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Department of Justice announced earlier this month that an Indian Rocks Beach, Florida-based woman has pleaded guilty to conspiracy to commit healthcare fraud and filing a false tax return. In reality, the DOJ alleges, the conspirators had bribed doctors to approve the claims. Kelly Wolfe and her company, Regency, Inc.,
Department of Health and HumanServices works to ensure the integrity of federal healthcare programs and to safeguard the health and welfare of those programs' beneficiaries. And I think it's important for us to recognize that we don't know a whole lot right now.
As we wrap up another year and get ready for 2025 to begin, it is once again time for everyone’s favorite annual tradition of Health IT Predictions! Check out the community’s predictions down below and be sure to follow along as we share more 2025 Health IT Predictions !
Fraud in healthcare has run rampant in recent years, as evident by two incidents in which healthcare organizations billed insurance companies for things patients never received. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received. Attorney Philip R.
In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and HumanServices’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. Increased Telehealth Services.
In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and HumanServices’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. Increased Telehealth Services.
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.
As government agencies and national regulatory organizations pass more regulations and the need for healthcare services grows, healthcare compliance officers (HCOs) are more important than ever. Healthcare entities must comply with an increasingly complex and changing set of laws and regulations. Reimbursement. Healthcare administration.
Traditional Medicare is administered by the federal government, and individuals pay a separate monthly premium for hospital visits, doctors/outpatient, and prescription drugs. In contrast, Medicare Advantage is provided through a private health plan and typically covers everything in one monthly premium.
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.
The Office of Inspector General for the Department of Health and HumanServices is basically like the FBI of the HHS and they have a list of thousands of individuals and entities excluded from federally funded health care programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud.
The Office of Inspector General for the Department of Health and HumanServices is basically like the FBI of the HHS and they have a list of thousands of individuals and entities excluded from federally funded health care programs for a variety of reasons, including a conviction for Medicare or Medicaid fraud.
County Struggles with Income Affect Social Determinants of Health. HHS puts $90 million toward addressing health disparities through data. Nearly half of rural hospitals lose money on childbirth services. Juneau clinic offers new option for treating opioid use disorder. Banner Health to build new hospital in Buckeye.
Amazon Pharmacy partners with health plans for discount drugs. Health Policy Brief: Pandemic-Driven Health Policies To Address Social Needs And Health Equity. HHS putting $35 million toward mental health support for children, young adults. How the PE Nursing Home Crackdown Could Affect the Home Health Industry.
Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.” The result?
Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.” The result?
HHS Secretary Outlines FY 2023 Mental Health Investments at Senate Hearing. million in ARP funds to train health workers in local communities. million in ARP funds to train health workers in local communities. Patient generated data can be a key factor in reducing health inequity. HHS is giving $226.5 HHS is giving $226.5
Homer hospital bond ARIZONA After 24 years as CEO of Banner, Peter Fine pinpoints the most important traits for leaders Banner’s momentum blueprint Doctors speak out as U.S. NATIONAL 50% of U.S. to buy property. NATIONAL 50% of U.S. to buy property. NATIONAL 50% of U.S. to buy property. Kenai Peninsula Borough Assembly considers $38.5M
million loss, scraps 145 positions Health systems lock in acquisitions as year draws to a close Kaiser mental health workers’ strike leaves some patients struggling for care Kaiser Permanente Northern California rated highest for quality care MMCC Arranges $4.7M operating margin in Q3 JLL Arranges $13.4M
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?
million for rural hospital expansion Hospices in Arizona & other states receive scrutiny over concerns of fraud, waste & abuse Phoenix Children’s Building New 44,000-Square Foot Level IV Neonatal Intensive Care Unit Firefighters oppose Banner’s planned $400M hospital There’s a growing nurse shortage in Arizona.
4 Health Systems Join Provider-Created Data Collective to Improve Care. Full 4th Circuit to tackle Medicaid fraud standard under False Claims Act. Why asking about social determinants of health is so important. Medical Impact of Roe Reversal Goes Well Beyond Abortion Clinics, Doctors Say.
News ranks hospitals in health equity. These hospitals earn top honors. These hospitals earn top honors. facility Southern Research CEO talks biotech incubator, future of Birmingham medicine ALASKA Juneau’s hospital is bleeding cash. list includes 3 from Arizona ARKANSAS Children’s Miracle Network Raises $5.4M
The CDC has stopped printing them Telehealth Visits Decline 46%, But Telebehavioral Healthcare Still High URAC to offer health equity accreditation Walgreens CIO is latest to leave in company’s C-suite shakeup AI is creating a complex landscape for healthcare executives ALABAMA Alabama hospital to remain on Cerner after sale Alabama gets $3.6M
The CDC has stopped printing them Telehealth Visits Decline 46%, But Telebehavioral Healthcare Still High URAC to offer health equity accreditation Walgreens CIO is latest to leave in company’s C-suite shakeup AI is creating a complex landscape for healthcare executives ALABAMA Alabama hospital to remain on Cerner after sale Alabama gets $3.6M
CVS Health, Walgreens each to settle all opioid cases for $5B. Cullman Regional to build north Alabama’s 1st freestanding emergency department. USDA funds 11 rural Alabama health care projects with $7.3 Rural Alabamians getting improvements in health care with federal grant. CMS bumps ASC payments to 3.8
4 benefits of behavioral health partnership for hospital performance. Court OKs denying coverage for mental health, substance-use care. Court OKs denying coverage for mental health, substance-use care. COVID-fatigued health workers are mobilizing. Doctors, nurses risked their lives to battle COVID.
To stay in compliance with federal and state regulations and to keep patients safe, it’s vital for hospitals and health systems to monitor the licenses of their practitioners for new information that may prevent a physician from practicing. These may include a medical doctorate degree from an accredited U.S. Professional Affiliations.
Amazon to offer behavioral healthservices 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.
NATIONAL 5 Stark law issues physicians are closely watching Anti-monopoly advocates urge FTC to block McKesson, Cardinal Health’s big-ticket oncology acquisitions Biden administration doles out $68.5M
NATIONAL 5 numbers on the rise of Stark law violations 3 takeaways on the new federal data privacy proposal after its first public showcase 80% of Change Healthcare restored after cyberattack Authentication failure blamed for Change Healthcare ransomware attack Biden administration issues new rule to protect privacy of those seeking reproductive health (..)
Fewer Than 2% of Hospitals Excelling at Health Equity, Value. How hospitals should prepare for the end of the public health emergency. Justice Department cracks down on ASC, anesthesia provider arrangements. North Alabama doctor’s medical license suspended after investigation into overdose death. Wade reversal.
Dr. Lorna Breen Health Care Provider Protection Act becomes law. Here are the top health systems by patient reviews. Most doctors have patients affected by social drivers but feel ill-equipped to address them, survey finds. Sensitive health data of 50 million Americans hacked or breached last year: analysis. What’s next?
AHA Urges DOJ to Protect Health Care Workers??from Coalition of hospitals, health plans and others urge for stronger guidance around third-party apps. Hospital, long-term care groups again petition Becerra to extend COVID-19 public health emergency. Justice Department to join whistleblower lawsuit against EHR vendor, CEO.
Luke’s Behavioral Health to lay off more than 250 employees after suspension Top Valley hospital, health care execs take home big paychecks HonorHealth selected as new med school’s clinical affiliate: 4 notes Phoenix Children’s appoints 4 new division chiefs SMI patients at risk after St. NATIONAL 92% Of U.S.
Vincent North in Sherwood Washington Regional Medical System Names Lucas Campbell as VP & Chief Transformation Officer 4 more Arkansas hospitals awarded federal funds Arkansas Legislative Council approves Department of HumanServices’ requests for $13.4M Opens in North Little Rock CHI St.
NATIONAL 10 multimillion-dollar Stark law cases in 2 years 40 hospital ownership changes made in 1 day 15 Areas That Would Change Under Health Data Rule Proposal 5 states cracking down on noncompetes New DOJ whistleblower program not ‘easy money’: legal expert CMS’ inpatient rule adds ‘insult to injury,’ say hospital groups CMS drops (..)
SCOTUS won’t hear challenge to health worker vaccine mandate. Why health systems are choosing Amazon as their cloud provider. Worst health system data breaches of 2022, according to Wired. Alabama Department of Corrections picks new medical, mental health care provider. UAB names interim health system CEO.
NATIONAL 94% of Organizations Experienced a Cyberattack in 2022 AHA blog: Strengthening crisis management in rural health care Biden signs bill ending Covid-19 national emergency Cancer drug shortages are creating dire circumstances for some patients CMS Releases FY24 IPPS Proposed Rule, Seeks to Boost Rates by 2.8%
NATIONAL 4 largest healthcare data breaches of 2023 Anesthesia practices sue CMS over reimbursement method Antitrust enforcements hit a high in 2022, with health deals impacted ASCs face leadership exodus CMS floats appeals process over observational stays CMS proposes additional Medicare appeals processes FTC eyes healthcare mergers, report shows (..)
NATIONAL AHA, FAH request CMS to extend comment period for TEAM proposed rule CMS launches new option to file EMTALA complaints Cybersecurity execs share healthcare’s biggest vulnerabilities Here’s how much hospital prices are rising – and why Hospital groups seek more time to comment on proposed payment model How noncompete ban could shake (..)
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