Healthcare Dive

APRIL 27, 2023

Political will appears to be rising to equalize Medicare payments to hospitals and doctor’s offices for certain low-acuity services, according to lawmaker comments during a Wednesday hearing.

Doctors 321

Doctors Medicare Medicare Hospitals 321

Fierce Healthcare

NOVEMBER 2, 2024

The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups. | cut to physician payments in 2025 despite protest from major industry groups.

Medicare 132

Medicare Medicare Doctors Medicaid 132

Healthcare Dive

SEPTEMBER 7, 2022

Multiple groups representing doctors oppose Medicare payment reductions at a time when physician practices face escalating costs.

Doctors 278

Doctors Medicare Medicare 278

Fierce Healthcare

SEPTEMBER 6, 2024

In its comments to the Centers for Medicare and Medicaid Services (CMS) on the draft CY2025 Medicare physician fee schedule (PFS), the American Medical Association badgered CMS on its pro | The American Medical Association submitted its comment letter to CMS on its draft CY2025 Medicare physician fee schedule.

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Medicare Medicare Doctors Medicaid 132

Medisys Compliance

JANUARY 29, 2025

Add in the complexities of Medicare and Medicaid, and it can feel overwhelming. This article will explore how outsourcing cardiology billing for Medicare and Medicaid can streamline your operations, boost revenue, and free you to focus on delivering exceptional cardiac care. Why Do Some Doctors Hesitate to Accept Medicaid?

Medicaid 59

Medicaid Medicaid Medicare Medicare 59

Electronic Health Reporter

JANUARY 20, 2020

The article The Doctor Won’t See You Now: The Unintended and Perhaps Inevitable Consequences of Medicare-for-All appeared first on electronichealthreporter.com. In the fall of 2013, when cancellation letters—notices of cancelled plans—went out to approximately four […].

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Doctors Medicare Medicare 111

Electronic Health Reporter

APRIL 4, 2025

By Thomas Thatapudi, CIO, AGS Health In 2018, the head of the Centers for Medicare and Medicaid Services issued a challenge to health IT developers and providers alike to help make every doctors office in […] The article An Automated Solution to Healthcares $125 Billion Fax Problem appeared first on electronichealthreporter.com.

Medicaid 91

Medicaid Medicaid Doctors Medicare 91

Kaiser Health News

JANUARY 28, 2022

A three-judge federal appeals court panel in Connecticut has likely ended an 11-year fight against a frustrating and confusing rule that left hundreds of thousands of Medicare beneficiaries without coverage for nursing home care, and no way to challenge a denial. But it can have serious repercussions.

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Nursing Homes Medicare Medicare Nurses 145

Healthcare IT Today

MARCH 19, 2020

One of the biggest health IT related news items to come out was the announcement by Vice President Mike Pence that HHS was issuing a regulation to permit doctors to practice across state lines. State Medical Licensure is something that has baffled many of us that have worked in healthcare.

Doctors 113

Doctors Medicaid Medicaid Medicare 113

Healthcare IT Today

FEBRUARY 22, 2023

There’s widespread consensus that payments to Medicare Advantage Organizations (MAOs) are a mess. These programs, which care for more than 30 million of the nearly 64 million Medicare enrollees , operate on the cutting edge of health care and suffer serious problems in data collection and billing.

Medicare 113

Medicare Medicare Overpayment Overpayments 113

Healthcare Dive

SEPTEMBER 12, 2023

The partnership, which Walgreens plans to launch in ACO REACH in 2024 and Medicare Advantage in 2025, is the retail giant’s first significant move in the healthcare space since CEO Roz Brewer departed earlier this month.

Doctors 176

Doctors Medicare Medicare 176

Health Populi

MAY 21, 2020

Doctors maintain their top status as U.S. However, as patients continue to be concerned about exposure to COVID-19, 3 in 5 are concerned about being at-risk to the virus in their doctor’s office, according to research from the Alliance of Community Health Plans (ACHP) and AMCP , the Academy of Managed Care Pharmacy.

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COVID-19 Doctors Health Insurance Medicare 161

The Health Law Firm

FEBRUARY 10, 2022

Board Certified by The Florida Bar in Health Law Recently it has come to our attention that there may be a nationwide effort by the Centers for Medicare and Medicaid Services (CMS) Medicare Administrative Contractors (MACs) to squelch physicians who prescribe opioids and other narcotic medications. Indest III, J.D.,

Medicare 98

Medicare Medicare Doctors Medicaid 98

Healthcare It News

AUGUST 25, 2022

healthcare providers to their patients, launched a pharmaceutical pilot to identify doctors whose patient treatment plans are at risk of lapsing due to costs. The company found that machine learning was able to accurately predict healthcare providers with at-risk patients due to loss of insurance coverage, including Medicare coverage gaps.

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Health Outcomes Doctors Medicare Medicare 306

Healthcare Dive

OCTOBER 31, 2023

Regulators on Monday proposed a long-awaited rule tying payments for hospitals and doctor’s offices in three popular Medicare programs to compliance with data-sharing regulations.

Doctors 184

Doctors Medicare Medicare Compliance 184

Healthcare It News

APRIL 5, 2024

Based on its initial investigation, the following information may have been accessed by hackers: name, address, birth date, email, telephone number, marital status, Aboriginal status, Medicare number, referring doctor, and type of diabetes.

COVID-19 306

COVID-19 Medicare Medicare Hospitals 306

Healthcare IT News - Telehealth

MARCH 12, 2020

Adrian Smith, R-Nebraska, and Ann Kuster, D-New Hampshire – would allow Medicare to enter into voluntary, value-based arrangements with medical groups to provide acute care to patients in skilled nursing facilities using a combination of telehealth and on-site staff. The RUSH Act – introduced in companion bills from Sens.

Nursing Homes 217

Nursing Homes Nurses Medicare Medicare 217

Compliancy Group

FEBRUARY 25, 2025

billion in false and fraudulent claims to Medicare and other government insurers for orthotic braces, prescription skin creams, and other items that were medically unnecessary and ineligible for Medicare reimbursement. Medicare and the insurers paid more than $360 million based on these false and fraudulent claims.

Fraud 52

Fraud Medicare Medicare Doctors 52

Healthcare IT News - Telehealth

APRIL 14, 2025

For Medicare, telemedicine reimbursement and regulation has been about kicking the can down the road – more temporary extensions of COVID-era flexibilities. Anything that will increase healthcare spending or Medicare spending is seen as difficult. The current ones run out on September 30. That's where we stand right now.

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Telemedicine Medicare Medicare Medicaid 124

HIT Consultant

DECEMBER 3, 2024

The Centers for Medicare & Medicaid Services (CMS) added codes for Digital Mental Health Treatment in its 2025 Medicare Physician Fee Schedules. This means the prescription of digital mental health therapeutics can now be billed thru Medicare and Medicaid, paving the way for private insurance to do the same.

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FDA Medicare Medicare Medicaid 111

Healthcare IT Today

MARCH 17, 2023

Watch the video for Von Raesfeld’s views on holistic care, why interpretive results are not always enough, what Medicare can do to help patients use data, and an ER story fraught with tension. This requires more openness an sharing, as well as education on all sides.

Doctors 133

Doctors Medicare Medicare Hospitals 133

Healthcare IT News - Telehealth

APRIL 10, 2020

The Centers for Medicare and Medicaid Services has temporarily suspended several regulations to enable hospitals, clinics and other providers to boost their front-line medical staff during the coronavirus pandemic.

Nurses 216

Nurses Medicare Medicare Licensing 216

Medisys Compliance

DECEMBER 23, 2022

The internet is ringing with the news of the CMS Updates Final rule for the 2023 Medicare Physician Fee Schedule. The finalized 2023 Medicare Physician Fee Schedule was announced by the Centers for Medicare & Medicaid Services (CMS) on November 1 2022. Medicare reimbursement for telehealth services. Principles of PFS.

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Medicare Medicare Medical Billing Medical Billing Outsourcing 98

Healthcare IT News - Telehealth

MAY 13, 2022

"They did so through a circular scheme of kickbacks and bribes paid to doctors and solicited from marketing companies, pharmacies, and providers of durable medical equipment." " WHY IT MATTERS. Generally, that amount ranged from $20 to $30 per consultation. ON THE RECORD.

Fraud 172

Fraud Doctors COVID-19 Medicare 172

Healthcare IT News - Telehealth

JUNE 20, 2023

A bipartisan group of legislators has reintroduced the Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act – first introduced in 2016 – to expand opportunities and coverage for telehealth through Medicare. This is the second time the bill has been reintroduced. Mike Thompson (D-Calif.)

Medicare 170

Medicare Medicare COVID-19 Doctors 170

Healthcare IT News - Telehealth

FEBRUARY 22, 2021

Among the allegations are that Wolfe and her conspirators submitted well over $400 million in illegal durable medical equipment claims to Medicare and the Civilian Health and Medical Program of the Department of Veterans, relying on the guise of "telemedicine" to explain the unusually high volume of claims.

Fraud 199

Fraud Telemedicine US Department of Health and Human Services COVID-19 199

Medisys Compliance

OCTOBER 1, 2022

Navigating through the complex medicare guidelines can be a complex and overwhelming task, however, here is the good news, the entire process is merely about using the right CPT codes. However, one needs to be careful while billing as Medicare follows strict rules and regulations for time increments. The Concept of Medicare Coverage.

Medicare 98

Medicare Medicare Medical Billing Outsourcing Medical Billing 98

Kaiser Health News

NOVEMBER 11, 2021

Finding the best private Medicare drug or medical insurance plan among dozens of choices is tough enough without throwing misleading sales tactics into the mix. The problems are especially prevalent during Medicare’s open-enrollment period, which began Oct. “You’re not from Medicare,” Heimer told her.

Medicare 145

Medicare Medicare Doctors Fraud 145

Healthcare IT News - Telehealth

SEPTEMBER 19, 2022

After declining for six years, the burnout rate among doctors began to spike with the onset of the COVID-19 pandemic, according to research by the American Medical Association, Mayo Clinic and Stanford Medicine. Though occupational burnout among doctors is higher relative to the U.S. Reforming Medicare payment. WHY IT MATTERS.

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COVID-19 Doctors Public Health Medicare 176

HIT Consultant

APRIL 18, 2025

– Synthesizing findings from three in-depth evaluations of digital health tools by the Peterson Health Technology Institute (PHTI) and analyzing trends in Medicare and Medicaid billing, the report sounds a timely alarm. However, the report reveals a concerning surge in Medicare billing for these services. million in 2023.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare IT Today

OCTOBER 23, 2024

The following is a guest article by David Lareau, CEO at Medicomp Systems A couple of years ago, we predicted an impending “explosion” of Medicare Advantage (MA) fraud and penalties. Doctors can’t – and shouldn’t – be replaced by AI. However, technology alone isn’t the answer. The concept of “Dr.

Medicare 75

Medicare Medicare Fraud Doctors 75

Healthcare IT News - Telehealth

SEPTEMBER 20, 2021

"We have seen all too often criminals who engage in health care fraud – stealing from taxpayers while jeopardizing the health of Medicare and Medicaid beneficiaries," said Deputy Inspector General for Investigations Gary L. More than $1.1 billion of that loss involved allegedly fraudulent claims related to telemedicine.

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Fraud Telemedicine Medicare Medicare 206

Healthcare IT News - Telehealth

MARCH 2, 2023

WHY IT MATTERS The dual team study published by Epic found that 60% of the time, the virtual primary care telehealth appointments held between March 1, 2020, and October 15, 2022, did not result in subsequent doctors visits. "Americans are having a harder time securing an appointment with a doctor than 10 years ago," he pointed out.

Doctors 189

Doctors Telemedicine Medicaid Medicaid 189

Healthcare IT News - Telehealth

APRIL 21, 2022

According to a press release , the surgeon, 56-year-old Dr. Elemer Raffai, is accused of allegedly submitting false claims to Medicare in exchange for kickbacks from telemedicine companies. Raffai, together with others, is allegedly connected to the submission of approximately $10 million in fraudulent claims to Medicare.

Fraud 176

Fraud Telemedicine Medicare Medicare 176

Healthcare IT News - Telehealth

OCTOBER 13, 2020

“Like clinicians at many healthcare providers across the nation, our doctors faced a dilemma. Physically assessing patients can potentially increase the risk of spreading the virus, especially if doctors visit more than one facility.” “This integration will improve efficiency and reduce risk for our doctors and staff.

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COVID-19 Doctors Telemedicine Medicaid 205

Healthcare IT News - Telehealth

JUNE 30, 2020

Signers pointed out that the authorities granted to the Department of Health and Human Services and the Centers for Medicare and Medicaid Services are restricted to the public health emergency period triggered by COVID-19. introduced legislation earlier this month to codify Medicare reimbursement of virtual care at FQHCs and RHCs.

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US Department of Health and Human Services COVID-19 Telemedicine Medicare 205

Healthcare IT News - Telehealth

DECEMBER 13, 2021

The bill, the Telehealth Extension Act , would also end geographic and site restrictions on approved telemedicine services for Medicare beneficiaries. Despite being broadly popular on both sides of the aisle , the geographic- and site-related Medicare provisions the new bill would establish have yet to be enshrined by Congress.

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COVID-19 Telemedicine Fraud Medicare 171