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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.

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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).

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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).

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VBC: Improving Healthcare Outcomes With A Strong Payer-Provider Relationship

HIT Consultant

Years before the pandemic, the Affordable Care Act (ACA) revolutionized the healthcare industry and encouraged a new approach to balancing all the variables: value-based care (VBC). As of 2021, nine in ten (88%) of US physicians had adopted electronic health records (EHRs), up from only 57% a decade prior.

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Two Healthcare Organizations Caught Up in Medicare Fraud Schemes

Compliancy Group

Department of Health and Human Services, Office of Inspector General (HHS-OIG), said. Pharmacy employees who submit fraudulent claims to Medicare and Medicaid and bribe medical providers to induce prescriptions put health care benefits for vulnerable populations at risk.”

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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?

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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.