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The Supreme Court’s Rulings on COVID-19 Vaccine - Bill of Health
(Just Now) WebThe Supreme Court’s decision puts those injunctions on hold, allowing CMS’s vaccination requirements for health care workers to take effect while the cases are …
https://blog.petrieflom.law.harvard.edu/2022/01/18/supreme-court-vaccine-mandate-osha-cms/
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DOJ announces 78 people charged over $2.5 billion in false health …
(5 days ago) WebDOJ announces 78 people charged over $2.5 billion in false health care billings. The operations resulted in seizures of more than $10.3 million in assets. The …
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Justice Department Charges Dozens for $1.2 Billion in Health Care …
(3 days ago) WebThe Department of Justice today announced criminal charges against 36 defendants in 13 federal districts across the United States for more than $1.2 billion in …
https://www.justice.gov/opa/pr/justice-department-charges-dozens-12-billion-health-care-fraud
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ALJ Decisions HHS.gov
(3 days ago) WebSearch DAB ALJ decisions by year since 1985, for CMS, SSA, HHS IG, and FDA actions, including civil money penalties, Medicare enrollment/revocation, and …
https://www.hhs.gov/about/agencies/dab/decisions/alj-decisions/index.html
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False Claims Act judgments for healthcare totaled $1.8 billion in …
(3 days ago) WebOne of the highest-profile cases involved Cigna, which agreed to pay $172 million to resolve allegations that it knowingly submitted and failed to withdraw inaccurate …
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Home Healthcare Company Settles False Claims Act Violations
(7 days ago) WebRecently, DOJ has seen several cases of alleged False Claims Act violations and Medicare fraud. A California doctor was sentenced to prison for nearly …
https://revcycleintelligence.com/news/home-healthcare-company-settles-false-claims-act-violations
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Supreme Court's False Claims case alleges overbilling of Medicare …
(2 days ago) WebThe Supreme Court on Tuesday hears a case that considers whether pharmacies knowingly overcharged Medicare and Medicaid under the False Claims Act. …
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Criminal Division Case Summaries - United States Department of …
(3 days ago) WebJune 28, 2023. Summary of Criminal Charges. Central District of California. Neda Mehrabani, 47, of Tarzana, California, was charged by information with health …
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Reforming How Medicare Pays for Digital Health - Bill of Health
(5 days ago) WebCongress has an opportunity to reform Medicare in 2024, when the Trust Fund will become insolvent. Policymakers expect Congress to address this problem …
https://blog.petrieflom.law.harvard.edu/2021/08/11/medicare-digital-health/
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Federal Guidance on Balance Billing: The No Surprises Act and its
(7 days ago) WebIn cases where the Member cannot travel, or where there are no in-network facilities or providers located within a reasonable travel distance, the balance billing …
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Twenty-Three Individuals Charged in $61.5 Million Medicare Fraud …
(8 days ago) WebMary Smelter-Bolton, 69, of Oakland County, and Cass Hawkins, 52, of Wayne County, were allegedly recruiters paid by various Jamil home health agencies to …
https://www.justice.gov/opa/pr/twenty-three-individuals-charged-615-million-medicare-fraud-schemes
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HHS Statement Regarding the Cyberattack on Change Healthcare
(7 days ago) WebFOR IMMEDIATE RELEASE March 5, 2024. Contact: HHS Press Office 202-690-6343 [email protected]. HHS Statement Regarding the Cyberattack on Change Healthcare. …
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CMS Finalizes Physician Payment Rule that Advances Health Equity
(6 days ago) WebContact: HHS Press Office 202-690-6343 [email protected]. CMS Finalizes Physician Payment Rule that Advances Health Equity. Final policies will expand …
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Medicare Fraud & Abuse: Prevent, Detect, Report - Centers …
(1 days ago) WebThe diference between “fraud” and “abuse” depends on specific facts, circumstances, intent, and knowledge. Examples of Medicare abuse include: Billing for unnecessary medical …
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Medicare Claims Processing Manual - Centers for Medicare
(5 days ago) WebMedicare Claims Processing Manual . Chapter 10 - Home Health Agency Billing . Table of Contents (Rev. 12306, 10-19-23) Transmittals for Chapter 10. 10 - General Guidelines …
https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c10.pdf
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Nursing Home Chain ReNew Health To Pay $7 Million In Medicare …
(7 days ago) WebAs part of the settlement agreement, ReNew Health will pay $6,841,727 to the federal government and $242,273 to the state of California, plus interest.. The backstory. In …
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No easy fixes to Obamacare enrollment fraud : Shots - Health …
(3 days ago) WebThe agency is also working closely, he wrote, with insurance companies, state insurance departments, and law enforcement "so that agents violating CMS rules or …
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The CMS Medicaid Targeted Case Management Brief - CHCS
(3 days ago) WebBy Sara Rosenbaum, JD, George Washington University School of Public Health and Health Services. T his issue brief examines the CMS targeted case management rule, …
https://www.chcs.org/media/CMS_Medicaid_Targeted_Case_Management_Rule.pdf
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Home health agencies threaten lawsuits over CMS payment …
(4 days ago) WebCMS switched up its case-mix system in the the Patient-Driven Groupings Model last year, basing pay rates on patient characteristics like clinical conditions and …
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Cases - Center for Medicare Advocacy
(3 days ago) WebJustice in Aging and the Center for Medicare Advocacy, along with pro bono firm Stinson, LLP, filed the case in February 2021. Read the complaint. On October 13, 2021, the …
https://medicareadvocacy.org/litigation/active-cases/
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S.352 - Health Care Improvement Act of 2021 - Congress.gov
(5 days ago) Web“There is hereby established the ‘State Health Insurance Affordability and Innovation Fund’ to be administered by the Secretary of Health and Human Services, acting through the …
https://www.congress.gov/bill/117th-congress/senate-bill/352/text
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If Social Security not fixed, retirees face automatic cut in 2033 : NPR
(6 days ago) WebMedicare and disability solvency. Still, the program, which provides health care for nearly 67 million people, is expected to face its own cash crunch in 2036. Social …
https://www.npr.org/2024/05/06/1249406440/social-security-medicare-congress-fix-boomers-benefits
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CMS issues proposed rule for mandatory organ transplant …
(3 days ago) WebThe Centers for Medicare & Medicaid Services May 8 released a proposed rule for the Increasing Organ Transplant Access Model, a new payment model that would …
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‘Perpetuity Of Uncertainty’: Home Health Providers Await Another …
(4 days ago) WebSummer is near, and that means so is the home health proposed payment rule from the Centers for Medicare & Medicaid Services (CMS). In 2022, a significant …
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Gov. Reynolds signs bill extending postpartum health care and …
(5 days ago) WebToday, Governor Kim Reynolds signed Senate File 2251, a bill for an act relating to eligibility for pregnant women and infants under the Medicaid program, and …
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CMS Finalizes Physician Payment Rule that Advances Health Equity
(3 days ago) WebCMS is also finalizing increases in payment for visits for many services, such as primary and longitudinal care. Overall, the finalized CY 2024 PFS conversion factor is …
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Navigating Insurance and Costs for Ambulatory Surgery - US …
(3 days ago) WebIn many cases, the amount Medicare will ask patients to pay will be less than what it would cost in a hospital outpatient setting. For instance, the reimbursement for …
https://health.usnews.com/best-ascs/articles/how-do-ambulatory-surgery-centers-bill
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Thousands Believe Covid Vaccines Harmed Them. Is Anyone …
(4 days ago) WebStill, an analysis of health records from nearly 2.6 million people in the United States found that about 0.04 percent, or about 1,000, were diagnosed with tinnitus within …
https://www.nytimes.com/2024/05/03/health/covid-vaccines-side-effects.html
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Appealing Health Plan Decisions CMS
(8 days ago) WebThe rules issued by the Departments of Health and Human Services, Labor, and the Treasury give consumers: The right to appeal decisions made by their health plan …
https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/appealing-health-plan-decisions
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Nondiscrimination in Health Programs and Activities
(5 days ago) WebExamples of health insurance coverage or other health-related coverage subject to the 2020 Rule (and thus the benefit design provisions under § 92.207(b)(1) …
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House panel eyes PBM reform to pay for telehealth extensions
(2 days ago) WebA new bill set to be considered on Wednesday by the House Ways & Means Committee would extend for two years telehealth flexibilities for Medicare enrollees that …
https://www.statnews.com/2024/05/07/telehealth-rules-hospital-home-care-pbm-limits-congress/
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H.R.8299 - To require the Secretary of Health and Human Services, …
(Just Now) WebSummary of H.R.8299 - 118th Congress (2023-2024): To require the Secretary of Health and Human Services, in consultation with the Secretary of Commerce, the …
https://www.congress.gov/bill/118th-congress/house-bill/8299
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For a Louisiana lawmaker, exempting incest and rape from the …
(6 days ago) WebDemocratic state Rep. Delisha Boyd is fighting an uphill battle in her attempt to pass a bill that would exempt cases of rape and incest from Louisiana's near-total …
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House committee passes Medicare telehealth extension bill
(Just Now) WebHealth systems urge Congress to lay down a permanent road map for telehealth services as clock ticks on December deadline. In July, the Senate Finance …
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MEDICAID DEFINITION OF COVERED CASE MANAGEMENT …
(3 days ago) WebThe IFC proposes certain refinements and clarifications to Medicaid’s case management benefit that are expected to save the program $1.2 billion over the next five …
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