households with Medicaid recipients and other federal subsidy programs, to provide them with the information they need to connect their patients with the Gilda's Club team supporting ACP enrollment.

Nursing Homes 163

Nursing Homes Medicaid Medicaid Public Health 163

MRO Compliance

AUGUST 8, 2024

The Role of Clinical Data Registries According to the latest information from the Centers for Medicare and Medicaid Services (CMS), 90% of payments are now linked to value, with 40% flowing through alternative payment models (APMs), showing the shift towards more cost-effective care driven by data from registries.

Patient Satisfaction 147

Patient Satisfaction Medicare Medicare Medicaid 147

HIT Consultant

AUGUST 17, 2023

They also serve a majority of Medicaid and non-insured patients, which makes it harder to keep the doors open on maternity wards, whose cost of upkeep can be substantial. One way the government has responded to hospitals’ and health systems’ financial needs is by funding grants to close revenue gaps. Has grown in the U.S.

Medicaid 98

Medicaid Medicaid Telemedicine Doctors 98

HIT Consultant

JANUARY 18, 2023

And to support this work, I predict that we will see more activity between payers, pharmacists, the government and technology organizations to ensure that pharmacists are able to perform these important activities and be reimbursed for their work. Greg Samios, President & CEO of Clinical Effectiveness at Wolters Kluwer.

Compliance 98

Compliance Medicaid Medicaid Medicare 98

HIPAA Journal

OCTOBER 11, 2022

The incident was detected in April 2022, and immediate action was taken to secure its email environment to prevent further unauthorized access. The forensic investigation confirmed the incident was confined to a single employee email account, which was accessed between March 30, 2022, and April 6, 2022.

Licensing 73

Licensing HIPAA Health Insurance Medicaid 73

Healthcare IT Today

AUGUST 7, 2022

Cybersecurity company Surfshark found the number of government requests for user data increased 4x from 2013 to 2020 among Apple, Google, Facebook, and Microsoft. The four companies submitted user data to governments between 69% and 80% of the time. Facebook accounted for 40% of all requests, compared to just 7% for Apple.

Governance 75

Governance Telemedicine Medicaid Medicaid 75

HIPAA Journal

NOVEMBER 4, 2022

Warner suggests the only way to improve healthcare cybersecurity rapidly is through a collaborative effort involving the public and private sectors, with the federal government providing overall leadership. Comments should be submitted no later than December 1, 2022. The post Cybersecurity is Now a Patient Safety Issue, Suggests Sen.

HIPAA 134

HIPAA Governance FDA Medicaid 134

C&M Health Law

SEPTEMBER 11, 2023

Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (“CMS”) issued a much anticipated and contested proposed rule that seeks to establish minimum staffing level requirements for nursing homes. A May 2022 study found that 23 states have standards less than 3.0 Proposed Staffing Standard – 3.0

Nursing Homes 98

Nursing Homes Nurses Medicaid Medicaid 98

Healthcare Compliance Blog

APRIL 29, 2022

On April 25, 2022, a former owner of multiple Texas adult day care centers was sentenced to 60 months in prison and ordered to pay $1,784,817.96 in restitution for her role in healthcare fraud, wire fraud, and theft of government funds. The money judgment represents the proceeds that she obtained as part of her scheme.

Fraud 59

Fraud Governance Compliance Medicaid 59

Hall Render

MARCH 3, 2022

The Centers for Medicare & Medicaid Services (“CMS”) recently announced the ACO Realizing Equity, Access, and Community Health (“REACH”) Model. The application period for the ACO REACH Model opens Monday, March 7, 2022, and closes April 22, 2022, with an effective date of January 1, 2023. Background. Key Deadlines.

Compliance 74

Compliance Medicaid Medicaid Medicare 74

C&M Health Law

FEBRUARY 6, 2023

Both cases were filed by manufacturers after the government sent letters stating that manufacturers had violated the 340B program by restricting the delivery of drugs to a covered entity’s contract pharmacies. Becerra , 2022 WL 484587 (D. 16, 2022), and the government prevailed in Sanofi-Aventis U.S., Espinosa , Nos.

Medicaid 52

Medicaid Medicaid Governance 52

Health Law Advisor

AUGUST 25, 2023

It is axiomatic that New York State requires every Medicaid provider to have an “effective” compliance program. The regulations were finalized in December 2022, with an effective date of March 28, 2023, and an enforcement moratorium that has just ended. New York Social Services Law § 363-d.

Compliance 52

Compliance Overpayments Overpayment Compliance Officers 52

Hall Render

JANUARY 27, 2023

Overall, its 2022 earnings rose 16% to $20.1 From 2021 to 2022, a new report indicates that there was an 84% increase in health care bankruptcies. From 2021 to 2022, a new report indicates that there was an 84% increase in health care bankruptcies. United Healthcare Group’s fourth-quarter earnings increase by 17% to $4.9

Medicaid 40

Medicaid Medicaid Hospitals Governance 40

Healthcare Blog

APRIL 13, 2023

As hospitals have become increasingly complex organizations, effective governance, risk, and compliance (GRC) strategies have become essential for ensuring patient safety and regulatory compliance. What are the Key Components of a Successful Governance, Risk, and Compliance (GRC) Strategy? What is patient safety culture? News Medical.

Governance 40

Governance Compliance Hospitals Regulatory Compliance 40

Hall Render

JUNE 20, 2022

Is housing health care and should Medicaid pay the rent? States are using Medicaid programs to cover rent, security deposits and furniture per The New York Times. Hall Render looked at a number of new hospital projects announced in 2022. State and local governments are stepping up to save facilities on the brink of closure.

Medicaid 40

Medicaid Medicaid Hospitals Nurses 40

HIPAA Journal

DECEMBER 8, 2022

Warner sought feedback from healthcare industry stakeholders on the white paper, with the comment period officially coming to an end on December 1, 2022; however, since the white paper covers such important issues, the deadline has been extended. Greater support is required from the federal government for victims of cyberattacks.

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HIPAA FDA Governance Hospitals 128