Health Blawg

APRIL 8, 2018

Once the federales blocked the health insurance company mega-mergers, it was only a matter of time before alternative approaches to rearranging the three-dimensional chessboard of the healthcare-industrial complex would emerge. Health insurance, pharmacy and urgent care all under one roof. Comments Comments.

Health Insurance 60

Health Insurance Health Care Lawyers ACA Payment Systems 60

Health Blawg

APRIL 8, 2018

Once the federales blocked the health insurance company mega-mergers, it was only a matter of time before alternative approaches to rearranging the three-dimensional chessboard of the healthcare-industrial complex would emerge. Health insurance, pharmacy and urgent care all under one roof.

Health Insurance 60

Health Insurance Health Care Lawyers ACA Payment Systems 60

Health Blawg

APRIL 8, 2018

Once the federales blocked the health insurance company mega-mergers, it was only a matter of time before alternative approaches to rearranging the three-dimensional chessboard of the healthcare-industrial complex would emerge. Health insurance, pharmacy and urgent care all under one roof.

Health Insurance 60

Health Insurance Health Care Lawyers ACA Payment Systems 60

Health Blawg

APRIL 8, 2018

Once the federales blocked the health insurance company mega-mergers, it was only a matter of time before alternative approaches to rearranging the three-dimensional chessboard of the healthcare-industrial complex would emerge. Health insurance, pharmacy and urgent care all under one roof.

Health Insurance 60

Health Insurance Health Care Lawyers ACA Payment Systems 60

Hall Render

MARCH 20, 2024

The Final Rule also imposes additional reporting requirements under the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals and for eligible clinicians reporting under the Promoting Interoperability performance category of the Merit-Based Incentive Payment System.

Medicare 40

Medicare Medicare Health Insurance Medicaid 40

Hall Render

AUGUST 10, 2023

On August 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its Final Hospital Inpatient Prospective Payment System (“IPPS”) and Long-Term Care Hospital (“LTCH”) PPS rule for fiscal year (“FY”) 2024 (“Final Rule”). The Final Rule increases the rate for IPPS payments by 3.3%

Hospitals 40

Hospitals Medicare Medicare Medicaid 40

The Digital Health Corner

APRIL 28, 2017

This type of payment system shifts the ROI of digital technology from one based on revenue generation to cost savings. In fact arguments for consolidation are based on the promise of improved cheaper care. This has yet to be demonstrated (in healthcare or any other industry).

Hospitals 60

Hospitals ACA Patient Satisfaction Payment Systems 60

Physician Credentialing Company

OCTOBER 25, 2024

Insurance Verification And Pre-Authorization Before delivering services, it’s very important for healthcare providers to check whether the patient’s insurance includes mental health services under the 90834 code or not. Medicare and Medicaid may have different payment systems from those of the private health insurance plans.

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52

C&M Health Law

DECEMBER 23, 2022

The regulations impact CMS-regulated payers and provide incentives for providers and hospitals that participate in the Medicare Promoting Interoperability Program and the Merit-based Incentive Payment System (MIPS). Most of the Proposed Rule’s provisions will be effective on January 1, 2026. Our initial takeaways are summarized below.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Health Care Law Brief

JULY 25, 2023

Unlike developers, exchanges, and networks, the Act does not empower OIG to directly assess penalties for non-compliance against health care providers. [6]

HIPAA 52

HIPAA Payment Systems Compliance Licensing 52

Healthcare Law Blog

JANUARY 26, 2024

The payers impacted by the Final Rule include Medicare Advantage (“MA”) organizations, state Medicaid and Children’s Health Insurance Program (“CHIP”) agencies, Medicaid and CHIP managed care plans, and plans on the Affordable Care Act exchanges (collectively, “Impacted Payers”).

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Medicaid 52

AIHC

NOVEMBER 29, 2023

Prior to this time, commercial carriers were already pushing HMOs (health maintenance organizations) and capitation contracts with physician networks or instituting “reasonable and customary charges” requiring physicians to collect data to negotiate reasonable contracts. Hospital reimbursement also changed.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

C&M Health Law

AUGUST 3, 2023

OIG differentiated the vetting Health Insurance Portability and Accountability Act (“HIPAA”) covered entities may conduct of entities that would be their business associates before granting access and use of EHI. Additionally, such vetting applied in discriminatory or unreasonable manner could implicate information blocking.

Fraud 52

Fraud HIPAA Governance Compliance 52

AIHC

NOVEMBER 29, 2023

Prior to this time, commercial carriers were already pushing HMOs (health maintenance organizations) and capitation contracts with physician networks or instituting "reasonable and customary charges" requiring physicians to collect data to negotiate reasonable contracts. Hospital reimbursement also changed.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Kaiser Health News

JUNE 29, 2022

AHIP, which represents the health insurance industry, released a statement that said Medicare Advantage plans “deliver better service, access to care, and value for nearly 30 million seniors and people with disabilities and for American taxpayers.” Cathy Rodgers (R-Wash.) Bliss said Medicare paid $2.6

Medicare 107

Medicare Medicare Governance Overpayments 107

Electronic Health Reporter

MARCH 26, 2019

This article is copyrighted strictly for Electronic Health Reporter. Illegal copying is prohibited.

HIPAA 89

HIPAA Payment Systems Health Insurance 89

HIPAA Journal

MARCH 29, 2024

On March 13, 2024, UHG said all major pharmacy and payment systems are up and more than 99% of pre-incident claim volume is flowing. What is HIPAA and does this Cyberattack Break the Law?

Ransomware 95

Ransomware US Department of Health and Human Services HIPAA Hospitals 95

Hall Render

JANUARY 26, 2024

hospitals Savannah hospitals at full capacity Georgia lawmaker proposes bill to limit AI’s use in health insurance decisions 6 GA Hospitals Among Best In US: New Ranking ‘It can all start there’: This is why Georgia is investing in behavioral health crisis centers $2.2M

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

AUGUST 4, 2023

1 CMS final rule boosts Medicare hospice payments by 3.1% To Address SDOH Needs U.S. sues UnitedHealth over ‘thousands’ of denied claims What’s a fair price for a prescription drug? ranked by U.S.

COVID-19 40

COVID-19 Nursing Homes Hospitals Nurses 40

Hall Render

MARCH 15, 2024

Million Hospital Will Bridge Western Wyoming Health Care Gap Gillette representative’s healthcare legislation signed into law The post Health Provider News appeared first on Law Firm | Health Care Law Firm in the USA | Hall Render.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

JANUARY 31, 2025

’s Vanda Pharmaceuticals battling FDA on multiple fronts Howard University physician group taps insider to be next CEO Deadline approaching for DC’s health care exchange D.C. is Americas loneliest city.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Medicaid 40

Hall Render

FEBRUARY 7, 2025

women face $1M in rejected claims as feud between United HealthCare and doctors escalates New York ASC adds bladeless LASIK NEW MEXICO Behavioral health overhaul picking up steam at Roundhouse How a New Mexico hospital CFO is fighting increasing denials New Mexico weighs medical malpractice legislation: 3 things to know NM awards $40.6M

Nurses 40

Nurses Nursing Homes Hospitals Medicaid 40

Hall Render

APRIL 21, 2023

NATIONAL 6 health systems using GPT and AI tools 100,000 nurses left industry during the pandemic, report finds AHA backs bill to delay Medicaid DSH cuts by 2 years AHA launches info hub for healthcare quality leaders AHA opposes MedPAC recommendations to Congress on site-neutral, Part B drug, wage index policies AHA ramps up 340B protection efforts (..)

US Department of Health and Human Services 40

US Department of Health and Human Services COVID-19 Nursing Homes Nurses 40

Kaiser Health News

FEBRUARY 9, 2023

Also this week, Rovner interviews Kate Baicker of the University of Chicago about a new paper providing a possible middle ground in the effort to establish universal health insurance coverage in the U.S. But first, this week’s health news. She’s one of the authors of a new paper outlining a new proposal for the U.S.

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare FDA 52