Compliancy Group

JANUARY 23, 2025

These settlements involved managed care providers, physicians, hospitals, pharmacies, pharmaceutical companies, laboratories, and other medical facilities. Crossroads: $863,934 Allegations that the substance use disorder treatment clinics billed for treatment services they did not provide, defrauding Medicaid. While the $1.67

Fraud 98

Fraud Medicare Medicare Regulatory Compliance 98

Healthcare IT News - Telehealth

OCTOBER 5, 2022

how streamlined licensing and credentialing can help with the psychiatrist shortage. How are hospitals and health systems turning to telehealth to address provider burnout as demand for behavioral health services mounts? Telehealth, however, does so directly and immediately. More than three-quarters of U.S. Twitter: @SiwickiHealthIT.

Licensing 195

Licensing Telemedicine Nursing Homes Hospitals 195

Bill of Health

JUNE 15, 2023

Merck alleges that the price negotiation program operates as a price control because it effectively requires manufacturers to accept the maximum fair price as a condition of participation in Medicare and Medicaid. Covered entities include various federally funded clinics and hospitals that serve low-income patients.

Medicare 195

Medicare Medicare Medicaid Medicaid 195

Verisys

MARCH 6, 2025

In a high-stakes environment, like a hospital emergency room, efficiency and accuracy in staffing ensure that qualified medical professionals are available to provide immediate, high-quality care. Provider data quality is a fundamental necessity for the healthcare industry.

Compliance 52

Compliance Licensing Doctors Malpractice 52

HIPAA Journal

JUNE 28, 2023

Good Samaritan Hospital in San Jose, CA, has agreed to settle a class action lawsuit that was filed in response to a data breach that exposed the protected health information of up to 233,835 individuals. The post Good Samaritan Hospital Settles Class Action Data Breach Lawsuit appeared first on HIPAA Journal.

Hospitals 102

Hospitals Fraud Licensing HIPAA 102

Healthcare IT Today

NOVEMBER 3, 2024

A Podimetrics survey found 65% of Medicaid beneficiaries living with type 2 diabetes also manage at least one chronic behavioral health condition. Partnerships Smartphone-based health assessment tool Helfie can now be licensed directly through the Microsoft Azure Marketplace.

Medical Billing 92

Medical Billing Licensing Medicaid Medicaid 92

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. Examples of states that have used waivers under the Medicaid program to test expanded access to telehealth. Blunt Rochester in a statement. WHY IT MATTERS.

US Department of Health and Human Services 167

US Department of Health and Human Services COVID-19 Medicaid Medicaid 167

AIHC

DECEMBER 27, 2024

Here, the court affirmed that hospitalization does not negate a persons right to bodily privacy when it noted that, It would be a strange doctrine that would decree that the sanctity of the right of privacyfully respected in a public restroom, is forfeited by the fact of falling ill and becoming hospitalized. 8] In Backus v.

Informed Consent 98

Informed Consent Bioethics ADA Nurses 98

Verisys

MARCH 6, 2025

The Centers for Medicare and Medicaid Services (CMS) Regulates reimbursement policies and ensures healthcare organizations adhere to the standards necessary to participate in federal healthcare programs. Credentialing, Licensing, and Education. Failure to comply with regulations can result in the loss of these essential credentials.

Compliance 52

Compliance HIPAA Licensing Governance 52

Healthcare IT News - Telehealth

SEPTEMBER 9, 2024

hospitals – and explored opportunities and barriers to growth. Meanwhile, the American Telemedicine Association is pleading with the Centers for Medicare and Medicaid Services for expanded flexibilities and further guidance on payment and coverage. The healthcare industry does not agree that state licensing needs to be revised.

Telemedicine 190

Telemedicine Licensing Health Outcomes Governance 190

Medisys Compliance

MARCH 9, 2025

Partial Hospitalization Programs (PHP): While technically outpatient, PHP offers intensive, structured mental health treatment programs for patients who need more than traditional outpatient therapy but not inpatient hospitalization. CMS websites and publications are your primary source for accurate information.

Medicare 59

Medicare Medicare Medical Billing Medical Billing Services 59

Healthcare IT Today

JANUARY 8, 2025

Outsourcing will pivot to a more surgical, targeted strategy, focusing on high-impact, specialized areas like revenue integrity, underpayment recovery, and the more commonplace out-of-state Medicaid and small balance recovery work where RCM outsourcing supplements streamlined, automation-empowered teams instead of replacing them.

Hospitals 90

Hospitals Payment Systems Licensing Medicaid 90

Healthcare IT News - Telehealth

SEPTEMBER 13, 2021

hospitals via telemedicine, has sued the U.S. Despite HHS instituting waivers making tele-ICU services payable under Medicare, RICU says it has been unable to expand its services to more hospitals – because the agency disallows payment for critical-care telemedicine if the physician is located outside the United States.

COVID-19 160

COVID-19 Doctors Medicare Medicare 160

Healthcare IT News - Telehealth

JUNE 1, 2020

"Especially hard hit have been safety-net clinics serving medically underserved and rural areas, many facing alarming drops in Medicaid and Medicare reimbursements as a result of the drop in face-to-face consultations," wrote the report authors. ON THE RECORD.

COVID-19 217

COVID-19 Electronic Medical Records Telemedicine Licensing 217

Medisys Compliance

MARCH 31, 2023

Ohio Medicaid is a government-sponsored healthcare program that provides medical benefits to eligible individuals in Ohio. To become a provider for Ohio Medicaid, you must first enroll in the Ohio Medicaid program. Here are the steps of provider enrollment for Ohio Medicaid: Provider Enrollment for Ohio Medicaid 1.

Medicaid 52

Medicaid Medicaid Licensing Medical Billing Outsourcing 52

Healthcare IT News - Telehealth

AUGUST 30, 2021

Trinity Health has 94 hospitals across 24 states. In 2017, the health system – which has 100 continuing care locations, including home care, hospice, PACE programs and senior living facilities – was in a bind, facing double-digit hospital readmissions of 16% across its high-risk Medicare population. THE PROBLEM.

Patient Satisfaction 196

Patient Satisfaction Nurses Medicare Medicare 196

Healthcare IT News - Telehealth

MAY 30, 2023

Further, what should CIOs and other health IT leaders at hospitals and health systems be doing to address new telemedicine challenges? In-person care is now fully available and we are going to have millions of people rolling off the Medicaid rolls in the next year, many of whom will not be able to maintain replacement insurance.

Telemedicine 216

Telemedicine COVID-19 Governance Medicare 216

Healthcare IT News - Telehealth

JULY 28, 2020

More than 100 physician groups, led by the American Medical Association, told the Centers for Medicare and Medicaid Services in no uncertain terms this past week that, while they supported temporary regulatory relaxations in response to COVID-19, they were strongly opposed to certain rules changes being made permanent. WHY IT MATTERS.

COVID-19 202

COVID-19 Public Health Nurses Medicare 202

HIPAA Journal

MARCH 10, 2022

Duncan Regional Hospital. Duncan Regional Hospital in Oklahoma has announced that hackers gained access to its systems and potentially exfiltrated sensitive patient and employee information. BakoDx said it has enhanced its security and monitoring capabilities and has hardened the security of its systems to prevent further cyberattacks.

Ransomware 140

Ransomware Licensing Health Insurance HIPAA 140

MedTrainer

MARCH 30, 2024

Built-in Automation Keep the enrollment process moving forward with automated reminders for providers to send documents, notification of recredentialing deadlines, and license expiration. Choose software with dynamic graphs that show application age, average time to complete applications, and number of closed applications per credentialer.

Malpractice 98

Malpractice Licensing Medicaid Medicaid 98

Healthcare IT News - Telehealth

SEPTEMBER 9, 2020

"If you're not licensed in that state, you can't practice medicine through a virtual medium in a non-COVID world," he said. In the meantime, he said, Summus is also working with some hospital systems on digital platforms. "It's a different legal arrangement."

COVID-19 153

COVID-19 Doctors HIPAA Telemedicine 153

Verisys

FEBRUARY 2, 2025

Hospital credentialing, sometimes referred to as healthcare credentialing, is the process of verifying that a provider is qualified to provide medical services. Done properly, hospital credentialing also protects providers and hospitals. Done properly, hospital credentialing also protects providers and hospitals.

Hospitals 52

Hospitals COVID-19 Licensing Medicare 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. We must enable technology to allow health systems to have a continual relationship with their patients; the care journey doesn't simply end when they leave the hospital.

COVID-19 184

COVID-19 Hospitals Telemedicine Licensing 184

Healthcare Law Blog

OCTOBER 21, 2022

The written or electronic notice shall contain the following text: “The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found here.

Licensing 97

Licensing Medicaid Medicaid Hospitals 97

Healthcare IT News - Telehealth

AUGUST 19, 2022

The pandemic has added to these challenges due to hospitals facing capacity issues during surges in cases, increased patient deaths, clinician health and safety risks, and uncertainty over treatments, which has led to a feeling of helplessness. Hospitalizations, for example, do not always require the patient to be within a medical facility.

COVID-19 192

COVID-19 Hospitals Nurses Licensing 192

Healthcare IT News - Telehealth

NOVEMBER 6, 2020

Some of the sessions will air live and others will be on-demand – one of which will focus on an innovative use case for telebehavioral health that has already improved patient care while gaining cost efficiencies for small and rural hospitals. " Michael Hasselberg, Rochester University Medical Center.

Hospitals 153

Hospitals Nurses Licensing Medicaid 153

HIT Consultant

FEBRUARY 5, 2024

The proper credentialing steps can be complex and time-consuming but are a fundamental responsibility of hospitals and healthcare facilities. All certifications and licenses must be verified for every provider who administers services to patients. Mistake No. 3: Allowing a physician to treat patients before credentialing is completed.

Malpractice 96

Malpractice Licensing Due Diligence Hospitals 96

Healthcare IT News - Telehealth

MARCH 29, 2022

With a shortage of physicians to address the growing need for care, a lack of providers who accept Medicaid, and access issues due to transportation or office hour challenges, healthcare organizations are looking to technology to help bridge the gap. Addressing the increasing need for behavioral health services is a nationwide challenge.

COVID-19 147

COVID-19 Nursing Homes Nurses Licensing 147

Health Populi

MAY 21, 2020

42% felt uncomfortable going to a hospital for any medical treatment. Another 8% had Medicaid or a state health insurance program. Thus, 38% of people would delay an elective procedure and 27% would delay a diagnostic test in a hospital setting for at least six months. ACHP and AMCP polled 1,263 U.S.

COVID-19 161

COVID-19 Doctors Health Insurance Medicare 161

HIPAA Journal

JULY 4, 2023

PHI of More Than 24,000 Mount Desert Island Hospital Patients Exposed Mount Desert Island Hospital in Bar Harbor, ME, has issued a statement about a security incident that was detected on May 4, 2023.

Medicaid 97

Medicaid Medicaid Health Insurance Licensing 97

The Health Law Firm Blog

OCTOBER 5, 2023

Board Certified by The Florida Bar in Health Law Do you have a medical, pharmacist, counselor, or nursing license in more than one state? Do you have a license in more than one profession? By George F. Indest III, J.D., Have you been notified that an investigation has been opened against your professional [.]

Licensing 52

Licensing Nurses Medicaid Medicaid 52

The Health Law Firm Blog

JULY 11, 2022

Board Certified by The Florida Bar in Health Law Do you have a medical, pharmacist, counselor, or nursing license in more than one state? Do you have a license in more than one profession? By George F. Indest III, J.D., Have you been notified that an investigation has been opened against your professional [.].

Licensing 52

Licensing Nurses Medicaid Medicaid 52

Healthcare IT Today

AUGUST 17, 2022

Resolute Health Hospital. The Hospitals of Providence Memorial Campus. They reported the breach to have occurred January 20, 2022. Here are the 5 organizations that could have had patients involved: Baptist Health System. Valley Baptist Medical Center – Brownsville. Valley Baptist Medical Center – Harlingen.

Licensing 110

Licensing Hospitals Health Insurance Medicaid 110

MRO Compliance

JUNE 1, 2022

This review is part of the Star rating system, which according to RAC Monitor was developed by the Centers for Medicare & Medicaid Services (CMS) to rate health plan performance for Medicare Advantage programs and Medicare risk adjustment initiatives. HEDIS audits are important for Medicare and Medicaid health plans.

Medicare 130

Medicare Medicare Compliance Medicaid 130

Physician Credentialing Company

JULY 23, 2024

Hospital credentialing, also referred to as healthcare or medical credentialing , is the crucial process for checking the background data and CV credentials of healthcare providers. In this blog, we will delve deep into the details of hospital credentialing steps, their importance, and the obstacles in undergoing this process.

Hospitals 52

Hospitals Licensing Malpractice Doctors 52

Healthcare IT Today

MARCH 27, 2023

Companies can also tap into OpenLoop’s Regulatory & Legal and Licensing & Credentialing services to keep their practice and clinicians up-to-date with industry laws and compliance standards while they focus on their patients.

Licensing 115

Licensing Health Outcomes Medicaid Medicaid 115

Physician Credentialing Company

FEBRUARY 27, 2025

Two critical healthcare facilities have become widely significant in recent times: outpatient hospitals together with ambulatory surgical centers (ASCs). What are Outpatient Hospitals? Patients access medical treatment at outpatient hospitals which serve them without needing hospital accommodation for the night.

Hospitals 52

Hospitals Medical Personnel Health Insurance Licensing 52