HIPAA Journal

NOVEMBER 21, 2022

million being defrauded from Medicaid, Medicare, and private health insurance programs. Five state Medicaid programs, two Medicare Administrative Contractors, and two private health insurers were tricked into changing the bank account details for payments. million, and $6.4 million, and $6.4

Medicaid 86

Medicaid Medicaid Medicare Medicare 86

Center for Health Insurance Reform

MARCH 31, 2023

The Affordable Care Act (ACA) recently celebrated its 13th anniversary with historic enrollment growth in the health insurance Marketplaces and the lowest-ever recorded uninsured rate.

Health Insurance 97

Health Insurance ACA Medicaid Medicaid 97

HIT Consultant

NOVEMBER 8, 2021

Jessica Altman, Pennsylvania’s insurance commissioner sums it up well : “When we talk about bringing something back to state control, that is a real narrative that can appeal to both sides of the aisle. There is nothing political about making health insurance more affordable.”.

Health Insurance 98

Health Insurance Medicaid Medicaid Governance 98

Healthcare It News

DECEMBER 16, 2022

The Medicaid and CHIP Access to Prescription Digital Therapeutics Act seeks to expand care options that can help improve health outcomes and quality of life for those facing barriers to healthcare. The act would also define "prescription digital therapeutic" in Medicaid and allow U.S. WHY IT MATTERS. THE LARGER TREND.

Medicaid 219

Medicaid Medicaid COVID-19 Health Outcomes 219

HIT Consultant

JULY 16, 2024

Anish Sebastian, CEO and Co-founder, Babyscripts A discussion of technology and the Medicaid population inevitably raises the topic of the digital divide — that is, the gap between people who have access to modern information and communications technology (ICTs) and those who don’t. “We But there’s a lot of reasons to be optimistic.

Medicaid 105

Medicaid Medicaid Health Insurance Health Outcomes 105

Fierce Healthcare

APRIL 23, 2024

Medicaid managed care plans and the Children’s Health Insurance Program (CHIP) will be subject to new wait time standards and quality ratings requirements, the Centers for Medicare & Medicaid S | CMS defended implementing stronger rules over nursing home staffing as well as explained its thoughts behind Medicaid access and managed care rules.

Nursing Homes 119

Nursing Homes Nurses Medicaid Medicaid 119

Kaiser Permanente

JANUARY 1, 2022

Medicaid and the Children’s Health Insurance Program (CHIP) have served as critical supports to children, pregnant women, parents, seniors, and individuals with disabilities – covering 80 million individuals during the COVID-19 pandemic. Since February 2020, Medicaid enrollment has grown sharply to cover an additional 9.9

Medicaid 92

Medicaid Medicaid Medicare Medicare 92

Health Populi

JUNE 18, 2021

with employer-sponsored health insurance worry that a major health event in their household could lead to bankruptcy, according to research gathered by West Health and Gallup in Business Speaks: The Future of Employer-Sponsored Insurance. Health Populi’s Hot Points: U.S. One-half of U.S.

ACA 139

ACA Health Insurance Medicaid Medicaid 139

Modern Healthcare

MARCH 31, 2023

The Centers for Medicare and Medicaid Services estimates health insurance companies will see a 3.32% increase in Medicare Advantage revenue next year.

Medicare 80

Medicare Medicare Health Insurance Medicaid 80

Compliance Now

AUGUST 10, 2023

As background, according to federal Health Insurance Portability and Accountability Act (HIPAA) rules, individuals have 60 days from losing CHIP and Medicaid eligibility to elect coverage under their group plan. The real potential of this number growing daily is what has prompted the Agencies to issue this “request.”

Medicaid 100

Medicaid Medicaid Compliance COVID-19 100

Compliance Now

AUGUST 10, 2023

As background, according to federal Health Insurance Portability and Accountability Act (HIPAA) rules, individuals have 60 days from losing CHIP and Medicaid eligibility to elect coverage under their group plan. The real potential of this number growing daily is what has prompted the Agencies to issue this “request.”

Medicaid 100

Medicaid Medicaid Compliance COVID-19 100

Bill of Health

MARCH 27, 2024

Billing medical insurance for Spravato involves codes for both drug delivery and supervision because treatment requires administration of the drug (using the intranasal spray) and a monitoring period of at least 2 hours at a certified treatment center. Spravato is covered by Medicare Part B , which pays 80% of expenses.

FDA 203

FDA Medicare Medicare Health Insurance 203

Healthcare IT News - Telehealth

OCTOBER 2, 2020

Department of Health and Human Services to issue guidance to states about how to increase access to telehealth under Medicaid and the Children’s Health Insurance Program. Existing strategies states can use to integrate telehealth and other virtual health care services into value-based health care models.

US Department of Health and Human Services 163

US Department of Health and Human Services COVID-19 Medicaid Medicaid 163

Healthcare IT News - Telehealth

MARCH 25, 2021

Researchers limited the study population to individuals covered through employer-based, Affordable Care Act and other private health insurance plans, but not Medicare or Medicaid – an important limitation, given emerging evidence about virtual care's role in exacerbating the digital divide.

COVID-19 213

COVID-19 Public Health Medicare Medicare 213

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”).

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

HIPAA Journal

JUNE 8, 2023

The Iowa Department of Health and Human Services has announced there have been three separate breaches of the protected health information of Iowa Medicaid recipients in the past two months – two hacking incidents and an impermissible disclosure, all three of which involved third-party contractors.

Medicaid 89

Medicaid Medicaid Ransomware Health Insurance 89

Bill of Health

MARCH 15, 2022

Similarly, our health care system is a significant barrier to employment because most private health insurance companies do not cover critical supports for disabled people, such as personal assistant services. However, expanding safety net programs , such as SSI and Medicaid, would be important as an interim measure.

COVID-19 246

COVID-19 ADA Medicaid Medicaid 246

Healthcare IT News - Telehealth

JULY 2, 2020

Secretary of Health and Human Services Alex Azar and Centers for Medicare and Medicaid Services Administrator Seema Verma to provide a written plan for permanent changes to Medicare, Medicaid and Children’s Health Insurance Program rules around telehealth.

COVID-19 179

COVID-19 Medicare Medicare Medicaid 179

Bill of Health

OCTOBER 17, 2024

Finally, SB 1120 limits the degree to which health insurers can use AI to determine medical necessity for member health care services. SB 1223 amended the California Consumer Privacy Act of 2018 to include neural data as sensitive personal information, whose collection and use companies can be directed to limit.

Medicare 150

Medicare Medicare Health Insurance Licensing 150

Center for Health Insurance Reform

MARCH 7, 2022

Health insurers reported healthy earnings during the fourth quarter of 2021, thanks in large part to publicly funded programs Medicare and Medicaid. CHIR's Megan Houston reviewed earnings reports for nine major insurers and reports on the key market trends in the health insurance industry.

Governance 97

Governance Health Insurance Medicaid Medicaid 97

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

FEBRUARY 3, 2023

WHY IT MATTERS The bill aims to keep stand-alone telehealth benefits separate, not as a replacement of medical plans, offering them under a group health plan or group health insurance coverage as excepted benefits. "We asked Congress and they listened.

Public Health 178

Public Health COVID-19 Medicare Medicare 178

Healthcare It News

FEBRUARY 28, 2023

The payer mix of health insurance is typical, with 35% of patients representing government insurance such as Medicare or Medicaid, 60% commercial insurance, and 6% self-pay patients. The majority of patients using the virtual-first clinic are females (70%), and the average age range has been 40-50.

Electronic Medical Records 281

Electronic Medical Records Telemedicine Health Insurance COVID-19 281

Bill of Health

FEBRUARY 28, 2024

It will also be essential to develop strategies to minimize barriers, such as health insurance and access to the health care system. 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

Center for Health Insurance Reform

DECEMBER 6, 2023

This week, the Centers for Medicare & Medicaid Services (CMS) is spotlighting how the Marketplaces can serve LGBTQI+ individuals, a community that has historically faced discriminatory barriers to health insurance and health care.

Health Insurance 98

Health Insurance Medicaid Medicaid Medicare 98

Health Populi

MAY 21, 2020

Nearly every respondent in the study reported having health insurance coverage. Among those covered with insurance, one-half had employer-sponsored insurance, 1 in 4 Medicare, and 13%, individual cover. Another 8% had Medicaid or a state health insurance program.

COVID-19 161

COVID-19 Doctors Health Insurance Medicare 161

Center for Health Insurance Reform

MARCH 31, 2022

In the proposed Notice of Benefit and Payment Parameters for 2023, the Centers for Medicare & Medicaid Services asked for feedback on how to promote health equity through ACA marketplace operations and plan certification standards.

ACA 94

ACA Health Insurance Medicaid Medicaid 94

HIT Consultant

MARCH 8, 2022

The steep incline in unemployment and fears that millions of people would lose their health coverage drove the declaration of the national public health emergency (PHE) on January 31, 2020. Under the PHE, states must keep Medicaid enrollees continuously covered, irrespective of their circumstances. .

Public Health 98

Public Health Medicaid Medicaid COVID-19 98

Healthcare IT News - Telehealth

SEPTEMBER 15, 2021

The Centers for Medicare and Medicaid Services (CMS) began to allow for reimbursement for videoconferencing between healthcare provider and patient. According to CMS.gov , CMS is expanding access to telehealth services with Medicare. This trend in remote access to care has expanded widely and is expected to continue.

Telemedicine 192

Telemedicine COVID-19 Medicare Medicare 192

HIPAA Journal

APRIL 29, 2024

Berry, Dunn, McNeil & Parker, LLC (BerryDunn) provides health data analytics services to healthcare providers, health insurers, and government regulatory and healthcare policy agencies and its clients provide BerryDunn with personal and health data to allow the firm to perform its contracted services.

Health Insurance 106

Health Insurance Health Analytics HIPAA Medicaid 106

HIPAA Journal

FEBRUARY 15, 2022

South Shore Hospital said it will be implementing additional security measures to better protect its network against cyberattacks, including stronger password policies, multifactor authentication, and additional anti-malware and anti-phishing tools.

Hospitals 125

Hospitals Health Insurance HIPAA Medicaid 125

HIT Consultant

AUGUST 2, 2022

– Brave Health , a virtual-first behavioral health provider focused on serving Medicaid and Medicare populations, today announced an innovative referral partnership with MedArrive. Today, access to basic behavioral health services for the nation’s most vulnerable populations is a public health crisis.

Medicaid 97

Medicaid Medicaid Telemedicine Public Health 97

MedTrainer

SEPTEMBER 20, 2023

This means your organization must comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). If you want to obtain or retain CMS certification in order to be reimbursed by services provided to patients with a Medicare/Medicaid health plan, you must comply with HIPAA rules and regulations.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

HIT Consultant

NOVEMBER 9, 2023

Director of Healthcare Strategy, LexisNexis Risk Solutions During the peak of the Covid-19 pandemic, over 10 million Americans enrolled in Medicaid – nearly a 14% increase from the beginning of 2020. A month before the public health emergency ended on May 11, 2023, 87 million individuals were enrolled in Medicaid.

Medicaid 64

Medicaid Medicaid Health Insurance COVID-19 64

HIT Consultant

JULY 13, 2022

has been driven by the establishment of the Center for Medicare and Medicaid Innovation (CMMI). Recently, CMMI stated that by 2030 every Medicare beneficiary should be in a value-based relationship – either an ACO or ACO-like model or Medicare Advantage – with a significant emphasis on health equity.

Medicare 98

Medicare Medicare Medicaid Medicaid 98

Bill of Health

DECEMBER 6, 2023

.: not accepting new patients, retired, moved away, or no longer accepting the particular type of insurance). To assess the prevalence of ghost networks, Senate Finance Committee staffers conducted a secret shopper study of 120 mental health provider listings across 12 Medicare Advantage plans.

Governance 147

Governance Medicaid Medicaid Medicare 147

Compliancy Group

FEBRUARY 12, 2024

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.

Fraud 52

Fraud Medicare Medicare US Department of Health and Human Services 52