AIHC

FEBRUARY 17, 2025

There are also self-reporting mechanisms in place to report overpayments on the OIG website ( Self-Disclosure ) and Self-Referral Disclosure for voluntary self-reporting of overpayments on the Centers for Medicare and Medicaid Services (CMS) website. In one case, the company had been in trouble with CMS several times.

Fraud 52

Fraud Compliance Overpayment Overpayments 52

Hall Render

DECEMBER 11, 2024

The Proposed Rule would remove the aggravating factors which permit OIG to lengthen periods of exclusion based on the loss of the individual’s or entity’s health care license, and the mitigating factors, which OIG could consider if aggravating factors are applied.

Compliance 40

Compliance Licensing Nurses Medicaid 40

AIHC

SEPTEMBER 5, 2023

Medicare covers many telebehavioral and telemental health services including audio-only services. 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.

COVID-19 59

COVID-19 Telemedicine Informed Consent Compliance 59

AIHC

OCTOBER 23, 2024

Examples of these types of audits would be a Joint Commission, or CMS (Centers for Medicare and Medicaid Services) contractor audit. Third-party audits may result in certification, registration, recognition, an award, license approval, a citation, a fine, or a penalty issued by the third-party organization or an interested party.

Compliance 52

Compliance Overpayment Overpayments Medicaid 52

The Health Law Firm Blog

APRIL 19, 2024

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law In a possibly precedent-setting case, on November 9, 2022, for the first time, an appeals court in New Jersey ruled that plaintiffs in medical malpractice cases do not need an affidavit of merit to file claims against a [.]

Malpractice 52

Malpractice Overpayment Overpayments Licensing 52

The Health Law Firm Blog

JANUARY 24, 2023

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law In a possibly precedent-setting case, on November 9, 2022, for the first time, an appeals court in New Jersey ruled that plaintiffs in medical malpractice cases do not need an affidavit of merit to file claims against a [.]

Malpractice 52

Malpractice Overpayment Overpayments Licensing 52

Healthcare IT News - Telehealth

JUNE 8, 2022

Additionally, several telehealth flexibilities (that generally expand Medicare coverage for telehealth services) have been extended 151 days (about five months) beyond the termination of the HHS PHE. Outside the blanket waiver, it is also a CMS reimbursement requirement that the practitioner must be licensed in the state.

US Department of Health and Human Services 209

US Department of Health and Human Services Compliance COVID-19 Overpayment 209

Healthcare Law Blog

JANUARY 5, 2023

Just in time for the holidays, the Centers for Medicare and Medicaid Services (“CMS”) issued the Contract Year 2024 Proposed Rule for Medicare Advantage organizations (“MAOs”) and Part D sponsors (the “Proposed Rule”). Health Equity in Medicare Advantage. We’ve summarized some of the key changes in the Proposed Rule.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

FEBRUARY 23, 2024

expansion Pennsylvania Hospital to Use Drones to Deliver Meds Superbug Infection Spreading In PA, Around U.S.:

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Hall Render

MAY 10, 2024

Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ Million CALIFORNIA California hospital dismisses CEO California physician pleads guilty to $2.5M million expansion ‘Very, very unusual.’ million expansion ‘Very, very unusual.’

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40

Hall Render

OCTOBER 7, 2022

Judge orders Anthem to face lawsuit over alleged Medicare overpayments. Delaware retirees protest switch to Medicare Advantage plan. Medicare cuts concern Kentucky home health leaders. UNC, Wilson hospitals fix issues that risked Medicare funding; complaints pending at Wilson. but state officials optimistic.

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

APRIL 26, 2024

New California rule aims to limit health care cost increases to 3% annually UC San Diego Health operations deal with California hospital slows to crawl Kaiser reports data breach affecting 13.4M in 256-Slice CT scanner Lifepoint reports $200M+ economic impact in Cen Ky St.

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses Medicaid 40

Hall Render

JUNE 30, 2023

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

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

APRIL 19, 2024

to Study Treatments for Vascular Abnormalities Federal Appeals Court Hears Arguments on Nation’s First Ban on Gender-affirming Care for Minors Jason Demke Hired as COO at Mercy Hospital Fort Smit Pulaski Tech Awarded $5.7M Can lawmakers do anything about it? healthcare?

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Hall Render

JANUARY 19, 2024

in costs, report finds Pennsylvania hospital staff vote for union removal St.

Nursing Homes 40

Nursing Homes Nurses COVID-19 Hospitals 40

Hall Render

MARCH 22, 2024

To qualify, facilities must close their beds Amazon’s physician acquisition strategy As Many Hospitals Continue to Face Significant Financial Challenges, MedPAC Recommends Highest Ever Medicare Payment Update Change competitors step in but breaking up may be hard to do CMS to launch new primary care ACO program Congress unveils $1.2T

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Nurses Hospitals 40

Hall Render

MARCH 15, 2024

Children’s National makes first high-level executive appointments under new CEO DC plans to open emergency department in one of its most underserved communities D.C.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

NOVEMBER 10, 2023

NATIONAL 340B repayments welcomed but concern remains, hospital group says 4 pieces of legislation fighting to alleviate the physician shortage crisis AHA Files Lawsuit Challenging HHS Guidance on Tracking Technologies AHA says 3.1%

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

FEBRUARY 21, 2025

raises $95 million to boost consumer product lawsuits Denver biotech cuts $500K check when it parted ways with its CFO Denver startup raises $2.8M NEW HAMPSHIRE Dartmouth researchers brace for Trumps NIH funding cuts New Hampshire emergency departments near full capacity as flu cases surge Lawmakers introduce Momnibus 2.0

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Nursing Homes Hospitals 40

Hall Render

APRIL 4, 2025

health care experts worry about future of rural hospitals if Medicare or Medicaid see cuts Pennsylvania hospital to close June 30 Survey of Pa. health care experts worry about future of rural hospitals if Medicare or Medicaid see cuts Pennsylvania hospital to close June 30 Survey of Pa.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Med League

MARCH 23, 2022

Upcoding Fraud: Upcoding is a kind of medical billing fraud that occurs when a provider sends a bill to Medicare or another payor for a more expensive service than the one actually performed. The sum of reimbursements for each code paid separately is higher than the reimbursement for the comprehensive code, causing an overpayment.

Medical Billing 40

Medical Billing Fraud Overpayment Overpayments 40