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

Provider Trust

SEPTEMBER 29, 2022

A 49-year-old Brownsville, TX man named Fernando Mendez was taken into custody in early September after being charged with defrauding Medicaid. Mendez, who was a physician assistant at CCI Therapy Counseling Centers International, was working with a suspended medical license. How Often Should You Verify Employee Licenses?

Licensing 52

Licensing Fraud Medicaid Medicaid 52

MedTrainer

APRIL 18, 2024

Behavioral health credentialing exploded in 2023 and 2024 as providers could enroll in Medicare for the first time. Download Now Common Challenges in Behavioral Health Credentialing Where behavioral health credentialing diverges from typical provider credentialing is Medicare enrollment.

Medicare 52

Medicare Medicare Licensing Compliance 52

Health Law RX

FEBRUARY 21, 2024

The Centers for Medicare & Medicaid Services (CMS) has revised certain payment policies under the Medicare physician fee schedule, and updated provider and supplier enrollment regulations. CMS recently published a final rule (the Final Rule ) effective January 1, 2024.

Medicare 52

Medicare Medicare Licensing Compliance 52

Medisys Compliance

APRIL 19, 2023

The Medicaid program in Florida provides medical services and assistance to low-income individuals and families. To participate in the Medicaid program, healthcare providers must meet several general requirements set forth by the Agency for Health Care Administration (AHCA).

Medicaid 52

Medicaid Medicaid Medical Billing Outsourcing Licensing 52

Bill of Health

OCTOBER 19, 2023

The traditional model for post-graduate education for medical students, called residency, is regulated by the Accreditation Council for Graduate Medical Education ( ACGME ) and largely funded by the Center for Medicare Services (CMS). There is an urgent need for Congress to ensure this funding through the Center for Medicare Services.

Nurses 279

Nurses Medicare Medicare Medicaid 279

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

The Health Law Firm

FEBRUARY 14, 2022

million Medicare fraud scheme asked a New Jersey court to eliminate a bail condition. Additionally, the doctor indicated that he was sought to directly address CMS and the Medical Practice's ability to bill Medicare and Medicaid. Indest III, J.D.,

Medicare 52

Medicare Medicare Fraud Doctors 52

Healthcare Law Blog

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”).

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

The Health Law Firm

DECEMBER 23, 2019

Board Certified by The Florida Bar in Health Law Healthcare professionals: Have you ever had discipline on your professional license during your career? Have you ever been assessed a repayment or fine by Medicare or Medicaid Programs or had your participation in that program terminated or suspended? Indest III, J.D.,

Medicaid 40

Medicaid Medicaid Medicare Medicare 40

Compliancy Group

MARCH 8, 2023

are missing out on most of these opportunities because their names are on the HHS OIG (Health and Human Services, Office of Inspector General) Medicare Exclusion List. How do people end up on the Medicaid Exclusion List, what are the consequences of being on the list, and can you ever get off the list?

Medicare 52

Medicare Medicare Fraud HIPAA 52

Healthcare IT News - Telehealth

NOVEMBER 10, 2020

Prepare Now for Anticipated Changes to Medicare and Private Payer Rules. 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. Today, Medicare reimburses for specific services when delivered via live video.

Public Health 144

Public Health Medicare Medicare COVID-19 144

Hall Render

DECEMBER 12, 2023

On November 16, 2023, the Centers for Medicare & Medicaid Services (“CMS”) published proposed changes to the Medicare provider enrollment requirements in the Calendar Year 2024 Physician Fee Schedule final rule (“Final Rule”).

Medicare 40

Medicare Medicare Licensing Malpractice 40

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

Provider Trust

MAY 9, 2023

What is a Medicaid Fraud Control Unit (MFCU)? But these programs cannot be controlled by Medicaid and Medicare alone. But these programs cannot be controlled by Medicaid and Medicare alone. With this legislation, Medicaid Fraud Control Units (MFCUs) were born.

Fraud 52

Fraud Medicaid Medicaid Nurses 52

Medisys Compliance

MAY 19, 2022

The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. During the COVID-19 public health emergency, any health care provider who is eligible to bill Medicare can bill for telehealth services regardless of where the patient or provider is located. Eligible services.

COVID-19 52

COVID-19 Medicare Medicare Medical Billing 52

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

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

Provider Trust

MARCH 16, 2022

Exclusions are administrative actions that are placed upon an individual or entity by HHS OIG, a state agency or Medicaid Fraud Control Unit (MFCU), or by one of the many agencies associated with SAM.gov. Additionally, there are varying, disparate State Medicaid exclusions sources that require periodic screening.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare IT News - Telehealth

APRIL 10, 2020

The Centers for Medicare and Medicaid Services has temporarily suspended several regulations to enable hospitals, clinics and other providers to boost their front-line medical staff during the coronavirus pandemic.

Nurses 213

Nurses Medicare Medicare Licensing 213

Medisys Compliance

MAY 20, 2024

Provider type: Psychiatrists, psychologists, licensed clinical social workers, and licensed professional counselors typically have different reimbursement rates. Payer type: Private insurance companies, Medicare, and Medicaid have their own reimbursement structures.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicare 59

Bill of Health

OCTOBER 17, 2024

Finally, SB 1120 constrains the unfettered use of AI tools to approve or deny medical treatments, by requiring a licensed health care professional to still make individualized determinations for each member of a health insurance plan. The law has been referred to as the “ Physicians Make Decisions Act.”

Medicare 150

Medicare Medicare Health Insurance Licensing 150

MedTrainer

MAY 30, 2024

Traditionally, credentialers call the appropriate entities to verify transcripts, licenses, etc. Multiple Data Sources : Information comes from state licensing boards, educational institutions, previous employers, and professional organizations. Many other challenges in the process require organization, persistence, and documentation.

Licensing 52

Licensing Malpractice Medicare Medicare 52

Physician Credentialing Company

SEPTEMBER 19, 2024

Liability issues can even result in the termination of their license. Another good option is seeing patients covered by the Medicare program, as Medicare allows reto-billing up to 30 days from when the application for registration is submitted to the Medicare Administrative Contractor (MAC).

Malpractice 52

Malpractice Medicare Medicare Medicaid 52

Medisys Compliance

JUNE 20, 2022

Under Fee-for-service (FFS) Medicare, home infusion therapy (HIT) involves the intravenous or subcutaneous administration of drugs or biologicals to an individual at home. Medicare Coverage. In case any assistance needed for Medicare medical billing services, contact us at info@medisysdata.com/ 302-261-9187.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

Healthcare Law Blog

MAY 5, 2022

Department of Health and Human Services Office of Inspector (“OIG”) released a report that studied prior authorization denials and payment denials by Medicare Advantage Organizations (“MAOs”) (the “Report”). Thirteen percent of denied prior authorization requests met Medicare coverage rules. The OIG Report. additional test results).

Medicare 52

Medicare Medicare Licensing Health Insurance 52

Medisys Compliance

APRIL 11, 2024

Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) can now directly bill Medicare for services they furnish and diagnose. This milestone represents a major victory for the mental health professions, expanding access to much-needed care for Medicare beneficiaries and offering exciting new possibilities for MFTs and MHCs.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

HIPAA Journal

NOVEMBER 12, 2024

The types of information involved varied from patient to patient and may have included names along with one or more of the following: address, email address, phone number, date of birth, Social Security number, driver’s license/state ID number, credit/debit card number, treatment/diagnosis information, prescription information, provider name, date (..)

Health Insurance 69

Health Insurance Fraud Licensing HIPAA 69

Healthcare It News

OCTOBER 31, 2022

" Since HL7 pledged to share the standards free of charge under licensing terms, many partnerships and collaborations with both public and private healthcare entities have bloomed.

Licensing 279

Licensing Medicaid Medicaid Health Outcomes 279

Healthcare IT News - Telehealth

JANUARY 25, 2021

According to a press statement from Thompson's office, it would: Eliminate most geographic and originating site restrictions on the use of telehealth in Medicare and establishing the patient’s home as an eligible distant site. This is a common-sense step to make sure our policies keep pace with our technology," he added.

COVID-19 209

COVID-19 Medicare Medicare Telemedicine 209

The Health Law Firm

MAY 12, 2015

Have you ever had discipline on your license as a health professional? Have you ever been assessed a repayment or fine by the Medicare or Medicaid Programs? If so, then you may have also been terminated from or excluded from the federal Medicare Program or your state Medicaid Program. Indest III, J.D.,

Medicaid 40

Medicaid Medicaid Medicare Medicare 40

Verisys

FEBRUARY 9, 2024

Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 Million Civil Judgment and Drug Treatment Center Enters Settlement to Pay $2.2

Fraud 52

Fraud Medicaid Medicaid Medicare 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

Verisys

NOVEMBER 8, 2023

The NPI improves the Medicare and Medicaid programs, other federal and private health programs, and the overall effectiveness and efficiency of the healthcare industry by simplifying administration and enabling the efficient electronic transmission of health information. Providers also need an NPI to enroll in Medicare.

Fraud 97

Fraud HIPAA Medicare Medicare 97

The Health Law Firm

OCTOBER 31, 2019

According to prosecutors, the doctor allegedly authorized genetic testing for patients he never met, in a state where he’s not licensed to practice medicine. billion worth of false Medicare and Medicaid claims between July 2018 and January 2019. The vast fraud scheme totaled $2.1 This appears to be a new national record.

Fraud 40

Fraud Medicare Medicare Doctors 40

Innovaare Compliance

OCTOBER 6, 2022

Annual Election Period (AEP) is about two weeks away when Medicare Advantage Prescription Drug Plans (MAPD) will be signing up new enrollees by the thousands. According to the Centers for Medicare & Medicaid Services (CMS), enrollment in MAPD keeps rising. However, such allowance is not extended beyond March 31, 2023.

Medicare 52

Medicare Medicare Compliance Public Health 52

The Health Law Firm Blog

JULY 26, 2023

Board Certified by The Florida Bar in Health Law Many healthcare professionals are unaware of the adverse long-term collateral effects of Medicare revocation or exclusion on their careers and future employment. By George F. Indest III, J.D.,

Medicare 52

Medicare Medicare Nurses Overpayments 52