HIPAA Journal

MARCH 28, 2025

The exposed data included full names, dates of birth, health insurance information, Medicaid/Medicare numbers, and medical information such as medical record numbers, clinical information, provider information, diagnosis/treatment information, and/or prescription information.

Licensing 61

Licensing Health Insurance HIPAA Medicaid 61

Verisys

APRIL 2, 2025

How to Acquire a Pharmacy License The process of becoming a licensed pharmacy can be complex even if you have experience, as every state has different documentation requirements. Pharmacies must obtain all the necessary licenses to meet the necessary professional standards before they can legally begin operation.

Licensing 52

Licensing Compliance Medicaid Medicaid 52

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. Merck can avoid price regulation by opting out of Medicare and Medicaid altogether.

Medicare 195

Medicare Medicare Medicaid Medicaid 195

Bill of Health

APRIL 16, 2025

All states require nursing homes to obtain a license to operate. Most state licensing agencies can consider the performance of other homes operated or owned by entities applying for a license when deciding whether to grant it. But few states use the licensing authority to address quality-of-care issues.

130

130

Medisys Compliance

DECEMBER 24, 2024

Medicare Reimbursement Medicare covers teletherapy under specific guidelines: Eligible Providers: Includes licensed clinical social workers (LCSWs), clinical psychologists, and other licensed professionals. Check state-specific Medicaid guidelines to ensure compliance.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicaid Medicaid Medical Billing 59

Healthcare IT News - Telehealth

JUNE 12, 2020

The Centers for Medicare and Medicaid Services relaxed requirements around reimbursements early in the pandemic, contributing to the upswing in countrywide telehealth visits. " WHY IT MATTERS. Since then, multiple groups have pushed the agency to make such changes permanent. ON THE RECORD.

Medicare 217

Medicare Medicare Nursing Homes Medicaid 217

Compliancy Group

JANUARY 23, 2025

billion in recuperated funds account for federal losses, many cases also involved Medicaid losses at the state level, in which the federal government was instrumental in aiding recovery efforts. While the $1.67 Gregory Gerber: $4.7M Allegations that he issued prescriptions without a medical need for opioids and other controlled substances.

Fraud 98

Fraud Medicare Medicare Regulatory Compliance 98

Healthcare IT News - Telehealth

JANUARY 25, 2021

Authorize the Centers for Medicare and Medicaid Service to continue reimbursement for telehealth for 90 days beyond the end of the public health emergency. Make permanent the disaster waiver authority, enabling Health and Human Service to expand telehealth in Medicare during all future emergencies and disasters.

COVID-19 216

COVID-19 Medicare Medicare Telemedicine 216

Bill of Health

OCTOBER 19, 2023

There are approximately 370,000 nurse practitioners that are licensed in the United States, and that number is growing. They provide a substantial amount of care to Medicare and Medicaid patients. Given that medical residency programs are federally funded, this very same opportunity should be afforded to APRN and PA programs.

Nurses 279

Nurses Medicare Medicare Medicaid 279

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

Healthcare IT News - Telehealth

MARCH 18, 2020

On Tuesday, Centers for Medicare and Medicaid Services expanded its Medicare telehealth coverage during the COVID-19 pandemic to enable more patients to get virtual care services from their providers.

COVID-19 217

COVID-19 HIPAA Nursing Homes Medicare 217

Verisys

APRIL 3, 2025

Licensure actions Disciplinary actions from state medical boards, like suspensions or revoked licenses. Exclusions from Medicare and Medicaid Instances where a provider has been banned from participating in government-funded healthcare programs. Civil judgments Lawsuits that reveal unethical behavior or misconduct.

Malpractice 52

Malpractice Licensing Compliance Hospitals 52

Healthcare IT News - Telehealth

JANUARY 12, 2021

From a regulatory and policy perspective, the reforms would: Require Medicaid telehealth reimbursement for services regardless of where the patient or provider is located in a non-facility setting. Develop interstate licensing reciprocity for states in the Northeast region for specialties with historical access shortage.

COVID-19 218

COVID-19 Telemedicine Medicaid Medicaid 218

Healthcare IT News - Telehealth

SEPTEMBER 3, 2020

In his study, Auerswald found that labor market barriers to entry, such as licensing requirements, and technical barriers to entry, such as regulatory approvals and interoperability standards, constitute "the most significant barriers to entrepreneurial entry.

Licensing 190

Licensing Medicare Medicare Governance 190

Healthcare IT News - Telehealth

OCTOBER 5, 2022

how streamlined licensing and credentialing can help with the psychiatrist shortage. How can telehealth, combined with streamlined licensing and credentialing, help solve the nation's current psychiatrist shortage? Telehealth, however, does so directly and immediately. More than three-quarters of U.S.

Licensing 194

Licensing Telemedicine Nursing Homes Hospitals 194

HIT Consultant

FEBRUARY 26, 2025

These challenges are particularly acute in Georgia, where Medicaid covers nearly 50% of all births and the state ranks 31st out of 40 in maternal mortality. Pregnant women with maternal hypertension or diabetes who are covered by Medicaid can opt into the program and receive appropriate RPM devices.

Health Outcomes 59

Health Outcomes Medicaid Medicaid Licensing 59

Verisys

FEBRUARY 10, 2025

At Verisys, we specialize in credentialing and license monitoring , offering industry-leading data accuracy and real-time insights. Verisys Licensure : Comprehensive Credentialing & Monitoring Covers all license types across all U.S.

Licensing 40

Licensing Compliance Medicaid Medicaid 40

Healthcare IT News - Telehealth

MARCH 13, 2019

The analysis, based on interviews with Medicaid officials from seven states and representatives from 19 Federally Qualified Health Centers in those states, points to insufficient reimbursement as a leading culprit for this lag, in addition to other logistical, policy, and operational barriers.

Medicaid 146

Medicaid Medicaid Telemedicine Licensing 146

Verisys

APRIL 3, 2025

In traditional credentialing, healthcare organizations manually collect and verify information from licensing boards, medical schools, and past employersa process that can take a significant amount of time to complete. To learn more about credentialing for hospitals , Medicaid providers , and retail pharmacies , contact us today.

Licensing 52

Licensing Malpractice Compliance Nurses 52

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 89

Medical Billing Licensing Medicaid Medicaid 89

Healthcare IT News - Telehealth

SEPTEMBER 9, 2024

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. Licenses that allowed physicians to practice across state lines and provided reimbursement parity due to the pandemic have now expired.

Telemedicine 188

Telemedicine Licensing Health Outcomes Governance 188

Verisys

MARCH 6, 2025

Credentialing involves a detailed review of a provider’s qualifications, including their: Education Work experience Certifications Licenses Professional standing This process ensures that patients see professionals who are properly trained and certified to provide the level of care they require.

Licensing 52

Licensing Compliance Nurses Malpractice 52

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

Compliancy Group

JANUARY 3, 2025

There are a variety of reasons that a provider can end up on this list, from committing fraud, providing care with a suspended license, or being involved in patient abuse cases. Aside from monetary losses, employing or contracting someone on these exclusion lists can result in the loss of Medicaid reimbursements. There has been a 4.2%

Medicaid 52

Medicaid Medicaid Compliance Fraud 52

Hall Render

NOVEMBER 1, 2024

Health care fraud remains a significant focus for federal and state enforcement agencies, with particular attention placed on the integrity of Medicaid and Medicare billing. He was also ordered to pay $557,000 in restitution to Indiana Medicaid and Medicare. As such, providers should prioritize billing compliance.

Fraud 40

Fraud Compliance Medicaid Medicaid 40

Provider Trust

APRIL 30, 2024

This year, as always, the Medicaid Fraud Control Units (MFCUs) released an annual report dissecting the exclusions, enforcements, and overall takeaways from their work throughout the previous fiscal year (FY). for every $1 spent How ProviderTrust Can Help With nearly 80 million individuals covered by Medicaid, every data point counts.

Fraud 52

Fraud Medicaid Medicaid Licensing 52

HIPAA Journal

FEBRUARY 16, 2022

The system contained patients’ names, birth dates, insurance card numbers, driver’s license numbers, and copies of patients’ insurance cards and driver’s licenses. The attackers compromised FCHC’s old dental system which contained the PHI of patients who had received dental services prior to August 31, 2020.

Ransomware 130

Ransomware Hospitals Licensing HIPAA 130

HIPAA Journal

JULY 4, 2024

SkinCure Oncology has notified 13,434 patients about an email attack that occurred in June 2023, and the Wisconsin Department of Health Services has announced a breach of the personal information of 19,150 Medicaid recipients. The helpline is manned Monday to Friday from 8:00 a.m. to 5:30 p.m. Central Time.

Medicaid 117

Medicaid Medicaid Fraud Licensing 117

Healthcare IT News - Telehealth

JUNE 3, 2020

He noted the moves by the Centers for Medicare and Medicaid Services to reimburse providers for services and allow telehealth care between states , and the relaxed HIPAA regulations around technology use , as important contributors to the uptick in telehealth availability. Telehealth in the long term.

Telemedicine 213

Telemedicine COVID-19 HIPAA Medicare 213

Verisys

APRIL 3, 2025

Data inaccuracies: A misspelled name, incorrect license number, or missing documentation might seem minor, but they can lead to license and certification rejections, compliance violations, and delayed insurance reimbursementspotentially causing financial and operational headaches.

US Department of Health and Human Services 52

US Department of Health and Human Services Licensing Compliance Malpractice 52

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

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

Verisys

MARCH 6, 2025

For example, requiring all names to follow a “Last Name, First Name” format and license numbers to be entered uniformly can prevent mismatches.

Compliance 52

Compliance Licensing Doctors Malpractice 52

Healthcare IT News - Telehealth

NOVEMBER 10, 2020

The Centers for Medicare and Medicaid Services (CMS) is expected to issue new rules for telehealth in the release 2021 Physician Fee Schedule later this year. This includes meeting all state-level telehealth, licensing, and credentialling requirements. Ensure licensing and credentialling is in proper order for all providers.

Public Health 161

Public Health Medicare Medicare COVID-19 161

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

HIPAA Journal

OCTOBER 17, 2022

The exposed information included names, dates of birth, Social Security numbers, driver’s license numbers, clinical/diagnosis information, health insurance member ID numbers, medical record numbers, and Medicare or Medicaid numbers. Valle De Sol said it has not received any reports from patients to suggest any misuse of their data.

Health Insurance 134

Health Insurance Licensing Fraud HIPAA 134

HIPAA Journal

MARCH 10, 2022

Individuals whose Social Security number, driver’s license, state identification number, or financial account information may have been involved have been offered complimentary credit monitoring services. The breach has been reported to the HHS’ Office for Civil Rights as affecting up to 25,745 individuals. Dr. Douglas C.

Ransomware 139

Ransomware Licensing Health Insurance HIPAA 139