Kaiser Health News

JANUARY 19, 2022

” The changes are part of a 400-page proposed rule governing the federal health insurance marketplace and a few states that use the federal platform for their own exchanges. The new broker provision aims to deter fraudulent sign-ups by clarifying that applicants must attest that the income projections listed are correct.

ACA 81

ACA Health Insurance Licensing Governance 81

Compliance Now

DECEMBER 20, 2022

The good faith transition relief that formerly shielded employers from penalties for incorrect and/or incomplete ACA filings is no longer available. Employers must successfully e-File complete, accurate ACA filings by this deadline or risk exposure to information return penalties and employer mandate penalties.

Compliance 100

Compliance COVID-19 ACA Governance 100

Compliance Now

DECEMBER 20, 2022

The good faith transition relief that formerly shielded employers from penalties for incorrect and/or incomplete ACA filings is no longer available. Employers must successfully e-File complete, accurate ACA filings by this deadline or risk exposure to information return penalties and employer mandate penalties.

Compliance 100

Compliance COVID-19 ACA Governance 100

Health Populi

SEPTEMBER 17, 2020

Census Bureau found that the level of health insurance enrollment fell by 1 million people in 2019 , with about 30 million Americans not covered by health insurance. The coronavirus pandemic has only exacerbated the erosion of the health insured population. lacked health insurance.

COVID-19 62

COVID-19 Health Insurance Public Health Health Care Access 62

Kaiser Health News

JULY 6, 2022

. “There are still some gaps that need to be filled,” said Katie Keith, a researcher at the Center on Health Insurance Reforms at Georgetown University. Your insurance matters. The ACA does set parameters. As the ACA went into effect, trouble spots emerged. Here are five other things to know: 1.

ACA 88

ACA Medicare Medicare Medicaid 88

Health Populi

OCTOBER 7, 2020

Nearly 8 million workers losing jobs also losing their employer-sponsored health insurance, discussed in this research from The Commonwealth Fund. The threat of a repeal of the Affordable Care Act during the public health crisis. The COVID-19 pandemic in America has combined with: A national economic recession and job losses.

COVID-19 147

COVID-19 Public Health Health Insurance Health Care Access 147

Bill of Health

JANUARY 8, 2024

The combined risk of this sport’s violence and its growing popularity necessitated governance. An important aspect of this “ Economic Stabilization ” order was allowing businesses to use health insurance as a way to compete for employees. By 1906, the Intercollegiate Athletic Association of the United States (IAAUS) was born.

ACA 113

ACA Health Insurance Public Health Governance 113

Health Populi

AUGUST 16, 2019

Co-pay accumulators are being discussed across health plan types, including government-sponsored plans like Medicare along with commercial health insurance programs. Federal government Blueprint for reducing prescription drug costs. Across party identification, U.S. Much now depends on the U.S.

Governance 79

Governance Health Care Reform FDA ACA 79

MedTrainer

JANUARY 12, 2024

Healthcare compliance is the process of following the laws, regulations, and ethical standards that govern the healthcare industry. The adoption of electronic health records (EHRs), telemedicine , and data analytics has brought about new challenges and opportunities. What is Healthcare Compliance?

Compliance 52

Compliance HIPAA Telemedicine ACA 52

MedTrainer

JANUARY 31, 2024

federal government enacted the Federal False Claims Act (FCA) in 1863 during the American Civil War. It was passed to combat fraud by government contractors during the conflict and set the stage for future compliance regulations. Healthcare compliance isn’t a new concept. Who started the first healthcare compliance program?

Compliance 52

Compliance Fraud Governance ACA 52

Health Populi

OCTOBER 22, 2019

Punctuating the issue of costs, being able to pay for health care tops Americans’ list of the most important characteristic in the health care system — above being seen by a doctor in a timely matter/not long wait, sufficient time to spend with a doctor, access to specialists, prevention, and a choice of health plans.

Prescription Drug Pricing 54

Prescription Drug Pricing Health Insurance Doctors Governance 54

Physician Credentialing Company

MAY 16, 2024

PHOs typically offer a wide range of services, including administrative support, billing and collections, and electronic health records (EHR) systems. Regulatory Considerations When evaluating Management Services Organizations (MSOs) within healthcare, it is critical to understand the regulatory landscape that governs their operation.

Compliance 52

Compliance ACA Health Insurance Hospitals 52

Compliancy Group

JANUARY 3, 2024

Medical billing compliance ensures that providers and administrators engage in ethical and accurate billing practices. When auditing claims, medical records, and financial documentation, it is essential to incorporate guidance based on the following questions: Are all codes for services and supplies correct?

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 52

MedTrainer

APRIL 8, 2024

As a healthcare professional, it is vital to maintain compliance with the 629 legal and regulatory requirements that govern the delivery of quality care. Legal And Regulatory Requirements In Healthcare More than 620 legal and regulatory requirements govern how the healthcare industry ensures patient safety, privacy, and quality of care.

Compliance 52

Compliance Governance ACA HIPAA 52

MedTrainer

JUNE 28, 2023

The primary goal of a Certified Fraud Examiner in healthcare is to safeguard the integrity of healthcare systems and protect patients, insurance providers, and government programs from financial losses due to fraudulent activities. Health Insurance Portability and Accountability Act (HIPAA). Anti-Kickback Statute (AKS).

Fraud 52

Fraud Compliance Governance Compliance Officers 52

MedTrainer

JANUARY 26, 2024

healthcare providers – health systems, hospitals and post-acute care facilities – must comply with 629 discrete regulatory requirements across nine domains. At the top of the list is the Health Insurance Portability and Accountability Act (HIPAA).

HIPAA 52

HIPAA Compliance ACA Health Insurance 52

Healthcare Law Blog

APRIL 6, 2022

The new state plan option allows state Medicaid and Children’s Health Insurance Program (“CHIP”) agencies to provide 12 months of continuous postpartum coverage, regardless of any changes in circumstances, through a state plan amendment (“SPA”). This option is available for five years and ends on March 31, 2027.

Medicaid 52

Medicaid Medicaid ACA Public Health 52

MedTrainer

AUGUST 31, 2023

Healthcare compliance refers to the process of adhering to the laws, regulations, and ethical standards that govern the healthcare industry. The Health Insurance Portability and Accountability Act (HIPAA) is a federal law in the United States that protects patients’ health information, and ensures its confidentiality and availability.

Compliance 52

Compliance Compliance Officers HIPAA Fraud 52

Medisys Compliance

APRIL 25, 2023

It is crucial to verify that the billing company is adhering to industry standards, such as HIPAA (Health Insurance Portability and Accountability Act) regulations, which protect patients’ medical information.

Regulatory Compliance 52

Regulatory Compliance ACA Medical Billing Outsourcing Compliance 52

MedTrainer

AUGUST 2, 2023

Federal Government Audits These audits are performed by government agencies such as the Centers for Medicare and Medicaid Services (CMS). They review healthcare claims and billing practices to ensure accuracy, detect fraud or abuse, and assess compliance with the payer’s policies and guidelines.

Compliance 52

Compliance ACA Medicaid Medicaid 52

MedTrainer

MARCH 28, 2024

Establishes a governance structure, reviews compliance reports, and ensures the organization operates ethically and within legal boundaries. Law by law, regulations were added, increasing the complexity of maintaining compliance for healthcare organizations. Cons: Limited focus on other aspects of compliance beyond their specific areas.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

The Digital Health Corner

APRIL 28, 2017

I would add that the enactment (and some would say the design) of the ACA itself spurred payer consolidation. Payers are consolidating as well because of pressures to scale for clients across large geographical regions and to support costs of technology.

Hospitals 60

Hospitals ACA Patient Satisfaction Payment Systems 60

Healthcare Law Blog

MARCH 20, 2023

1] In addition to the challenges presented by provider shortages, even when patients are able to locate an available mental health provider, many are hesitant to engage in treatment due to cost uncertainties, which often arise due to limited availability for in-network care and the subsequent need to seek out-of-network care. [2]

Medicaid 52

Medicaid Medicaid Licensing ACA 52

Health Populi

MAY 6, 2018

.” At the time, this was one of the world’s biggest public-sector financed health plan. Over time, America’s approach to health care provision fragmented by plan sponsor, whether U.S.

Medicaid 54

Medicaid Medicaid Medicare Medicare 54

MedTrainer

NOVEMBER 15, 2023

In the United States, there are several compliance frameworks and entities that govern requirements for the healthcare industry. Each governing body oversees a different aspect of regulatory compliance. To understand which compliance frameworks govern which requirements, we need to break it down entity by entity.

Compliance Framework 52

Compliance Framework Governance Compliance Medicaid 52

Center for Health Insurance Reform

JANUARY 20, 2022

The federal government has taken a series of actions to strengthen the Affordable Care Act (ACA) and Medicaid, and the Biden administration has announced its intent to do more in this arena.

ACA 98

ACA Federal Policy Health Insurance Medicaid 98

Healthcare Law Blog

JANUARY 26, 2023

BACKGROUND The Proposed Rule is the latest in a long line of federal legislation and rulemakings governing the conscience rights of healthcare providers and entities. The Church Amendments In the 1970s, the federal government enacted the Church Amendments, 42 U.S.C.

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ACA Medicaid Medicaid Compliance 105

AIHC

AUGUST 13, 2024

Written by Corliss Collins , BSHIM, RHIT, CRCR, CSM, CCA, CBCS, CPDC and Joanne Byron , BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, OHCC, ICDCT-CM/PCS The 2024 Final Rule for Section 1557 of the Affordable Care Act (ACA) was issued by the Department of Health and Human Services (HHS) on April 26, 2024.

Compliance 52

Compliance ACA Health Insurance Medicaid 52

Health Populi

MARCH 7, 2018

There’s an old saw that the US government is an insurance company with an army” quips @PaulKrugman @HIMSS #HIMSS18 #HX360 #Healthinsurance #Medicare #Healthcare #Healthcosts. The post Tweets at Lunch with Paul Krugman – Health IT Meets Economics appeared first on HealthPopuli.com. More #nurses than #miners #healthcosts.

ACA 48

ACA Governance Nurses Medicare 48

Hall Render

MAY 2, 2023

Guidance from the DOL reminds group health plans and health insurance issuers are required to notify in advance their participants, beneficiaries, and/or enrollees of reductions in benefits, which could include changes in coverage of COVID-19 diagnosis and treatment, including testing.

Public Health 40

Public Health COVID-19 COVID-19 Vaccine ACA 40

Center for Health Insurance Reform

APRIL 6, 2023

The Biden administration is poised to finalize new rules governing the Affordable Care Act Marketplaces and insurance reforms for plan year 2024.

Governance 97

Governance ACA 97

Hall Render

AUGUST 19, 2022

Connecticut ditches $20M health information exchange software. Two Health Insurers Grilled for Proposing Rate Increases of 20 and 25 Percent. HCA Florida Fort Walton-Destin Hospital, Okaloosa school district to build health academy. Two Georgia health systems to receive $300M in federal funds. From CIO to CEO?

COVID-19 40

COVID-19 Nursing Homes US Department of Health and Human Services Nurses 40

Health Populi

FEBRUARY 4, 2018

Health care ranks highest among working Americans as the top critical issue facing the country, well above terrorism, the role of the Federal government, unemployment and jobs, education, immigration and taxes. healthcare is based largely on cost: one-half of workers experienced an increase in health care costs in the past year.

Medicare 59

Medicare Medicare Health Insurance Doctors 59

Healthcare Law Blog

MAY 17, 2022

The 2023 NBPP final rule makes regulatory changes in the individual and small group health insurance markets and establishes requirements for the 2023 benefit year. Clayton County. This provision was strongly supported by various stakeholders.

ACA 52

ACA Health Insurance Medicaid Medicaid 52

Hall Render

MAY 24, 2024

New York health plans pitch merger NYC hospital-building boom on Upper East Side roils upper-crust residents NYU Langone opens ASC in NYC Urgent care center ranks No. health director Care New England reports $1.9M in Q1 Cleveland Clinic expands partner network Cleveland Clinic will pay $7.6M Senate confirms Larkin as R.I.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Health Law Gurus

DECEMBER 19, 2018

Created as a response to the President’s October 12 th executive order on health care, the report criticizes laws and regulations that govern the health care industry and describes how they stifle competition, and as a result, lead to ever-growing health care spending.

Nurses 52

Nurses Licensing Hospitals Health Insurance 52

Health Populi

MAY 14, 2018

Seniors and government programs over-paying for drugs. High and rising out-of-pocket costs for health consumers. Foreign governments’ “free-riding” Americans’ investment in innovation. health consumers/voters want to see, shown in the second graph.

Prescription Drug Pricing 48

Prescription Drug Pricing Governance ACA Medicare 48