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SUSANNAH LUTHI     President Donald Trump and White House officials on Thursday threw their weight behind a congressional ban on surprise medical bills based on contract reforms, such as barring hospital contracts with physicians who aren’t in the same insurance networks. “We’re going to hold insurance companies and hospitals totally accountable,” Trump said at an event […]

The new guidance provides greater detail about what prosecutors should look for in compliance programs. By C. Ryan Barber| April 30, 2019 at 05:19 PM The U.S. Justice Department issued new guidance Tuesday detailing how prosecutors will evaluate the effectiveness of corporate programs to prevent fraud and other misconduct, a key consideration in determining the penalties imposed against companies.

CARE DELIVERY SHELBY LIVINGSTON   The CMS finalized a rule on Friday that would give Medicare Advantage plans more flexibility to offer additional telehealth services to seniors as part of their basic benefits package starting in 2020. The rule, proposed in October 2018, allows seniors to use telehealth services in their homes, rather than being required to […]

April 09, 2019 02:00 PM Associated Press Federal authorities said Tuesday they’ve broken up a $1.2 billion Medicare scam that peddled unneeded orthopedic braces to hundreds of thousands of seniors via foreign call centers. The Justice Department announced charges against 24 people across the U.S., including doctors accused of writing bogus prescriptions for unneeded back, […]

April 3, 2019   In 2019, OCR moved to quarterly cybersecurity newsletters.  The purpose of the newsletters remains unchanged: to help HIPAA covered entities and business associates remain in compliance with the HIPAA Security Rule by identifying emerging or prevalent issues, and highlighting best practices to safeguard PHI.     Advanced Persistent Threats and Zero […]

March 27, 2019 08:28 AM UPDATED 8 HOURS AGO Modern Healthcare Centene Corp. on Wednesday said it will buy fellow Medicaid insurer WellCare Health Plans in an estimated $17.3 billion deal. All in all, the two insurers would cover nearly 22 million people in Medicare, Medicaid and the ACA exchanges. Centene CEO Michael Neidorff will serve […]

SHELBY LIVINGSTON   March 22, 2019 04:24 PM Lawmakers and government officials are seeking to ramp up scrutiny over electronic health records. A week after whistleblower allegations against Community Health Systems’ related to its electronic health record implementation were revealed, Rep. Jim Banks (R-Ind.) asked the National Coordinator for Health Information Technology for information on the ONC’s processes […]

The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) announced today that it issued a Notice of Resolution to the State of Hawaii after Hawaii took corrective action in response to OCR’s investigation of complaints of discrimination by the state against non-profit pregnancy resource centers. Complainants, Aloha Pregnancy […]

March 14, 2019 04:51 PM UPDATED 4 HOURS AGO SHELBY LIVINGSTON   A whistleblower accused Franklin, Tenn.-based Community Health Systems of submitting hundreds of millions of dollars in false claims to HHS for federal incentive payments for meaningfully using electronic health records. The lawsuit, unsealed by a federal court in Miami on Thursday, claimed that CHS made […]

Modern Healthcare, March 06, 2019 05:23 PM   Amazon, Berkshire Hathaway and JPMorgan Chase’s year-old and highly touted joint venture will be called Haven. The venture’s newly launched website reveals few details about the widely anticipated, not-for-profit entity. The three parent companies said in January that they would leverage their combined scale and expertise to develop technology solutions to […]