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. Issue: It is illegal to submit claims for payment to Medicare or Medicaid that you know or should know are false or fraudulent.

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

Med-Net Compliance

SEPTEMBER 20, 2022

million scheme to defraud Medicare by billing for services under another doctor’s name after Medicare revoked his privileges to participate in the program. According to court documents and evidence presented at trial, the podiatrist was revoked from participating in the Medicare program in January 2015.

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Fraud US Department of Health and Human Services Medicare Medicare 59

Med-Net Compliance

JUNE 22, 2022

Investigation of the case was conducted by the US Department of Veterans Affairs-Office of Inspector General (VA-OIG), VA Police Detroit and the Medicare Fraud Strike Force (MFSF) partners, a partnership among the Criminal Division, US Attorney’s Offices, and US Health and Human Services-Office of Inspector General (HHS-OIG).

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COVID-19 Vaccine COVID-19 Fraud US Department of Health and Human Services 59

HIPAA Journal

MARCH 29, 2024

While it is currently unclear what types of data were stolen in the attack, UnitedHealth Group said personally identifiable health information, eligibility and claims information, and financial information are likely to have been compromised. United Health Group has also confirmed that it has paid out more than $3.3 40% of the $3.3

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Ransomware US Department of Health and Human Services HIPAA Hospitals 99

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 IT Today

SEPTEMBER 17, 2024

An ongoing lawsuit between two health IT companies raises questions that call for more discussion. has led independent observers to predict a shake-up in health care and the potential for future lawsuits. Department of Health & Human Services should be applied. PointClickCare Technologies, Inc. )

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US Department of Health and Human Services Nurses Health Care Reform Hospitals 78

Healthcare Law Blog

MARCH 17, 2022

On Thursday, March 16, the Office of the Inspector General for the Department of Health and Human Services (“OIG”) issued OIG Advisory Opinion (“AO”) No. 22-05 , relating to subsidization of certain Medicare cost-sharing obligations in the context of a clinical trial involving medical devices (the “Proposed Arrangement”).

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US Department of Health and Human Services Informed Consent Medicare Medicare 52

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).

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

Healthcare Law Blog

DECEMBER 7, 2022

On December 5, 2022, the Department of Health and Human Services (“ HHS ”), Office of Inspector General (“ OIG ”), released their Semiannual Report to Congress for the period beginning on April 1, 2022, and ending on September 30, 2022 (the “ Semiannual Report ”). [1]. million $1.19 billion Questioned Costs $1.17

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

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

YouCompli

NOVEMBER 30, 2022

How to use the SBAR Framework. The same tool nurses use to communicate about health emergencies – can help you secure investment in your compliance department. . While its primary use is in clinical cases, healthcare professionals across the organization are finding it useful for communicating with clinical leaders.

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Regulatory Compliance US Department of Health and Human Services Compliance Compliance Officers 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. Task forces, such as the Medicare Fraud Strike Force , work together to help uphold the FCA. How the OIG Finds & Prosecutes Healthcare Fraud.

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Fraud US Department of Health and Human Services Medicaid Medicaid 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.

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US Department of Health and Human Services Telemedicine Licensing Informed Consent 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

YouCompli

FEBRUARY 22, 2023

Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. This is why Medicare publishes its rules on their Inpatient Prospective Payment System (IPPS) or its Outpatient Prospective Payment System (OPPS). The inflated charges resulted in inappropriate outlier payments from Medicare.

Compliance 52

Compliance US Department of Health and Human Services Overpayments Overpayment 52

Healthcare Law Blog

JANUARY 12, 2022

The phrase “whole person health” kept echoing through the virtual hallways during the second day of the 40 th Annual J.P. Cordani made the same point we heard yesterday – technology and virtual care present tremendous opportunities to address chronic condition management, mental health and physical health needs.

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US Department of Health and Human Services Doctors Nurses Medicare 52

Healthcare Law Blog

MARCH 25, 2022

Various smaller health insurance issuers have challenged the risk-adjustment program under the Patient Protection and Affordable Care Act (ACA), alleging, among other things, that its underlying methodology favors larger insurers. See Vista Health Plan, Inc. United States Dep’t of Health & Hum. The Risk-Adjustment Program.

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ACA US Department of Health and Human Services Health Insurance Medicaid 52

YouCompli

NOVEMBER 16, 2022

Most of us have had the experience of preparing for an important conversation or interaction, only to leave it feeling defeated, misunderstood and not even really heard. According to betterup.com, discriminative listening is a skill all humans are born with. Discriminative Listening: . Soldier on with your scripted remarks?

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

YouCompli

NOVEMBER 18, 2023

Most of us have had the experience of preparing for an important conversation or interaction, only to leave it feeling defeated, misunderstood, and not even really heard. Discriminative Listening According to betterup.com , discriminative listening is a skill all humans are born with. Soldier on with your scripted remarks?

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

Healthcare Law Blog

JANUARY 14, 2022

And since the conference was virtual, what better topic to start us off today than a consideration of the new Virtual-First trend that surfaced in 2021. We’ll follow that with a dive onto the couch to consider the conference’s mental health offerings and where the behavioral health sector is heading. During Day 4 of the J.P.

US Department of Health and Human Services 52

US Department of Health and Human Services Hospitals Medicaid Medicaid 52

YouCompli

SEPTEMBER 6, 2023

I was responsible for allocating financial, human, and physical resources to accomplish certain tasks.   By doing so, you and your project team will be excellent stewards of the human and physical resources needed to complete the project. Was “project manager” in your current or previous job descriptions? Agree to due dates.

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

Physician Credentialing Company

OCTOBER 17, 2024

In the healthcare sector, healthcare organizations and practitioners provide medical services to patients and ask for reimbursement in return from the insurers. There are many codes assigned for the service provided to the patients, and CPT code 99214 is very important for billing office or outpatient medical patient visits.

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US Department of Health and Human Services Medical Billing Medicare Medicare 40

Health Populi

JANUARY 18, 2021

But for those of us working with and innovating solutions for health and health care, #CES2021 was baked with health goodness , in and beyond “digital health” categories. In my consumer-facing health care work, I’ve adopted the mantra that our homes are our health hubs.

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US Department of Health and Human Services COVID-19 Electronic Medical Records Hospitals 77

AIHC

FEBRUARY 16, 2024

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.” The result?

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

AIHC

FEBRUARY 16, 2024

Lessons Learned about Consequences & Incentives Submitted by the AIHC Education Department Introduction The Office of Inspector General has released the new General Compliance Program Guidance or “GCPG” in late 2023. One of the seven items, #5 is “Enforcing Standards: Consequences and Incentives.” The result?

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

Hall Render

APRIL 29, 2022

County Struggles with Income Affect Social Determinants of Health. HHS puts $90 million toward addressing health disparities through data. Hospitals sue HHS over Medicare billing calculation. Nearly half of rural hospitals lose money on childbirth services. Juneau clinic offers new option for treating opioid use disorder.

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COVID-19 US Department of Health and Human Services Nursing Homes Nurses 40

Hall Render

MARCH 25, 2022

Dr. Lorna Breen Health Care Provider Protection Act becomes law. Here are the top health systems by patient reviews. Sensitive health data of 50 million Americans hacked or breached last year: analysis. Private equity’s pandemic-era health care push. 12 million dollar drug lab, mental health center coming to Dothan.

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COVID-19 US Department of Health and Human Services Nursing Homes Nurses 40

Hall Render

JUNE 21, 2024

NATIONAL 50% of U.S. to buy property. NATIONAL 50% of U.S. to buy property. NATIONAL 50% of U.S. to buy property. The deal fell through, but that won’t solve Bartlett’s budget issues. Kenai Peninsula Borough Assembly considers $38.5M Kenai Peninsula Borough Assembly considers $38.5M

US Department of Health and Human Services 40

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

Hall Render

OCTOBER 6, 2023

The CDC has stopped printing them Telehealth Visits Decline 46%, But Telebehavioral Healthcare Still High URAC to offer health equity accreditation Walgreens CIO is latest to leave in company’s C-suite shakeup AI is creating a complex landscape for healthcare executives ALABAMA Alabama hospital to remain on Cerner after sale Alabama gets $3.6M

US Department of Health and Human Services 40

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

Hall Render

OCTOBER 6, 2023

The CDC has stopped printing them Telehealth Visits Decline 46%, But Telebehavioral Healthcare Still High URAC to offer health equity accreditation Walgreens CIO is latest to leave in company’s C-suite shakeup AI is creating a complex landscape for healthcare executives ALABAMA Alabama hospital to remain on Cerner after sale Alabama gets $3.6M

US Department of Health and Human Services 40

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

Hall Render

JUNE 7, 2024

News ranks hospitals in health equity. These hospitals earn top honors. These hospitals earn top honors. facility Southern Research CEO talks biotech incubator, future of Birmingham medicine ALASKA Juneau’s hospital is bleeding cash. list includes 3 from Arizona ARKANSAS Children’s Miracle Network Raises $5.4M

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

Hall Render

JULY 28, 2023

million for rural hospital expansion Hospices in Arizona & other states receive scrutiny over concerns of fraud, waste & abuse Phoenix Children’s Building New 44,000-Square Foot Level IV Neonatal Intensive Care Unit Firefighters oppose Banner’s planned $400M hospital There’s a growing nurse shortage in Arizona.

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

Hall Render

AUGUST 19, 2022

Amazon to offer behavioral health services through Ginger partnership. CDC, amid criticism for COVID-19 response, plans reorganization as public health threats grow. House approves sweeping climate, tax, health care package. Joint Commission’s New Accreditation Standards Tackle Health Disparities. CALIFORNIA.

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COVID-19 Nursing Homes US Department of Health and Human Services Nurses 40

Hall Render

OCTOBER 4, 2024

NATIONAL 5 Stark law issues physicians are closely watching Anti-monopoly advocates urge FTC to block McKesson, Cardinal Health’s big-ticket oncology acquisitions Biden administration doles out $68.5M

US Department of Health and Human Services 40

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

Hall Render

FEBRUARY 2, 2024

NATIONAL Amazon Pharmacy, One Medical pilot program integrates medication consultations Bad news for FTC’s noncompete ban Cigna to sell Medicare business to HCSC for $3.3B

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

Hall Render

APRIL 1, 2022

AHA Urges DOJ to Protect Health Care Workers??from Coalition of hospitals, health plans and others urge for stronger guidance around third-party apps. Hospital, long-term care groups again petition Becerra to extend COVID-19 public health emergency. Justice Department to join whistleblower lawsuit against EHR vendor, CEO.

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COVID-19 US Department of Health and Human Services Nursing Homes Nurses 40

Hall Render

JUNE 14, 2024

NATIONAL AHA Comments on CMS’ Inpatient Payment Proposal for FY 2025 AHA urges CMS to make Transforming Episode Accountability Model voluntary AMA adopts new policy to create equity in clinical trials and research DOJ loses bid to toss Humana Medicare Advantage case Drug shortages hit highest number since 2001, impacting patients, hospitals and pharmacies (..)

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