Bill of Health

OCTOBER 17, 2024

This article seeks to summarize these developments in the law. This aligns with recent guidance from the Centers for Medicare and Medicaid Services that Medicare Advantage plans may not make a determination of medical necessity solely based on algorithms using broad data sets. AB 3030 focuses on the use of generative AI.

Medicare 150

Medicare Medicare Health Insurance Licensing 150

Electronic Health Reporter

JANUARY 27, 2021

This article is copyrighted strictly for Electronic Health Reporter. The Centers for Medicare and Medicaid Services (CMS) in recent months predicted both lower premiums and richer benefits for Medicare Advantage (MA) […]. Illegal copying is prohibited.

Medicare 155

Medicare Medicare Medicaid Medicaid 155

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 121

Ransomware Hospitals Medicaid Medicaid 121

Bill of Health

APRIL 4, 2025

The settlement compelled the tobacco companies to pay billions of dollars to the states to compensate them for Medicaid costs incurred by smokers, placed limits on tobacco advertising, and funded public information efforts. Related Articles Food Safety Decoding Front-of-Package Food Labels: Are They Really Telling Us Whats Healthy?

Public Health 147

Public Health FDA World Health Medicaid 147

Bill of Health

OCTOBER 28, 2022

A full posting of abstracts/summaries of these articles may be found on our? Associations Between Copays, Coverage Limits for Naloxone, and Prescribing in Medicaid. Daval CJR, Avorn J, Kesselheim AS. Holding Pharmaceutical and Medical Device Executives Accountable as Responsible Corporate Officers. JAMA Intern Med. 2022 Sep 19.

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FDA Medicaid Medicaid 241

Healthcare IT Today

JANUARY 19, 2025

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Personal emergency response system LogicMark expanded access to devices through Medicaid waivers in six states. Welcome to the weekly edition of Healthcare IT Today Bonus Features.

Medicaid 89

Medicaid Medicaid Telemedicine Hospitals 89

Fierce Healthcare

JULY 30, 2024

As artificial intelligence rapidly makes inroads in healthcare, federal agencies already have the authority to regulator AI at the hospital bedside, according to some healthcare researche | An article published in JAMA Health Forum argues that through the conditions of participation in Medicare and Medicaid, CMS has the authority to oversee how hospitals (..)

Hospitals 133

Hospitals Medicaid Medicaid Medicare 133

MRO Compliance

SEPTEMBER 19, 2023

The Centers for Medicare and Medicaid Services (CMS) Medicare Advantage Risk Adjustment Data Validation (RADV) audit season peaks from March through April every year. View Full Article  Health information (HI) professionals nationwide anticipate a looming tsunami of payer requests for medical records.

Medicare 130

Medicare Medicare Medicaid Medicaid 130

Electronic Health Reporter

MARCH 31, 2020

This article is copyrighted strictly for Electronic Health Reporter. Maven, the largest telemedicine provider for women’s and family health, announced a new partnership with MassHealth, the Massachusetts, Medicaid and the Children’s Health Insurance Program. Illegal copying is prohibited.

COVID-19 131

COVID-19 Telemedicine Health Insurance Medicaid 131

AIHC

NOVEMBER 12, 2024

This article addresses how these privacy rights extend beyond rules designated under HIPAA and States passing rules banning unauthorized pelvic exams. These revisions resulted from recent articles, media reports, and concerns from nurses, some physicians, and medical students opposing these exams. [3],[4]

Informed Consent 98

Informed Consent HIPAA Compliance Hospitals 98

MRO Compliance

JULY 12, 2023

Accurate, properly documented, interoperable patient data is required to achieve CMS’s goal for 100 percent of Medicare (and the majority of Medicaid) beneficiaries to be enrolled in some type of accountable, or value-based, care arrangement by 2030. View Full Article

Medicaid 130

Medicaid Medicaid Medicare Medicare 130

Healthcare IT Today

NOVEMBER 3, 2024

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. A Podimetrics survey found 65% of Medicaid beneficiaries living with type 2 diabetes also manage at least one chronic behavioral health condition.

Medical Billing 92

Medical Billing Licensing Medicaid Medicaid 92

Healthcare IT Today

JANUARY 23, 2025

The following is a guest article by Ashish V. The HEI Reward Factor will assess how well plans serve beneficiaries with social risk factors such as low income, disability, or dual eligibility for Medicaid. Data from measurement years 2024 and 2025 will impact Star ratings in 2027.

Medicare 97

Medicare Medicare Medicaid Medicaid 97

Bill of Health

MARCH 14, 2025

Approximately 14 states Medicaid programs cover any form of a GLP-1 drug to treat obesity. Related Articles Government Regulation When Clinical Trials Meet Patents: Finding Balance in Law By Erin Lynch Government Regulation Decoding Front-of-Package Food Labels: Are They Really Telling Us Whats Healthy?

FDA 130

FDA Governance Medicaid Medicaid 130

Electronic Health Reporter

OCTOBER 6, 2022

This article is copyrighted strictly for Electronic Health Reporter. The Centers for Medicare and Medicaid Services (CMS) has made no secret of its intentions to crack down on fraud, abuse, and waste, throwing more budget dollars into audits, heightening program […]. Illegal copying is prohibited. By Dana Finnegan, MDaudit.

Fraud 113

Fraud Medicaid Medicaid Medicare 113

Healthcare IT Today

APRIL 26, 2023

The following is a guest article by Ashley Perry, MPH, Chief Strategy and Solutions Officer at Socially Determined When Congress passed the Consolidated Appropriations Act of 2023 , it decoupled the Public Health Emergency (PHE) from the Medicaid program’s continuous enrollment provision, which was implemented as part of the PHE in March 2020.

Medicaid 75

Medicaid Medicaid Public Health Health Outcomes 75

Healthcare IT Today

FEBRUARY 26, 2023

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. The Mississippi Division of Medicaid chose HHAeXchange and FEI Systems to build an electronic visit verification system for the state.

Medicaid 81

Medicaid Medicaid FDA Health Insurance 81

Healthcare IT Today

JANUARY 14, 2025

Michael Poku, MD, MBA, Chief Clinical Officer at Equality Health In 2025, Value-Based Care will reach a pivotal crossroads, especially for Medicaid populations. Thank you so much to everyone who took the time out of their day to submit a prediction to us and thank you to all of you for taking the time to read this article!

ACA 83

ACA Medicaid Medicaid Fraud 83

Hall Render

MARCH 10, 2025

On March 7, 2025, the Centers for Medicare & Medicaid Services (CMS) posted a memo dated March 10, 2025, that gives nursing homes and surveyors more time to prepare for implementation of new rules and updates to allow surveyors to add extra attention and increase oversight in nursing homes.

Nursing Homes 52

Nursing Homes Nurses Medicaid Medicaid 52

Healthcare IT Today

JUNE 10, 2021

The following is a guest article by Phyllis Wojtusik, RN, Executive VP, Health System Solutions at Real Time Medical Systems.

Medicaid 110

Medicaid Medicaid Medicare Medicare 110

Hall Render

MARCH 27, 2025

The Centers for Medicare & Medicaid Services (CMS) has given surveyors additional rules and updates to allow surveyors to assess and cite violations of the regulations on nursing homes with admission agreements that create prohibited third-party guarantee of resident payments.

Nursing Homes 52

Nursing Homes Nurses Medicaid Medicaid 52

Healthcare IT Today

JANUARY 22, 2025

Contact us here with a link to the open position and we’ll be happy to feature it in next week’s article at no charge! Do you have an open health IT position that you are looking to fill? Note: These jobs are listed byHealthcare IT Today as a free service to the community.

Due Diligence 69

Due Diligence Medicaid Medicaid Medicare 69

Hall Render

JANUARY 29, 2025

The Centers for Medicare & Medicaid Services (CMS) is reinforcing its emphasis on hospice quality of care and identifying fraud. Hall Render blog posts and articles are intended for informational purposes only.

Fraud 80

Fraud Medicare Medicare Compliance 80

Medisys Compliance

JULY 19, 2024

Introduction The landscape of Medicare and Medicaid billing for behavioral health services has undergone significant changes recently. This article discusses the latest changes, providing a comprehensive guide to navigating the evolving billing landscape. All rights reserved.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare IT Today

FEBRUARY 6, 2025

Healthcare providers look to policymakers and advocates to work together to further tackle these challenges on a larger scale by increasing funding, expanding Medicaid coverage and access, strengthening data collection and reporting, and empowering communities to take action to address social determinants of health.

Medicaid 76

Medicaid Medicaid COVID-19 Federal Policy 76

Hall Render

FEBRUARY 17, 2025

According to a statement released on the Center for Medicare and Medicaid Services (CMS) website, effective February 14, 2025, implementation of the Hospice Special Focus Program for calendar year 2025 has ceased so that CMS may further evaluate the program. Hall Render blog posts and articles are intended for informational purposes only.

Medicare 89

Medicare Medicare Nursing Homes Medicaid 89

Bill of Health

DECEMBER 27, 2022

A full posting of abstracts/summaries of these articles may be found on our  website. Variations in Use of Diabetes Drugs With Cardiovascular Benefits Among Medicaid Patients. Beall RF, Glazer T, Ahmad H, et al. Patent “Evergreening” of Medicine-Device Combination Products: A Global Perspective. Healthcare Policy.

Medicare 147

Medicare Medicare Medicaid Medicaid 147

Healthcare IT Today

JANUARY 14, 2024

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Welcome to the weekly edition of Healthcare IT Today Bonus Features. The program is supported by funding from the FCC’s Affordable Connectivity Program.

Medicaid 97

Medicaid Medicaid FDA Medicare 97

Bill of Health

FEBRUARY 28, 2024

This article will explore the development of Food is Medicine and its limitations, and briefly offer recommendations for successful Food is Medicine initiatives. Some states have implemented initiatives to integrate Food is Medicine into Medicaid , which can be valuable to expand access to broader groups of the population.

Health Insurance 234

Health Insurance Medicaid Medicaid Health Care Reform 234

Bill of Health

NOVEMBER 17, 2022

A full posting of abstracts/summaries of these articles may be found on our? Medicaid Spending on Antiretrovirals from 2007-2019. Brown BL, Mitra-Majumdar M, Darrow JJ, Moneer O, Pham C, Avorn J, Kesselheim AS. Fulfillment of Postmarket Commitments and Requirements for New Drugs Approved by the FDA, 2013-2016. Value Health.

FDA 189

FDA World Health Medicaid Medicaid 189

Bill of Health

MARCH 24, 2023

A full posting of abstracts/summaries of these articles may be found on our  website. Market dynamics of authorized generics in Medicaid from 2014 to 2020. medical device regulation, to a review of price negotiation processes in peer countries and potential lessons for Medicare price regulation. 2023 Feb 25;S0012-3692(23)00301-X.

Medicare 147

Medicare Medicare Medicaid Medicaid 147

Hall Render

NOVEMBER 1, 2024

Health care fraud remains a significant focus for federal and state enforcement agencies, with particular attention placed on the integrity of Medicaid and Medicare billing. He was also ordered to pay $557,000 in restitution to Indiana Medicaid and Medicare.

Fraud 40

Fraud Compliance Medicaid Medicaid 40

Bill of Health

APRIL 25, 2022

A full posting of abstracts/summaries of these articles may be found on our website. Anticipated efficiencies, real costs: Medicaid managed care organizations and the pharmacy benefit. Bendicksen L, Kesselheim AS. J Manag Care Spec Pharm. 2022 Mar;28(3):354-361. Dhruva SS, Darrow JJ, Kesselheim AS, Redberg RF.

COVID-19 147

COVID-19 Medicaid Medicaid FDA 147

Hall Render

MARCH 11, 2025

Government fraud enforcement remains aggressive : Despite this ruling, health care providers should continue prioritizing compliance with Medicare and Medicaid billing regulations. Hall Render blog posts and articles are intended for informational purposes only.

Medicare 52

Medicare Medicare Governance Fraud 52

Center for Health Insurance Reform

MARCH 6, 2023

States have begun conducting Medicaid redeterminations and renewals after an almost 3-year pause, a process that is being called the "Unwinding."

Medicaid 89

Medicaid Medicaid Health Insurance 89

Compliancy Group

FEBRUARY 12, 2025

This article provides an in-depth overview of the key compliance risk areas and recommendations outlined in the ICPG, emphasizing the importance of a proactive approach to compliance and quality assurance. The ICPG was issued after creating the GCPC , a general compliance reference guide for healthcare stakeholders.

Nurses 52

Nurses Compliance Medicare Medicare 52

Healthcare IT Today

MAY 28, 2024

The following is a guest article by Shannon West, Chief Product Officer at Datavant Since the dawn of electronic medical records, American healthcare delivery systems have traced a winding path toward the dream of seamless and timely health data interoperability.

Electronic Medical Records 126

Electronic Medical Records Medicaid Medicaid Medicare 126