Bill of Health

DECEMBER 27, 2022

A full posting of abstracts/summaries of these articles may be found on our  website. Frequency of Approval and Marketing of Biosimilars With a Skinny Label and Associated Medicare Savings. Getting the Price Right: Lessons for Medicare Price Negotiation from Peer Countries. Beall RF, Glazer T, Ahmad H, et al. Healthcare Policy.

Medicare 147

Medicare Medicare Medicaid Medicaid 147

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

Bill of Health

MARCH 24, 2023

The selections feature topics ranging from an analysis of the approval and marketing of biosimilars with a skinny label and their associated Medicare savings, to a discussion of the Philips Respironics recall and the need for reforms to U.S. A full posting of abstracts/summaries of these articles may be found on our  website.

Medicare 147

Medicare Medicare Medicaid Medicaid 147

Electronic Health Reporter

JUNE 25, 2020

This article is copyrighted strictly for Electronic Health Reporter. The Centers for Medicare & Medicaid Services (CMS) announced the creation of a new office, the […]. The article CMS Announces New Office (“Aubrey”) To Streamline Interoperability and Informatics appeared first on electronichealthreporter.com.

Medicaid 103

Medicaid Medicaid Medicare Medicare 103

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.

Fraud 113

Fraud Medicaid Medicaid Medicare 113

Electronic Health Reporter

FEBRUARY 11, 2019

Following the release of its proposed new rules designed to improve the interoperability of electronic health information, members of leadership from the Centers for Medicare & Medicaid Services (CMS) hosted a call to provide additional detail about the proposed rule, and to answer questions from the media.

Medicaid 107

Medicaid Medicaid Medicare Medicare 107

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

Electronic Health Reporter

FEBRUARY 20, 2019

During her trip to HIMSS19, Center for Medicare & Medicaid Service administrator Seema Verma spoke with registered members of the media to preview her keynote speech and answer questions about her department’s newly released proposed interoperability rule. This content is copyrighted strictly for Electronic Health Reporter.

Medicaid 115

Medicaid Medicaid Medicare Medicare 115

Electronic Health Reporter

FEBRUARY 11, 2019

The rules, issued by the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), would increase choice and competition […].

Medicaid 115

Medicaid Medicaid Medicare Medicare 115

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

Bill of Health

NOVEMBER 17, 2022

A full posting of abstracts/summaries of these articles may be found on our? Medicare’s National Coverage Determination for Aducanumab – A One-Off or a Pragmatic Path Forward? Medicaid Spending on Antiretrovirals from 2007-2019. Brown BL, Mitra-Majumdar M, Darrow JJ, Moneer O, Pham C, Avorn J, Kesselheim AS.

FDA 189

FDA World Health Medicaid Medicaid 189

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

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 therapies are commonly prescribed to treat type 2 diabetes and are increasingly prescribed for weight loss.

Medicaid 97

Medicaid Medicaid FDA Medicare 97

Medisys Compliance

JULY 15, 2024

Introduction As an internal medicine practitioner, staying updated with the latest Medicare billing changes is crucial for maximizing reimbursements and ensuring compliance. This article explores these changes, providing insights to help you navigate the evolving landscape of Medicare billing.

Medicare 59

Medicare Medicare Medical Billing Outsourcing COVID-19 59

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

MedTrainer

AUGUST 8, 2024

As of March 2024, over 67 million in the United States are Medicare beneficiaries. Medicare is the single largest payer for healthcare services in the United States. In FY2021, the Centers for Medicare and Medicaid Services ( CMS ) reported that Medicare processed more than 1.1 Here’s what you need to know.

Medicare 52

Medicare Medicare Compliance Medicaid 52

HIT Consultant

AUGUST 6, 2023

In an article that appeared on the Skilled Nursing News website , Mark Zimmet, CEO of Zimmet Healthcare Services Group, LLC, summarized the issue as follows: “SNF stakeholders now have access to an array of diverse resources to inform decision-making. Nursing homes are evolving. percent of U.S. healthcare payments, representing close to 238.8

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Nursing Homes Nurses Medicare Medicare 98

Medisys Compliance

JANUARY 31, 2024

Introduction Understanding the details of Medicare coding and claims submission can be daunting for anyone. This article serves as a guide to help you avoid billing mistakes for Medicare and ensure smooth claims processing for your Medicare patients. Common Billing Mistakes 1.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

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. offering in-home treatment.

Medicare 124

Medicare Medicare Hospitals Compliance 124

Bill of Health

MARCH 25, 2022

A full posting of abstracts/summaries of these articles may be found on our? Medicaid Expenditures and Estimated Rebates on Line Extension Drugs, 2010-2018. Bakker E, Hendrikse NM, Ehmann F, van der Meer DS, Llinares Garcia J, Vetter T, Starokozhko V, Mol PGM. Hwang TJ, Vokinger KN. Lancet Oncol. 2022 Feb;23(2):e58. PMID: 35114127.

FDA 208

FDA COVID-19 Medicaid Medicaid 208

Jane Sarashon

FEBRUARY 27, 2024

In addition to highlighting the Patient’s Bill of Rights, NABIP’s keynotes and general sessions will speak to similar topics being brainstormed at VIVE this week — including mental health, maternal health, pharmacy and prescription drugs (pricing, PBMs), population health, and Medicare and Medicaid innovations.

ACA 118

ACA Prescription Drug Pricing Health Insurance Hospitals 118

Electronic Health Reporter

JANUARY 15, 2019

The 340B Drug Pricing Program was created in 1992 to give safety net providers — those that deliver a significant level of both healthcare and other health-related services to the uninsured, Medicaid, and other vulnerable populations — discounts on outpatient drugs to “stretch scare federal resources as […].

Medicaid 107

Medicaid Medicaid Payment Systems Medicare 107

MRO Compliance

AUGUST 3, 2022

I recently wrote an article titled “Internal Audits Help Combat Payer Risk” where I described several keys for a smooth-running revenue cycle. Consider auditing software that can instantly transmit charts, discussions, and appeal filings to Medicare, Medicaid and commercial auditors, preventing file loss and delivery delay.

Compliance Officers 130

Compliance Officers Medicare Medicare Compliance 130

MRO Compliance

JUNE 23, 2022

I recently wrote an article titled “Revenue Integrity: How to Reduce Costs and Retain Revenue” where I provided several tips on how to assess costs and resources and how to better prepare for audits to avoid denials. Maintaining and managing audits is one of the most time-consuming yet critical parts to ensure revenue integrity.

Medicaid 130

Medicaid Medicaid Medicare Medicare 130

Healthcare IT Today

FEBRUARY 17, 2023

Amid swirling accusations that Medicare Advantage Organizations (MAOs) are overbilling the U.S. government and calls for better oversight , the Centers for Medicare & Medicaid Services announced in early February that it would investigate overbilling by those plans. They expect to recoup 4.7 But the needles pile up fast.

Overpayments 89

Overpayments Overpayment COVID-19 Medicare 89

Healthcare IT Today

JULY 16, 2024

The following is a guest article by Nick Barger, PharmD, Vice President, Product at DrFirst. This article is the fourth in the Healthcare Regulatory Talk series. Check out all the articles in the Healthcare Regulatory Talk series. DrFirst is a proud sponsor of Healthcare Scene.

Compliance 124

Compliance Medicaid Medicaid Medicare 124

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. Recently, though, Medicaid has imposed tight restrictions on its food programs , leaving more people food-insecure.

COVID-19 132

COVID-19 Medicaid Medicaid Doctors 132

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

Bill of Health

OCTOBER 7, 2022

A full posting of abstracts/summaries of these articles may be found on our? County-level variation in cardioprotective antihyperglycemic prescribing among medicare beneficiaries. Reforming Patient Cost Sharing for Cancer Medications in Medicare Part D. Bendicksen L, Kesselheim AS, Rome BN. 2022 Aug;162(2):433-435. Lancet Oncol.

Prescription Drug Pricing 130

Prescription Drug Pricing FDA Medicare Medicare 130

Healthcare IT Today

AUGUST 22, 2024

The following is a guest article by Adam Rademacher, Director of Operations at AMN Healthcare Language Services AI’s transformative impact spans across industries– including healthcare. Or “Do you have Medicare/Medicaid?”

Medicaid 124

Medicaid Medicaid HIPAA Medicare 124

Hall Render

MAY 23, 2023

The Centers for Medicare & Medicaid Services (“CMS”) is now accepting applications from ACOs to participate in the Medicare Shared Savings Program (“MSSP” or “Program”) for the agreement period beginning January 1, 2024. Hall Render blog posts and articles are intended for informational purposes only.

Medicare 64

Medicare Medicare Medicaid Medicaid 64

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

Health Law RX

FEBRUARY 21, 2024

The Centers for Medicare & Medicaid Services (CMS) has revised certain payment policies under the Medicare physician fee schedule, and updated provider and supplier enrollment regulations. Summary of Major Updates The below outlined changes are described in more detail in this article.

Medicare 52

Medicare Medicare Licensing Compliance 52

Healthcare IT Today

FEBRUARY 7, 2024

This article explains the complexities that makes it so hard to implement electronic prescribing for controlled substances (EPCS), summarizes the intended impacts of the bills, and introduces Imprivata digital identity technology, which has been used in health care for such purposes for many years. Two bills in U.S.

Telemedicine 130

Telemedicine COVID-19 Doctors Medicare 130

Healthcare Law Today

NOVEMBER 30, 2022

On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) released its final 2023 Medicare Physician Fee Schedule (PFS) rule. Telehealth and other digital health modalities continue to increase in importance for Medicare populations and corresponding health care providers.

Medicare 132

Medicare Medicare Telemedicine Nurses 132

Innovaare Compliance

DECEMBER 11, 2023

Before the Medicare Advantage Open Enrollment Period (MA OEP) [1] begins on January 1, 2024, Medicare Advantage Organizations (MAOs) still have time to review if they are completely ready for a new contract year. This blog article focuses on some of the “must make” changes to take effect as of January 1, 2024, or before.

Medicare 52

Medicare Medicare Compliance Medicaid 52

HIT Consultant

APRIL 3, 2023

We can’t graft a new digital, platform-based healthcare system onto healthcare infrastructure designed to support traditional operations and care models,” Mayo Clinic President and CEO Gianrico Farrugia writes in an article for the World Economic Forum. Healthcare needs transformation.

Medicaid 98

Medicaid Medicaid Medicare Medicare 98