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TRG Settles for $3.1M Over Alleged Improper Billing Practices

HIT Consultant

Improperly billed for services: The government alleges that TRG billed Medicare for radiology services performed by a radiologist located in the UK, which violates program regulations. The allegations against TRG raise concerns about the quality of care patients may have received and the potential misuse of federal healthcare funds.

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CMS Augments “In Lieu Of Services” Medicaid Guidance to Support State Medicaid Managed Care Efforts to Address Social Determinants of Health

Sheppard Health Law

In Lieu of Services and Settings Background Though federal healthcare programs generally excluded non-clinical services from reimbursement, the evolution of value-based care prompted managed care plans to provide alternative benefits to enrollees under flexibilities in their risk-based contracts.

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7 Infamous Examples Healthcare Fraud in Florida

Etactics

You see, a judge sentenced Fernandez to three years in prison for her role in the conspiracy to commit healthcare fraud. She was also indicted for making a false statement in a situation involving a federal healthcare benefit program. What happened that led to a woman spending three years in prison?

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8 Frightening Healthcare Fraud Examples

Etactics

Fortunately, the Health Insurance Portability and Accountability Act (HIPAA) does help regulate healthcare fraud. But things become tricky when involving Federal healthcare programs. million to resolve its civil healthcare fraud case. Thus,it’s important to understand what constitutes healthcare fraud.

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Newsletter, August 2023

Patient Safety Movement

2B: Create a learning ecosystem and shared accountability system to ensure that evidence-based practices are implemented and goals for reduced harms and risks of harm for all Americans are realized. 2C: Advance interoperability of healthcare data and assure free access to the tracking of harms and use of evidence-based solutions.

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Key Healthcare Provisions of the Consolidated Appropriations Act, 2023

Sheppard Health Law

By extending these flexibilities, the Act takes steps to ensure continuity of care for Medicare beneficiaries, provides regulators with additional time to determine which flexibilities will be made permanent, and also allows providers to adapt to a changing regulatory landscape. HDHP/HSA Safe Harbor for Telehealth Services.

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Healthcare Security & Privacy Challenges of ChatGPT, AI Tools

HIT Consultant

Bias in training data can lead to unfair outputs, highlighting the ethical issue of accountability in AI decision-making. Furthermore, the “black box” nature of AI complicates transparency and trust, critical factors for widespread adoption in healthcare. Yet, this, too, has its risks.