Remove ACA Remove Medicaid Remove US Department of Health and Human Services
article thumbnail

Fifth Circuit Upholds ACA Risk Adjustment Program

Healthcare Law Blog

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger insurers. See Vista Health Plan, Inc. United States Dep’t of Health & Hum. at 15,432 ); and.

ACA 52
article thumbnail

Texas OIG Inspectors Discover Errors in Reported Nursing Home Staff Hours

Med-Net Compliance

On November 3, 2022, the OIG released the results of a recent inspection of a nursing home by the Texas Health and Human Services (HHS) Office of Inspector General Audit and Inspections Division (OIG Inspections).

Insiders

Sign Up for our Newsletter

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

article thumbnail

Importance of Regulatory Compliance in Healthcare

Compliancy Group

Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. It also reduces waste, fraud, and abuse that threaten the efficiency of healthcare delivery and services. name, phone number).

article thumbnail

Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

In one incident, a New Jersey pharmacy admitted to conspiracies to defraud benefits providers, including Medicare and Medicaid, of $65 million for medications never provided to patients. Department of Health and Human Services, Office of Inspector General (HHS-OIG), said.

Fraud 52
article thumbnail

Health Provider News

Hall Render

in 2022, survey finds Senate votes to end COVID-19 national emergency Why are 600+ rural hospitals at risk of closing? in 2022, survey finds Senate votes to end COVID-19 national emergency Why are 600+ rural hospitals at risk of closing? What happens if it disappears?

article thumbnail

Health Provider News – August 19, 2022

Hall Render

Amazon to offer behavioral health services through Ginger partnership. CDC, amid criticism for COVID-19 response, plans reorganization as public health threats grow. House approves sweeping climate, tax, health care package. Joint Commission’s New Accreditation Standards Tackle Health Disparities. CALIFORNIA.

article thumbnail

Health Provider News – July 1, 2022

Hall Render

Fewer Than 2% of Hospitals Excelling at Health Equity, Value. How hospitals should prepare for the end of the public health emergency. Justice Department cracks down on ASC, anesthesia provider arrangements. Insurance company Cigna, Ascension Health Alabama struggle to reach contract renewal. Wade reversal.