Compliance & Legal
Viral hashtag campaigns aren't new, but it's not often you see groundswell campaigns about healthcare management topics.
Seniors living in three states will now need prior approval from Medicare before they can get an ambulance to take them to cancer or dialysis treatments. The change is part of a three-year pilot to combat extraordinarily high rates of fraudulent billing by ambulance companies.
The Obama administration took another step to close what many see as a health-law loophole that allows large employers to offer medical plans without hospital coverage and bars their workers from subsidies to buy their own insurance.
Dr. Oliver Korshin, a 71-year-old ophthalmologist in Anchorage, is not happy about the federal government's plan to have all physicians use electronic medical records or face a Medicare penalty.
The former chief financial officer of a now-closed Texas hospital is one step closer to a potential five years in federal prison after pleading guilty to wrongly claiming EHR incentive money.
Millions of low-income children are failing to get the free preventive exams and screenings guaranteed by Medicaid and the Obama administration is not doing enough to fix the problem, according to the HHS Office of Inspector General.
Although CMS paused the RAC audit program in March, hospitals must remain vigilant. The agency has promised a new round of recovery auditor contracts will be awarded before the end of 2014.
Defying expectations, the court announced last week it has agreed to hear a case that challenges the heart of the Affordable Care Act: subsidies to help people pay their insurance premiums.
Hospitals and health systems want to mitigate their compliance spend as much as possible, as well as reduce the odds of facing large penalties for being out of compliance. The path to lowering the costs of compliance starts with putting appropriate policies and procedures in place -- and getting the right people at the table to make that happen.
California's public health department has failed to adequately manage investigations of nursing homes statewide, resulting in a backlog of more than 11,000 complaints -- many involving serious safety risks to patients, according to an audit released last week.