Bill of Health

JULY 28, 2023

The selections feature topics ranging from a review of modifications to blood glucose monitoring systems and related patent protections, an examination of insulin price changes from 2012-2019, and a discussion of why a proposed federal bill that would ban government health care programs from using the quality-adjusted life-year is misguided.

Medicaid 130

Medicaid Medicaid Governance 130

AIHC

MARCH 12, 2024

Written by the AIHC Education Department This article provides an overview of how the media and government are reacting to the potential of artificial intelligence (AI) and potential threats associated with this advanced technology. A Government-Commissioned Report Released February 2024 The U.S.

Ransomware 52

Ransomware Governance Compliance HIPAA 52

Hall Render

FEBRUARY 10, 2023

North Carolina legislators are considering a Medicaid expansion bill that includes a repeal of its CON law. Higher interest rates have resulted in fewer government and non-profit health care providers going to market to place debt. Hall Render blog posts and articles are intended for informational purposes only.

Medicaid 40

Medicaid Medicaid Hospitals Governance 40

Hall Render

AUGUST 22, 2023

The Fourth Circuit recently held that providers may not defend a False Claims Act (“FCA”) lawsuit by arguing that eligibility requirements violate the Medicaid Act. the government alleged a clinical pharmacy manager for a Tennessee Walgreens falsified twelve different patients’ medical records between January 2015 and June 2016.

Medicaid 40

Medicaid Medicaid Governance Fraud 40

Healthcare IT Today

SEPTEMBER 19, 2024

The following is a guest article by Aaron Timm, EVP and Chief Commercial Officer at Vivalink In recent years, Hospital-at-Home (HaH) programs have been accepted more widely as a way of providing acute-level care to patients at home. with its introduction of the Acute Hospital Care at Home (AHCAH) waiver in 2020.

Hospitals 120

Hospitals Governance Telemedicine Payment Systems 120

Bill of Health

MARCH 25, 2022

A full posting of abstracts/summaries of these articles may be found on our? A New Way to Contain Unaffordable Medication Costs – Exercising the Government’s Existing Rights. Medicaid Expenditures and Estimated Rebates on Line Extension Drugs, 2010-2018. Mayo Clin Proc. 2022 Feb;97(2):250-260. PMID: 35120693.

FDA 209

FDA COVID-19 Medicaid Medicaid 209

Health Care Law Brief

FEBRUARY 8, 2024

billion to fund Medicaid, $4.8 In addition to those provisions that look to extend current government programs, the HMH Bill proposes the following new initiatives: Provider Specific Provisions : Transforming Safety Net Hospitals. The Department of Health (“DOH”) would establish Medicaid reimbursement rates for such off-site services.

Medicaid 52

Medicaid Medicaid Nurses Licensing 52

HIT Consultant

AUGUST 6, 2023

Often, insurance or the government covers part of the healthcare costs, but if a patient doesn’t have healthcare coverage, they will be responsible to reimburse their providers for the entire cost of the care. They are no longer simply a place for aging Medicare and Medicaid patients to live out their final years.

Nursing Homes 98

Nursing Homes Nurses Medicare Medicare 98

Hall Render

OCTOBER 22, 2024

Effective October 1, 2024, the Centers for Medicare & Medicaid Services (“CMS”) introduced significant updates to the CMS-855A form , specifically requiring a new Skilled Nursing Facility (“SNF”) Attachment for every SNF. Hall Render blog posts and articles are intended for informational purposes only.

Medicare 40

Medicare Medicare Nurses Medicaid 40

Jane Sarashon

NOVEMBER 7, 2024

With my ongoing focus on social determinants and drivers of health for health equity and access, the first essay that caught my attention is on Government Obligations and the Negative Right to a Healthy Urban Environment. I’ll focus this post on one of the pieces that resonate with what I’m working on these days.

Bioethics 52

Bioethics Public Health Governance Medicaid 52

Medisys Compliance

FEBRUARY 27, 2024

In this article, we will explore the complex landscape of radiology billing compliance, exploring key regulations, audit processes, and strategies for ensuring adherence to guidelines. Understanding Regulatory Framework Radiology billing is governed by a multitude of regulations at the federal, state, and local levels.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

MAY 20, 2024

This article dives into the world of mental health services reimbursement rates, empowering providers with knowledge to navigate this complex system. Payer type: Private insurance companies, Medicare, and Medicaid have their own reimbursement structures. What are Reimbursement Rates?

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicare 59

Healthcare IT Today

OCTOBER 19, 2022

The following is a guest article by Serrah Linares, Vice President of Partner Sales at Change Healthcare , and Rachel Mack Robinson, Founder and President at DotCom Therapy. get their health coverage through Medicaid, this is absolutely essential to ensure healthcare equity. Today in the U.S.,

Medicaid 110

Medicaid Medicaid COVID-19 Telemedicine 110

Healthcare IT Today

OCTOBER 20, 2023

This is the final article in a series about social determinants of health (SDoH). Previous articles covered the definition, collection, sharing, and use of SDoH. Food Aid Federal government food programs expanded significantly during the COVID-19 crisis. I’ll finish with a look at some specific areas of intervention.

Medicaid 125

Medicaid Medicaid COVID-19 Doctors 125

MedTrainer

MAY 21, 2024

The Centers for Medicare and Medicaid Services (CMS) defines behavioral health as the emotions and behaviors that affect your overall well-being. This article will explore the requirements for behavioral health training, the entities that govern required and recommended courses, and ways to simplify training delivery.

Compliance 52

Compliance Medicaid Medicaid HIPAA 52

Healthcare IT Today

AUGUST 20, 2023

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. That said, 66% trust their health plan more that the government or non-traditional entities such as Amazon or Walmart to their health insurance.

Health Insurance 98

Health Insurance Medicaid Medicaid FDA 98

Healthcare IT Today

FEBRUARY 17, 2023

government and calls for better oversight , the Centers for Medicare & Medicaid Services announced in early February that it would investigate overbilling by those plans. This article focuses on the relatively young technologies that enable CMS to uncover overbillings, whether they be errors or fraud.

Overpayments 107

Overpayments Overpayment COVID-19 Medicare 107

AIHC

NOVEMBER 15, 2022

The Centers for Medicare & Medicaid Services (CMS) is the federal agency responsible for enforcement and has been working with the American Hospital Association (AHA) to comply with challenges related to compliance. In 2019, the federal government finalized a rule requiring hospitals to disclose the prices they negotiate with insurers.

Hospitals 52

Hospitals US Department of Health and Human Services Compliance Governance 52

Jane Sarashon

FEBRUARY 15, 2022

While his friend did not win his race, William Weld did win the governor’s post and Abner joined State government under Weld. He ended up working in Massachusetts State government for about 15 years. Abner would talk about Medicaid, and the VC community didn’t understand what Medicaid was having little to no exposure to the payor.

Medicaid 94

Medicaid Medicaid Telemedicine Governance 94

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. The federal government has been haranguing vendors and clinicians to make interoperable systems since the HITECH act was passed in 2009. A CMS fact sheet offers more details on CMS’s thinking and plans.

Electronic Medical Records 112

Electronic Medical Records Doctors Governance Medicaid 112

Healthcare IT Today

OCTOBER 25, 2024

The following is a guest article by Mike Crouse, Director of Insider Risk at Everfox Ransomware attacks on the healthcare sector continue to grow, with incidents nearly doubling from 2022 to 2023—a concerning figure considering their potential to leave patients in life-or-death situations.

Ransomware 112

Ransomware Hospitals Medicaid Medicaid 112

Healthcare IT Today

OCTOBER 18, 2023

Previous articles in this series showed why social determinants of health (SDoH) are the hottest recent addition to data used by the medical industry. This article shows how organizations are collecting it. We’ve explored how SDoH data is defined and shared. The percentage is much higher in some areas.

Doctors 125

Doctors Public Health Medicare Medicare 125

Medisys Compliance

MARCH 5, 2024

This article explores into the details of cardiology billing, offering insights into payer audits and reimbursement challenges in cardiology billing. This complexity is reflected in the coding and billing requirements set forth by government payers such as Medicare, as well as private insurance companies.

Medical Billing Outsourcing 105

Medical Billing Outsourcing Medical Billing Compliance Governance 105

Hall Render

OCTOBER 28, 2024

The Centers for Medicare & Medicaid Services (“CMS”) is reinforcing regulatory expectations regarding nursing home residents’ rights to vote. Nursing homes certified by Medicare or Medicaid must ensure that their residents can fully exercise their rights as United States citizens, including their right to vote. 42 CFR §483.10(b)(1)

Nursing Homes 40

Nursing Homes Nurses Medicaid Medicaid 40

MedTrainer

DECEMBER 7, 2023

This article is your guide to the important aspects of healthcare compliance in New Mexico with strategic insights for effective management. Telehealth Policy For providers in New Mexico, telehealth services are governed by regulations that emphasize equitable access and reimbursement rates.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

AIHC

AUGUST 8, 2023

Written by: Carl Byron , CCS, CHA, CIFHA, CMDP, CPC, ICDCT-CM/PCS, OHCC This 3-part article shares insight regarding how well-meaning decisions can turn into unintended consequences. The “Cobra” - In the late 1800s-early 1900s when India was ruled by the British government, there was a problem with venomous cobras invading major cities.

COVID-19 40

COVID-19 Governance Hospitals Medicaid 40

Healthcare IT Today

SEPTEMBER 11, 2024

The following is a guest article by Deepti Sharma, Senior Vice President of Product Management at HSBlox Healthcare providers are continuing to form and invest in Accountable Care Organizations (ACOs) as a means of improving care quality and reducing costs.

Medicare 68

Medicare Medicare Medicaid Medicaid 68

MedTrainer

NOVEMBER 27, 2023

This article outlines some of the key compliance aspects specific to Ohio, so you know what’s needed to establish a sufficient compliance program. This department focuses on ensuring access to quality healthcare services while managing the state’s Medicaid budget and policies. The license is valid for three years unless revoked.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

YouCompli

SEPTEMBER 27, 2023

Enforcement agencies like to “follow the money,” so to speak, and they often find it in medical claims submitted to government payors such as Medicare and Medicaid. The services involved allergy immunotherapy preparation and office visits, also known as evaluation and management services, billed to Medicare and Medicaid.

Compliance 52

Compliance Overpayments Overpayment Medicare 52

Healthcare IT Today

NOVEMBER 15, 2023

The previous article in this series explained some of the ways payers, providers, and digital health companies demonstrate that they have made a positive difference in their patients’ lives. ” This article looks at the measurements and reporting strategies used by some specific companies.

Medicare 115

Medicare Medicare Hospitals Compliance 115

AIHC

SEPTEMBER 25, 2024

There is value in learning from another organization’s lessons publicly posted by a government authority, such as the Department of Justice (DOJ), Centers for Medicare & Medicaid Services (CMS), the HIPAA enforcement agency, the Office of Civil Rights (OCR) or the Federal Bureau of Investigations (FBI).

Fraud 52

Fraud Compliance Compliance Officers Licensing 52

Hall Render

JANUARY 27, 2023

The main drivers of the increase in filings were increased labor and supply costs, interest rate increases, lack of government stimulus funds and lower investment returns. The Kaiser Family Foundation released a summary of all of the Medicaid Waivers (section 1115) that are pending or that have been approved by each state.

Medicaid 40

Medicaid Medicaid Hospitals Governance 40

Healthcare IT Today

AUGUST 7, 2022

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Cybersecurity company Surfshark found the number of government requests for user data increased 4x from 2013 to 2020 among Apple, Google, Facebook, and Microsoft. Partnerships.

Governance 98

Governance Telemedicine Medicaid Medicaid 98

Hall Render

AUGUST 8, 2022

The web server contained ePHI, including patients’ names, Medicaid numbers, health care provider names, dates of service, dates of birth, addresses and treatment information. Further, data governance is key to proactively managing ePHI. Hall Render blog posts and articles are intended for informational purposes only.

HIPAA 73

HIPAA Governance Medicaid Medicaid 73

MedTrainer

DECEMBER 4, 2023

This article gives a clear and detailed look at the important things you need to know about following healthcare laws in Kentucky, especially for those who provide healthcare and manage compliance. Medicaid Telehealth Regulations In Kentucky, Medicaid telehealth regulations are crucial for healthcare providers and compliance professionals.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

OCTOBER 11, 2024

As you may have discovered (hopefully not the hard way), meeting the basic requirements set forth by the Centers for Medicare and Medicaid (CMS) and OSHA should be a bare minimum. To truly be prepared with a multi-hazard approach, you should conduct risk assessments and use all the tools and resources available to you.

Compliance Officers 52

Compliance Officers Compliance Medicaid Medicaid 52

Hall Render

NOVEMBER 14, 2024

The governing body is responsible for assuring that this is done as part of their oversight responsibilities set forth in 42 CFR § 484.105(a). Hall Render blog posts and articles are intended for informational purposes only. HHAs are already required by 42 CFR § 484.105 to document, in writing, the services that they furnish.

Payment Systems 40

Payment Systems Medicare Medicare Medicaid 40