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HIPAA stands as a beacon of privacy and security standards within the industry. These screenings search through various databases containing records of individuals or organizations barred from participating in Medicaid, Medicare, or other federal/state healthcare programs due to fraud, abuse, or other offenses.
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.
Checks credentialing for Health Insurance Portability and Accountability Act (HIPAA) compliance. It’s also a requirement of federal payers like Medicare, Medicaid, and private insurance companies. In addition, there can be other indirect costs, such as rising malpractice insurance costs and associated fiscal penalties.
Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs. This is also called “store-and-forward telemedicine.”
Written by: Joanne Byron , BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, COCAS, CORCM, OHCC, ICDCT-CM/PCS This article addresses how to track telehealth policies while addressing HIPAA compliance and mobile device management as the United States enters into a post-pandemic era. What Additional Information Should I Know for Compliance?
Department of Health and Human Services, Statewide Medicaid Managed Care, Florida Department of Agriculture and Consumer Services, or another agency to continue to process your complaint. If you would like to file a complaint based on a HIPAA violation, you will have to file with the U.S. Department of Health and Human Services.
It involves collecting and reviewing information such as education, training, licensure, certifications, work history, malpractice history, and references — all in pursuit of verifying that providers are who they say they are and qualified to deliver legitimate, safe, and ethical care.
As a reminder, telemarketing in healthcare must follow strict privacy regulations, such as the Health Insurance Portability and Accountability Act (HIPAA), Public Law 104-191 in the United States. Know how the Health Insurance Portability and Accountability Act (HIPAA) effects your practice.
to UConn cardiology center UConn gene discovery moves closer to treating neuromuscular disease, holds promise for weight loss DC D.C. to UConn cardiology center UConn gene discovery moves closer to treating neuromuscular disease, holds promise for weight loss DC D.C.
Eric Holder’s wife accused of major HIPAA ‘breach’ by her former women’s health practice. Delaware Adds Centene Plan to Medicaid Managed Care Offerings. Key advocates reflect on Hawaii postpartum Medicaid coverage extension. State settles University of Iowa medical malpractice lawsuit for $7.5
attracts Merck as an investor Centura Health Pushes Back on Class Action Alleging Wrongful Liens Children’s Hospital Colorado fined $548K for HIPAA violations CommonSpirit builds market leadership team Denver business leader tapped to be CEO of Aurora innovation campus Denver metro hospitals No. 3 in the U.S. 3 in the U.S.
So far, Georgia has only one Bull Realty Brokers $5.9M healthcare centers receive $935K in federal funding to provide free COVID-19 vaccines New CEO at Mt. So far, Georgia has only one Bull Realty Brokers $5.9M healthcare centers receive $935K in federal funding to provide free COVID-19 vaccines New CEO at Mt.
United Therapeutics ‘no longer pursuing’ nearly 350 acres in Hackett Hill area NEW JERSEY 4 N.J. in Q3 Mergers give hospitals new EHR systems N.J. nursing home scam highlights host of problems | Editorial North Jersey Physical Therapy takes 1,800 sq. near Morristown, Sheldon Gross says NJ hospitals contribute $31.4B
Senators Seek HHS Update to HIPAA, FBI Warns About Legacy Devices. A federal judge schedules a hearing on Florida’s Medicaid transgender rule. Minnesota health systems doing better financially, but bracing for Medicaid cliff. Billings Clinic Broadwater renovations end; CEO talks Medicaid with Governor. MISSISSIPPI.
governor pushes new Medicaid expansion proposal with work requirement Missouri state senator wants voters to have say in KU Health System, Liberty Hospital merger Kansas ACLU request to halt excessive wait times at Larned turned down by judge ‘Who cares about us? health care spending hits $4.5 health care spending hits $4.5
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%
OCR Announces Four HIPAA Enforcement Actions. Lawmakers not giving up on bill to expand Medicaid to undocumented kids. Despite malpractice lawsuits, Gainesville hospital stands behind star surgeon. Rural healthcare providers feel the pain of North Carolina’s “Medicaid gap”. to settle Medicaid contractor dispute.
s Vanda Pharmaceuticals pays $100M for commercial rights to Johnson & Johnson company’s drug Hundreds of DC’s Medicaid nursing home patients sent to Maryland Medical facility in DC’s Ward 8 gets $22.5M
11 Plan To Slash $1.5B face growing challenges to stay open KENTUCKY BehaVR merges with New York City-based Fern Health For years, a powerful Louisville hospital sued people for unpaid bills.
New mental health clinic in Rexburg accepts Medicaid and Medicare ILLINOIS 3 IL Children’s Hospitals Among Nation’s Best: U.S. Now, it’s against funding clinics missing standards. are among the nation’s highest.
for physician referral scheme In Los Angeles, hospital CEO pay could be capped Kaiser Permanente ratings affirmed amid healthy financial profile Nurses vote ‘no confidence’ in California hospital administration, board Nursing facility, management company settle physician kickback allegations for $3.8M
Francis Hospital-Interquest Progresses In Colorado Colorado’s wealthiest hospitals favored in $1.2 in Indiana aging-in-place work. nursing home Massachusetts hospitals spent $1.5B in Indiana aging-in-place work. nursing home Massachusetts hospitals spent $1.5B in Indiana aging-in-place work.
Dunleavy adds $9M to budget to address food stamp, Medicaid backlog New study provides snapshot of increase in maternal deaths in Alaska Mental Health Trust Grants $1.6M Dunleavy adds $9M to budget to address food stamp, Medicaid backlog New study provides snapshot of increase in maternal deaths in Alaska Mental Health Trust Grants $1.6M
Anthony’s Hospital celebrates expansion, renovation project milestone ‘Our voices weren’t being heard’: COVID-19 restrictions rolled back in Metro nursing home Nebraska lawmakers send $10.7
Francis emergency room KENTUCKY Apollo’s 220-hospital ‘stranglehold’ harms patients and workers, report alleges Humana cuts ‘small’ number of jobs in multiple locations LMU School of Nursing will open Lexington site at CHI Saint Joseph Health Mercy Health announces acquisition of orthopedic center in Paducah, Ky.
Dunleavy proposes extending Medicaid coverage for new mothers ARIZONA Banner Health pays $1.25M penalty over HIPAA failures from 2016 breach Arizona nursing school at risk of losing accreditation St. billion since pandemic U.S. billion since pandemic U.S. Luke’s Health System says it will lay off workers in Idaho.
Medicaid fraud scheme Union leaders say payroll problems persist for home care workers CT universities embrace holistic care as a way to teach the new generation of health care workers Thousands of CT residents to lose HUSKY coverage, health group says. Therapist pleads guilty to $1.6M Therapist pleads guilty to $1.6M
Medicaid fraud scheme Union leaders say payroll problems persist for home care workers CT universities embrace holistic care as a way to teach the new generation of health care workers Thousands of CT residents to lose HUSKY coverage, health group says. Therapist pleads guilty to $1.6M Therapist pleads guilty to $1.6M
Luke’s hospital doubles its square footage in McCall Teton Valley Health recruits new CEO from neighboring hospital New national 988 suicide and crisis lifeline helps more Idahoans In Idaho, Half of People Removed From Medicaid Didn’t Send State Their Info ILLINOIS HSHS St. Luke’s named to Becker’s Great Heart Programs list Univ.
million to combat lack of health care providers in rural communities ‘Conscience’ bills let medical providers opt out of providing a wide range of care St.
Mental health hospital slated for Wichita could solve some problems but faces staffing questions Missouri and Kansas limit payouts in medical malpractice lawsuits. in federal funds will allow CT colleges to hire more nursing instructors, provide student tuition support Connecticut hospital expenses $3.5B But who really benefits?
warns Crozer closures would leave ‘significant gap’ as it moves to takeover health system Pa. attorney general files lawsuit against owner of Crozer Health for alleged mismanagement Penn State Health taps interim CEO Penn State pays $1.25 million to resolve False Claims Act cybersecurity allegations PeopleOne Health closes $32.3M
Connecticut is weighing several changes to Medicaid. Here’s what it means. Cloud Hospital names Chief Quality Officer Tampa’s Lions Eye Institute adopts new name Troubled Cano Health records $60.6M
Medicare fraud scheme HCA to acquire Prime Florida hospital HHS Office for Civil Rights Imposes a $1.19 to successfully perform new ‘experimental’ heart pump surgery Emory Healthcare’s chief AI officer exits Medical scan company to pay US, Georgia government $5.25 million for violating False Claims Act Ga. AG Deal, NIH 4th Circ.
cancer care investment at West Michigan hospital University foundation sells former Michigan hospital for $2.5M cancer care investment at West Michigan hospital University foundation sells former Michigan hospital for $2.5M
Medicaid fraud scheme New York hospital exec chosen to lead Greenwich Hospital Why 5 ASCs are facing opposition 120 doctors in CT are at risk for losing their jobs. Medicaid fraud scheme New York hospital exec chosen to lead Greenwich Hospital Why 5 ASCs are facing opposition 120 doctors in CT are at risk for losing their jobs.
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