Healthcare IT Today

MAY 16, 2024

Mike Semel, President and Chief Security Officer of Semel Consulting The Ascension health system data breach can’t be easily separated from the United Healthcare Change Health breach that recently caused a huge financial and medical impact across the healthcare sector and may have breached the personal information for a third of Americans.

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Ransomware US Department of Health and Human Services Hospitals Compliance 122

Total HIPAA

FEBRUARY 23, 2023

If the Covered Entity or Business Associate discovers additional information later, they should submit updates as indicated on the HHS form. Here are a few examples from the HHS website: A municipal social service agency disclosed PHI while processing Medicaid applications. You can view the full list of HHS examples here.

US Department of Health and Human Services 52

US Department of Health and Human Services HIPAA Compliance Medicaid 52

Healthcare IT News - Telehealth

AUGUST 11, 2021

Department of Health and Human Services works to ensure the integrity of federal healthcare programs and to safeguard the health and welfare of those programs' beneficiaries. And I think it's important for us to recognize that we don't know a whole lot right now.

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US Department of Health and Human Services Fraud Medicare Medicare 167

Verisys

APRIL 3, 2025

Poor communication between departments : Credentialing requires input from many players, including HR, compliance teams, and insurance payers. This can result in providers being unable to bill for services, disruptions in patient care, and compliance violations.

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US Department of Health and Human Services Licensing Compliance Malpractice 52

HIPAA Journal

JANUARY 30, 2023

Attendees will gain valuable insights into health information privacy, healthcare cybersecurity, HIPAA enforcement, and a wealth of information to help them maintain HIPAA compliance and take healthcare data privacy and security to the next level. Jillson, JD – Counsel to the Director, Bureau of Consumer Protection, U.S.

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US Department of Health and Human Services HIPAA Compliance Medicaid 81

HIT Consultant

JUNE 26, 2023

signed a Letter of Intent with CRISP Shared Services to participate in a health data interoperability pilot program that will lay the foundation for OHIT’s Health Information Exchange in the Territory. Virgin Islands (USVI) Governor Albert Bryan Jr. Why It Matters OHIT Director Michelle M.

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US Department of Health and Human Services Local Policy Governance Medicaid 52

Total HIPAA

JANUARY 18, 2022

HIPAA breaches involving fewer than 500 individuals which occurred during 2021 must be reported to the US Department of Health and Human Services (HHS) by Tuesday, March 1, 2022. Here are a few examples from the HHS website: A municipal social service agency disclosed PHI while processing Medicaid applications.

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HIPAA US Department of Health and Human Services Compliance Medicaid 92

Compliancy Group

JUNE 6, 2024

Many compliance violations in healthcare arise from financial conflicts of interest, particularly when providers get kickbacks or achieve financial gain from their referral services. Department of Health and Human Services, enforces the Stark Law. CMS Updates in 2023 : Voluntary self-referral disclosure laws.

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Compliance Officers Compliance US Department of Health and Human Services Medicare 59

AIHC

APRIL 10, 2024

Checklist for Individual & Small Group Practices Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM This article provides an overview of Health Information Technology for Economic and Clinical Health Act (HITECH) and basic checklist of policies and procedures for compliance of smaller health care organizations.

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Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 99

Healthcare Compliance Blog

JUNE 9, 2022

His exclusion means that no federal healthcare program payment may be made, either directly or indirectly, for any items or services furnished by him or at his direction or prescription. HHS-OIG will continue to work with the US Attorney’s Office to ensure the integrity of the Medicare Trust Fund.”.

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US Department of Health and Human Services Overpayment Overpayments Medicare 59

American Medical Compliance

AUGUST 1, 2022

In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. Increased Telehealth Services.

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US Department of Health and Human Services COVID-19 Nursing Homes Medicare 52

Healthcare Compliance Blog

MAY 9, 2022

A home health services company headquartered in Kentucky, and its related entities, paid $2.1 million to the United States government to settle claims of improperly billing the Medicare Program for home health services provided to beneficiaries living in Florida.

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US Department of Health and Human Services Medicare Medicare Compliance 59

Healthcare IT Today

SEPTEMBER 22, 2022

Zócalo Health set to deliver the only Latino healthcare experience focused on the culture of patients’ primary and social health needs. Zócalo Health , a Latino-founded healthcare service designed for Latino patients, announced today $5M in seed funding co-led by Animo, Virtue, and Vamos Ventures. million people.

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US Department of Health and Human Services COVID-19 Medicaid Medicaid 52

American Medical Compliance

AUGUST 1, 2022

In Spring 2022’s Semiannual Report to Congress (SAR), the Department of Health and Human Services’ Office of Inspector General (HHS-OIG) reported that nearly $3 billion had been misspent on Medicare and Medicaid services. Increased Telehealth Services.

US Department of Health and Human Services 52

US Department of Health and Human Services COVID-19 Nursing Homes Medicare 52

Jane Sarashon

FEBRUARY 4, 2024

As a constant observer and advisor across the health/care ecosystem, for me the concept of a “health plan” in the U.S. Furthermore, health plan members now see themselves as medical bill payers, seeking value and consumer-level services for their health insurance premium investment. is getting fuzzier by the day.

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US Department of Health and Human Services Health Insurance Medicare Medicare 75

Healthcare Compliance Blog

APRIL 26, 2022

The Office of Inspector General (OIG) for the US Department of Health and Human Services (HHS) has made educational resources available for healthcare providers to comply with federal healthcare laws and regulations. Department of Health and Human Services (hhs.gov).

US Department of Health and Human Services 59

US Department of Health and Human Services Fraud Compliance Medicaid 59

Med-Net Compliance

OCTOBER 19, 2022

The settlement resolves allegations that between 2013 and 2020, the company paid remuneration to its home health medical directors in Oklahoma and Texas for the purpose of inducing referrals of Medicare and TRICARE home health patients. The corporate officers were previously the CEO and COO of the company.

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US Department of Health and Human Services Medicare Medicare Medicaid 59

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. A federal district court judge will determine any sentence after considering the US Sentencing Guidelines and other statutory factors.

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

Healthcare IT Today

JANUARY 10, 2024

As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. Jason Considine, Chief Commercial Officer at Experian Health Staffing shortages will continue to be a major pain point for providers in 2024 and have a direct impact on their bottom line.

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US Department of Health and Human Services Nurses Hospitals Telemedicine 97

Med-Net Compliance

NOVEMBER 8, 2022

On November 3, 2022, the OIG released the results of a recent inspection of a nursing home by the Texas Health and Human Services (HHS) Office of Inspector General Audit and Inspections Division (OIG Inspections). OIG inspectors recommended the facility develop a process to collect this data and post the information as required.

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

Med-Net Compliance

OCTOBER 26, 2022

The US Department of Health and Human Services (HHS) Office of Inspector General (OIG) has announced that they will be enhancing their focus on potentially preventable hospitalizations of Medicare-eligible skilled nursing facility (SNF) residents. and 42 CFR § 483.25).

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

Healthcare Law Blog

MARCH 7, 2023

The Centers for Medicare & Medicaid Services (“CMS”), on behalf of the U.S. Department of Health and Human Services (“HHS”), recently issued a proposed rule to adopt standards under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) for “health care attachment” transactions (the “Proposed Rule”).

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US Department of Health and Human Services HIPAA Medicaid Medicaid 52

Healthcare IT Today

AUGUST 13, 2023

Because there’s so much happening out there in healthcare IT we aren’t able to cover in our full articles, we still want to make sure you’re informed of all the latest news, announcements, and stories happening to help you better do your job. Welcome to the weekly edition of Healthcare IT Today Bonus Features.

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US Department of Health and Human Services Doctors Telemedicine Payment Systems 75

Med-Net Compliance

AUGUST 18, 2022

An Indiana provider of skilled nursing and long-term care services has agreed to pay $5,591,044.66 It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.? Ensure that your policies are reviewed at least annually and updated when new information becomes available.

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

MedTrainer

JULY 29, 2024

Corporate compliance training software is vital to tailoring programs to staff, departments, and locations. Corporate compliance training software is vital to tailoring programs to staff, departments, and locations. Department of Health & Human Services ( HHS ). monitorship or reporting obligations).”

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Compliance US Department of Health and Human Services Regulatory Compliance Compliance Officers 52

Verisys

JANUARY 6, 2022

Federal payments for healthcare services account for 28% of all healthcare spending in the United States. Payments from Medicare, Medicaid, TRICARE, CHIP, and other federal programs are a significant source of funds for nearly every healthcare organization and provider. There are two types of OIG exclusions : permissive and mandatory.

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US Department of Health and Human Services Fraud Medicaid Medicaid 52

Healthcare IT Today

JANUARY 4, 2023

The following is a guest article by Nate Maslak, Founder & CEO at Ribbon Health. The ability to seek treatment from a doctor specializing in your specific medical need is beneficial and improves health outcomes. And consumers have come to expect and demand this personalization. Personalized Healthcare in Action . million in 2020.

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US Department of Health and Human Services Doctors COVID-19 Health Outcomes 70

Compliancy Group

FEBRUARY 28, 2024

Within the US Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) is responsible for overseeing and administering various healthcare programs, including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP).

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Compliance US Department of Health and Human Services Fraud Medicare 52

C&M Health Law

JANUARY 20, 2023

This builds on the HIPAA Transactions Rule standards for financial and administrative transactions among health care providers and health plans and aligns with Department of Health and Human Services (HHS) interoperability regulations.

HIPAA 52

HIPAA US Department of Health and Human Services Compliance Health Insurance 52

Verisys

JANUARY 19, 2022

Due to the complex nature of medical credentialing, it requires coordination between several disparate departments within an organization. According to recent surveys of major metropolitan hospitals , departments that typically share the responsibility for credentialing include: The Compliance Office. Human Resources.

US Department of Health and Human Services 52

US Department of Health and Human Services Hospitals Malpractice Compliance Officers 52

YouCompli

SEPTEMBER 13, 2023

Enforcement agencies are prioritizing efforts to deter FWA as more individuals enroll in government healthcare programs like Medicare and Medicaid, and telehealth services continue to evolve post-pandemic. For example, they can describe how to read a billing statement and identify services or supplies that were not provided.

US Department of Health and Human Services 52

US Department of Health and Human Services Compliance Officers Fraud Compliance 52

Verisys

JANUARY 27, 2022

COVID has impacted every aspect of daily life, and these changes have affected people’s mental health, making telehealth services for behavioral health more important than ever. Others may become susceptible to mental health issues, such as depression or anxiety. The use of telemedicine in the U.S.

US Department of Health and Human Services 52

US Department of Health and Human Services Telemedicine Licensing Informed Consent 52

Provider Trust

JANUARY 26, 2022

Luckily for all us, there’s a spectrum–and it was created with visibility and safety in mind. Department of Justice (DOJ), the U.S. And when patient care and reimbursements are on the line, even one bad actor can put an entire organization’s reputation in jeopardy. How the OIG Finds & Prosecutes Healthcare Fraud.

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Fraud US Department of Health and Human Services Medicaid Medicaid 52

Verisys

FEBRUARY 23, 2022

As government agencies and national regulatory organizations pass more regulations and the need for healthcare services grows, healthcare compliance officers (HCOs) are more important than ever. The Social Security Act establishes rules for reimbursement from Medicare, Medicaid, and CHIP. Reimbursement. Healthcare administration.

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Compliance Officers Compliance US Department of Health and Human Services Governance 52

MedTrainer

OCTOBER 16, 2023

Dive with us as we explore the complexities and necessities of compliance in the healthcare sector. Health Insurance Portability and Accountability Act (HIPAA) HIPAA is a pivotal regulation that focuses on the protection of patient health information, enforced by the U.S. Department of Health and Human Services (HHS).

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Compliance US Department of Health and Human Services HIPAA Medicaid 52

Compliancy Group

MARCH 19, 2024

Insurance carriers, cloud service providers, pharmacies, medical equipment manufacturers, and other organizations in this industry must comply with various health and safety regulations. It also reduces waste, fraud, and abuse that threaten the efficiency of healthcare delivery and services. name, phone number). healthcare.

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Regulatory Compliance Compliance US Department of Health and Human Services ACA 52

HIT Consultant

MARCH 21, 2023

Clarissa Riggins, Chief Product Officer, Experian Health How do you solve a persistent and growing problem like claims denials? But hope rings eternal among caring, compassionate, creative revenue cycle management professionals across the country at health systems large and small.

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US Department of Health and Human Services Patient Satisfaction Medicaid Medicaid 52