Healthcare Law Blog

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). Refining Definitions for Fully Integrated and Highly Integrated D-SNPs (§§ 422.2

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

Healthcare IT Today

AUGUST 28, 2022

The latest survey from Definitive Healthcare found that about 40% of healthcare professionals plan to incorporate AI and machine learning into their daily operations in the next two years , while 73% of organizations already using AI plan to expand their use.

Nurses 75

Nurses Hospitals Health Insurance Medicaid 75

Verisys

NOVEMBER 8, 2023

Providers, employers, health plans, and payers use these numbers for billing purposes. CMS.gov The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the creation of a standard, unique health identifier for healthcare providers, which the NPI satisfies.

Fraud 97

Fraud HIPAA Medicare Medicare 97

HIT Consultant

JULY 24, 2022

For example, while Medicare only accounts for approximately 20% of the country’s population, data from the Centers for Medicare and Medicaid Services (CMS) detailing utilization for this small segment of Americans have not only served as the foundation for regulatory decisions but has also become the industry proxy for other population segments. .

COVID-19 98

COVID-19 Medicare Medicare Telemedicine 98

HIT Consultant

SEPTEMBER 10, 2021

Doctors often refer to the “golden hour,” which is the concept that a patient needs to receive definitive care within an hour of injury to increase their chances of survival. visited an HRSA health center. of residents lacking health insurance. Social Determinants of Health. Trauma Center Deserts.

COVID-19 98

COVID-19 Hospitals Health Insurance Medicaid 98

Health Blawg

FEBRUARY 19, 2018

The practices get information to help address social determinants of health via the platform as well. Four years in, the company is seeing positive results in terms of gaps in care closed, across the domains of both behavioral health and physical medicine.

Public Health 113

Public Health Health Insurance Medicaid Medicaid 113

American Medical Compliance

MARCH 15, 2024

Furthermore, it prohibits knowingly submitting false or false claims to Medicare, Medicaid, or other federally funded healthcare programs. HIPAA regulations govern the use, disclosure, and safeguarding of protected health information (PHI) by covered entities and their business associates.

Compliance 88

Compliance Fraud HIPAA Health Insurance 88

Compliancy Group

JANUARY 3, 2024

Medical billing compliance ensures that providers and administrators engage in ethical and accurate billing practices. It pays to know the law and avoid temptations to cut corners.

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 52

Healthcare Blog

OCTOBER 19, 2023

There are public health policies on a legislative level you are sure to recognize. These include The Affordable Care Act, which helps give Americans access to affordable health insurance, or The Clean Water Act and Safe Drinking Water Act, which ensures access to clean water and clean air. 2021, May 6). Columbia University.

Public Health 105

Public Health Compliance Hospitals Health Insurance 105

AIHC

JANUARY 5, 2022

A news release from November 22, 2021, entitled New HHS Report Highlights How the No Surprises Act Will Prevent Surprise Medical Bills Faced by Millions of Americans highlights that millions of Americans with private health insurance experience some kind of surprise medical billing. Track results – are your processes working?

Medical Billing 52

Medical Billing Health Insurance Medicare Hospitals 52

Verisys

JANUARY 19, 2022

As the number of satellite facilities per provider increases and the definition of healthcare expands, it adds to healthcare organizations’ burdens–not just in providing care, but also in terms of the administrative burden and costs necessary to maintain a practice. Human Resources. Medical Staffing Services.

US Department of Health and Human Services 52

US Department of Health and Human Services Hospitals Malpractice Compliance Officers 52

Physician Credentialing Company

MAY 16, 2024

Definition of MSO In healthcare, a Management Services Organization (MSO) provides vital non-clinical services to healthcare providers, enabling them to enhance their operational efficiency and focus on patient care. Compliance with Healthcare Laws MSOs must navigate a complex array of healthcare laws and regulations to ensure compliance.

Compliance 52

Compliance ACA Health Insurance Hospitals 52

HIPAA Journal

JANUARY 12, 2024

The Genetic Information Nondiscrimination Act of 2008 (GINA) made it an offence for health insurance companies and employers to discriminate against individuals based on genetic information. The addition of standards to account for the passage of the GINA Act 2008.

HIPAA 91

HIPAA Compliance Health Insurance Medicaid 91

HIT Consultant

JUNE 16, 2022

Yet, even if the hospital is in your insurance network, if the surgeon or anesthesiologist who performs the surgery happens to be out of network, you could receive a medical bill of $35,000 or more, even though you have great health insurance. It is business as usual for all other components of the No Surprises Act.

Medical Billing 52

Medical Billing Compliance Health Insurance Hospitals 52

HIPAA Journal

JULY 4, 2024

In 1996, Congress passed the Health Insurance Portability and Accountability Act ( HIPAA ) with the objective of reforming the health insurance industry. This guide explains why the HIPAA rules and regulations exist, what they consist of, and who they apply to. What are Covered Entities? What is PHI under HIPAA?

HIPAA 58

HIPAA Compliance Fraud Medicare 58

AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

Compliance 99

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 99

Verisys

FEBRUARY 1, 2022

An NPI number is shared with other providers, employers, health plans, and payers for billing purposes. CMS.gov’s Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 ( HIPAA ) mandated the adoption of a standard, unique health identifier for each healthcare provider.

Fraud 52

Fraud Medicare Medicare HIPAA 52

AIHC

SEPTEMBER 5, 2023

Medicare covers many telebehavioral and telemental health services including audio-only services. Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations.

COVID-19 59

COVID-19 Telemedicine Informed Consent Compliance 59

MedTrainer

DECEMBER 7, 2023

The Medicaid and Health program of Idaho provides health coverage to eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities in the state, offering a range of medical and health-related services.

Compliance 52

Compliance Licensing Compliance Officers Informed Consent 52

Health Populi

MAY 6, 2018

Over time, America’s approach to health care provision fragmented by plan sponsor, whether U.S. government (which offers several flavors of plans through the VA, Tricare for active military, Medicare for aging people and Medicaid for people with low-incomes) or private sector employers, unions, and other insurance-conveners.

Medicaid 54

Medicaid Medicaid Medicare Medicare 54

Health Blawg

FEBRUARY 19, 2018

The practices get information to help address social determinants of health via the platform as well. Four years in, the company is seeing positive results in terms of gaps in care closed, across the domains of both behavioral health and physical medicine.

Public Health 60

Public Health Health Insurance Medicaid Medicaid 60

Health Blawg

FEBRUARY 19, 2018

The practices get information to help address social determinants of health via the platform as well. Four years in, the company is seeing positive results in terms of gaps in care closed, across the domains of both behavioral health and physical medicine.

Public Health 60

Public Health Health Insurance Medicaid Medicaid 60

HIT Consultant

OCTOBER 7, 2021

Value-based care, a model that rewards better patient health outcomes, has experienced a surge in interest amid heightened consumer awareness and among payers seeking to lower costs and stabilize reimbursement. Michael Pattwell is the Principal Consultant of Value-Based Care at Edifecs , a global health IT company.

COVID-19 75

COVID-19 Nurses Nursing Homes Health Insurance 75

Redox

FEBRUARY 7, 2019

As you might expect, this being healthcare and all, there isn’t one definition of “telemedicine”. Mobile health (mHealth) : health care and public health information provided through mobile devices. My only tweak to the ONC’s definition would be to ignore the focus on “video conferencing”. Original Source.

Telemedicine 40

Telemedicine Public Health Medicaid Medicaid 40

Health Blawg

FEBRUARY 19, 2018

The practices get information to help address social determinants of health via the platform as well. Four years in, the company is seeing positive results in terms of gaps in care closed, across the domains of both behavioral health and physical medicine.

Public Health 60

Public Health Health Insurance Medicaid Medicaid 60

Health Blawg

FEBRUARY 19, 2018

The practices get information to help address social determinants of health via the platform as well. Four years in, the company is seeing positive results in terms of gaps in care closed, across the domains of both behavioral health and physical medicine.

Public Health 60

Public Health Health Insurance Medicaid Medicaid 60

Health Blawg

FEBRUARY 19, 2018

The practices get information to help address social determinants of health via the platform as well. Four years in, the company is seeing positive results in terms of gaps in care closed, across the domains of both behavioral health and physical medicine.

Public Health 60

Public Health Health Insurance Medicaid Medicaid 60

Health Blawg

FEBRUARY 19, 2018

The practices get information to help address social determinants of health via the platform as well. Four years in, the company is seeing positive results in terms of gaps in care closed, across the domains of both behavioral health and physical medicine.

Public Health 60

Public Health Health Insurance Medicaid Medicaid 60

Health Blawg

FEBRUARY 19, 2018

The practices get information to help address social determinants of health via the platform as well. Four years in, the company is seeing positive results in terms of gaps in care closed, across the domains of both behavioral health and physical medicine.

Public Health 60

Public Health Health Insurance Medicaid Medicaid 60

Healthcare Law Blog

MARCH 7, 2023

The Centers for Medicare & Medicaid Services (“CMS”), on behalf of the U.S. Department of Health and Human Services (“HHS”), recently issued a proposed rule to adopt standards under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) for “health care attachment” transactions (the “Proposed Rule”).

US Department of Health and Human Services 52

US Department of Health and Human Services HIPAA Medicaid Medicaid 52

MedTrainer

MARCH 28, 2024

The answer has as many layers as the definition of compliance itself. But that’s only one aspect of this complex – and sometimes confusing – process. Just as perplexing is who is responsible for compliance in healthcare organizations.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

Healthcare Blog

OCTOBER 19, 2023

There are public health policies on a legislative level you are sure to recognize. These include The Affordable Care Act, which helps give Americans access to affordable health insurance, or The Clean Water Act and Safe Drinking Water Act, which ensures access to clean water and clean air. 2021, May 6). Columbia University.

Public Health 52

Public Health Compliance Hospitals Health Insurance 52

Hall Render

JANUARY 11, 2023

Federal Food, Drug, and Cosmetic (“FD&C”) Act – If an app includes a software function that meets the definition of a medical device under section 201(h) of the FD&C Act, the app may be subject to regulatory oversight by the FDA.

Compliance 40

Compliance HIPAA FDA Due Diligence 40

Health Law RX

SEPTEMBER 27, 2023

On September 21, 2023, the Centers for Medicare & Medicaid Services (CMS) posted a new notice on its website : Effective September 21, 2023, the Departments have directed certified IDR entities to resume processing all single and bundled disputes already submitted to the IDR portal and assigned to a certified IDR entity.

Medical Billing 52

Medical Billing Hospitals Medicaid Medicaid 52

AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

Compliance 52

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 52

C&M Health Law

JANUARY 20, 2023

Definition of Electronic Signature : CMS proposes defining the term “electronic signature” as an electronic sound, symbol, or process, attached to or logically associated with attachment information and executed by a person with the intent to sign the attachment information.

HIPAA 52

HIPAA US Department of Health and Human Services Compliance Health Insurance 52

AIHC

NOVEMBER 3, 2021

With the advancement of technology, the emergence of advanced cyber threats has escalated, which hinders the privacy and security of health information systems such as EHRs. This definition applies to “access” as used in this subpart, not as used in subpart E of this part [the HIPAA Privacy Rule]).” Is This Really a Problem?

HIPAA 52

HIPAA Electronic Medical Records Compliance Governance 52