Healthcare IT News - Telehealth

SEPTEMBER 13, 2021

licensed, board-certified intensivists who were trained in the United States and have practice experience there. According to court documents, RICU had contacted HHS and Centers for Medicare and Medicaid Services officials after the agencies relaxed telehealth regulations under COVID-19. WHY IT MATTERS.

COVID-19 129

COVID-19 Doctors Medicare Medicare 129

Provider Trust

MAY 9, 2023

What is a Medicaid Fraud Control Unit (MFCU)? But these programs cannot be controlled by Medicaid and Medicare alone. But these programs cannot be controlled by Medicaid and Medicare alone. With this legislation, Medicaid Fraud Control Units (MFCUs) were born.

Fraud 52

Fraud Medicaid Medicaid Nurses 52

Healthcare IT News - Telehealth

OCTOBER 20, 2021

Early on in the pandemic, the Centers for Medicare & Medicaid Services (CMS) extended telehealth waivers that helped bring virtual care services into the mainstream. That is an amalgamation of telehealth, RPM, clinical documentation surveillance and analytics tools in a way that will position you to be reimbursed.

COVID-19 171

COVID-19 Hospitals Telemedicine Licensing 171

HIPAA Journal

MAY 16, 2022

Upon discovery of the breach, an investigation was launched to determine the nature and scope of the attack, and a comprehensive review was then conducted of all documents that were potentially accessed.

Health Insurance 116

Health Insurance Ransomware HIPAA Licensing 116

HIPAA Journal

OCTOBER 18, 2022

Many healthcare organizations wait until the document review is completed before announcing a breach, which could be several months after data has been stolen. Lifespire said it is unaware of any instances of misuse of patient data but has offered affected individuals free access to credit monitoring and identity protection services.

HIPAA 124

HIPAA Health Insurance Licensing Medicaid 124

HIPAA Journal

JUNE 28, 2023

The total settlement fund has not been disclosed; however, all class members are entitled to claim up to $1,500 as reimbursement for ordinary expenses, which are documented expenses that were incurred as a result of the data breach. A lawsuit – Young, et al. The final approval hearing has been scheduled for Sept.

Hospitals 87

Hospitals Fraud Licensing HIPAA 87

Med-Net Compliance

SEPTEMBER 7, 2022

A 49-year-old Texas physician assistant was arrested and charged for his role in a scheme to defraud Medicaid by working with a suspended medical license. On July 20, 2021, the Texas Medical Board allegedly ordered the immediate suspension of his physician assistant license, deeming him to be a “continuing threat to public welfare.”

Medicaid 59

Medicaid Medicaid Licensing Medical Personnel 59

MedTrainer

JULY 28, 2023

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. Medicare/Medicaid Compliance Reviews. The OIG performs regular compliance reviews of Medicare and Medicaid providers.

Fraud 98

Fraud Compliance Medicaid Medicaid 98

Healthcare IT News - Telehealth

AUGUST 30, 2021

In doing so, Trinity also hoped to receive readmission incentives from the Centers for Medicare and Medicaid Services, avoid penalties, and reduce costs as it transitioned to value-based care reimbursement. "Document all of this essential information in a scope statement. "Select measures of success," she continued.

Patient Satisfaction 175

Patient Satisfaction Nurses Medicare Medicare 175

Healthcare Compliance Blog

MARCH 28, 2022

An Illinois licensed practical nurse (LPN) was convicted and sentenced for failing to administer lifesaving measures to a resident in a nursing home in 2017. Additionally, the LPN’s nursing license was suspended for an unspecified period of time. Discussion Points: Review your policies and procedures on CPR. Update as needed.

Nurses 59

Nurses Nursing Homes Licensing Fraud 59

MedTrainer

MAY 30, 2024

Healthcare credentialers must collect an average of 30 documents per provider to initiate and complete the credentialing process – also known as primary source verification (PSV). Traditionally, credentialers call the appropriate entities to verify transcripts, licenses, etc. Keeping the spreadsheet current requires continuous effort.

Licensing 52

Licensing Malpractice Medicare Medicare 52

Health Care Law Brief

MAY 11, 2022

No bonus amount may be paid to any worker who has been suspended or excluded under the Medicaid program during the vesting period and at the time an employer submits a claim. Covered employers will be required to retain records of claims and substantiating documentation for a period of no less than six years. Covered Employers.

Medicaid 97

Medicaid Medicaid Overpayments Overpayment 97

Verisys

FEBRUARY 8, 2024

Upon moving to another compact state, a nurse holding a compact license must apply for a new license in their new primary state of residence within 60 days of relocating. NLC Relocation Rule Explanation NLC Relocation FAQ Arizona: The Arizona Board of Nursing has issued a reminder for nursing licenses expiring in 2024.

Regulatory Compliance 52

Regulatory Compliance Compliance Licensing Nurses 52

HIPAA Journal

MARCH 6, 2023

The types of information exposed varied from individual to individual and may have included names, addresses, medical information, health insurance information, Medicaid identification numbers, driver’s licenses, account and routing numbers, and Social Security numbers.

Electronic Medical Records 85

Electronic Medical Records HIPAA Licensing Nurses 85

Med-Net Compliance

SEPTEMBER 14, 2022

A Massachusetts home health aide, who was licensed as a Certified Nursing Assistant (CNA), has been indicted in connection with a home surveillance video showing her abusing an elderly patient, Attorney General Maura Healey announced. Document that the training occurred, and record in each employee’s education file.

US Department of Health and Human Services 59

US Department of Health and Human Services Fraud Medicaid Medicaid 59

Medisys Compliance

AUGUST 20, 2024

Psychologists: Licensed psychologists can provide psychotherapy, psychological testing, and assessments but cannot prescribe medications. Licensed Clinical Social Workers (LCSWs): LCSWs provide therapy, counseling, and support for patients dealing with mental health issues, particularly in community settings.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Licensing Medical Billing Informed Consent 59

Med-Net Compliance

JULY 19, 2022

In order to participate in the Medicare, Medicaid, and all federal healthcare programs once the term of exclusion ends, the individual or entity must apply for reinstatement and receive written notice from OIG that reinstatement has been granted. OIG maintains a list of all currently excluded individuals and entities called the?

US Department of Health and Human Services 59

US Department of Health and Human Services Licensing Medicare Medicare 59

MedTrainer

MAY 10, 2024

1, 2024 , mental health counselors can enroll with Medicare as part of The Centers for Medicare and Medicaid Services ( CMS ) plan to bring approximately 400,000 marriage and family therapists (MFT) and mental health counselors (MHC) into their network. Effective Jan. This is where it gets complex.

Licensing 52

Licensing ACA Medicare Medicare 52

MedTrainer

DECEMBER 20, 2023

Both licensing and credentialing processes are pivotal in upholding the integrity and safety of healthcare delivery in the state of New Jersey. The New Jersey State Board of Medical Examiners oversees medical credentialing and licensing within the state. Primary Source Verification. Payers in New Jersey have specific requirements.

Licensing 52

Licensing Medicaid Medicaid Malpractice 52

Med-Net Compliance

NOVEMBER 8, 2022

The inspection objective was to determine whether the direct care licensed nursing hours recorded at the nursing home supported the hours submitted to the US Centers for Medicare & Medicaid Services (CMS) in compliance with federal requirements. Train appropriate staff to accurately document and report direct care hours worked.

Nursing Homes 59

Nursing Homes Nurses US Department of Health and Human Services Licensing 59

MedTrainer

DECEMBER 4, 2023

The Kentucky Cabinet for Health and Family Services (CHFS), Department for Medicaid Services administers the state’s Medicaid program, ensuring access to essential health care services for eligible low-income individuals and families in Kentucky.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

HIPAA Journal

APRIL 25, 2023

TRPHD said the document review was completed on March 15, 2023, and notifications were mailed to affected individuals on April 14, 2023. The email account breach was detected on February 13, 2023, and the forensic investigation confirmed the email account was accessed between June 16, 2022, and July 18, 2022.

Health Insurance 95

Health Insurance Public Health Ransomware Fraud 95

Healthcare IT Today

APRIL 29, 2023

Two key steps: Revisiting licensing agreements and ensuring new systems aren’t tethered to old processes. Jim Jirjis, MD, told Colin the back-end work for the project had an unintended benefit: By streamlining documentation, nurses had patient information readily available when facilities needed to be evacuated before a hurricane hit.

Medicaid 92

Medicaid Medicaid Public Health Licensing 92

Med-Net Compliance

OCTOBER 27, 2022

A federal jury convicted a licensed Illinois psychologist of defrauding Medicare over the course of several years by causing the submission of fraudulent claims for psychotherapy services he never provided. Issue: It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.

Nursing Homes 59

Nursing Homes Fraud US Department of Health and Human Services Nurses 59

MedTrainer

NOVEMBER 27, 2023

The Division of Health Benefits administers the state’s Medicaid program, which provides essential healthcare coverage to eligible individuals and families. Providers must be licensed in North Carolina, except under certain conditions, and must ensure that services align with their scope of practice. Medicaid expansion under H.B.

Compliance 52

Compliance Licensing Telemedicine Medicaid 52

Verisys

JULY 12, 2023

It is the responsibility of the technician, as well as the pharmacy/supervising pharmacist, to ensure that all training is completed within six (6) months of the technician’s registration and documented with the Board of Pharmacy within ten (10) days of the completion of training. The majority of the bill is effective July 1, 2023.

Licensing 52

Licensing COVID-19 Medicaid Medicaid 52

MedTrainer

MAY 29, 2024

One of the newest changes that impacts medical credentialing services in Oklahoma is a major change to SoonerCare, the state’s Medicaid program. Controlled Dangerous Substance (CDS) Required The Oklahoma State Bureau of Narcotics and Dangerous Drugs Control requires registration as well as a controlled dangerous substance (CDS) license.

Licensing 52

Licensing Medicaid Medicaid Malpractice 52

C&M Health Law

SEPTEMBER 11, 2023

Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (“CMS”) issued a much anticipated and contested proposed rule that seeks to establish minimum staffing level requirements for nursing homes. HPRD from licensed practical nurses, and 2.38 On September 1, 2023, the U.S. HPRD consisted of 0.75

Nursing Homes 98

Nursing Homes Nurses Medicaid Medicaid 98

MedTrainer

NOVEMBER 27, 2023

The Ohio Department of Medicaid is responsible for administering the state’s Medicaid, a comprehensive healthcare program that provides medical coverage to low-income individuals and families in Ohio. This department focuses on ensuring access to quality healthcare services while managing the state’s Medicaid budget and policies.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Healthcare Compliance Blog

MARCH 31, 2022

The agencies received millions of dollars in funding from Medicaid, which is funded in part by the federal government, and much of that money was meant to pay the wages and benefits of their aides. Under the Wage Parity Law, which is funded by Medicaid, aides are to be paid a minimum amount in total compensation.

Medicaid 59

Medicaid Medicaid Governance Fraud 59

MedTrainer

NOVEMBER 27, 2023

The Department of Community Health (DCH) serves as the lead agency for Medicaid and PeachCare for Kids® , and also oversees the State Health Benefit Plan , Healthcare Facility Regulation Division and State Office of Rural Health. The Medical Assistance Plans Division oversees Georgia’s Medicaid and PeachCare for Kids® programs.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

HIPAA Journal

JUNE 8, 2023

The security breach was detected on February 5, 2023, and the forensic investigation confirmed there had been unauthorized access to documents on its systems between January 7, 2023, and February 5, 2023.

Ransomware 105

Ransomware HIPAA Licensing Health Insurance 105

HIPAA Journal

MAY 23, 2023

The unauthorized individual was discovered to have accessed documents in the account that included the full names, internal patient identification numbers, and insurance providers of 50 patients. Additional security measures have been implemented and further training has been provided to the workforce.

Licensing 116

Licensing Health Insurance Medicaid Medicaid 116

Verisys

OCTOBER 23, 2023

Alabama : License renewals for pharmacy technicians, pharmacy interns, and facilities are open as of 9/15/2023. The board urges that nurses who were practicing under an EMSA license should apply for licensure by endorsement to continue to practice in California. These documents will no longer be accepted if submitted via mail.

Licensing 52

Licensing Nurses Compliance Medicaid 52

MedTrainer

MAY 15, 2024

Florida Medicaid Portal The Florida Medicaid Web Portal is very specific and if you aren’t familiar with submitting the documentation, it is easy to make a wrong turn. Providers must first submit their Medicaid enrollment application and receive the Application Tracking Number (ATN) before they can access the clearinghouse.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Physician Credentialing Company

NOVEMBER 21, 2024

We will also discuss the documents needed and various credentialing challenges. Insurance credentialing is the verification process in which credentials like educational degrees, licenses, training certificates, and work experience are evaluated to determine whether a specific provider can provide standard care to insured patients or not.

Licensing 52

Licensing Malpractice Medicaid Medicaid 52

Medisys Compliance

MAY 23, 2024

Introduction The Centers for Medicare & Medicaid Services (CMS) establish specific billing guidelines for behavioral health services provided to Medicare beneficiaries. Documentation Requirements: Detailed and accurate documentation is vital for justifying medical necessity and supporting claim submissions.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicare 59