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ACO Reporting- A Patient-Centered Approach

p3care

An ACO (Accountable Care Organization) works for the better care of patients. Consider it as a group that combines hospitals, doctors, and other healthcare specialists for the sake of providing healthcare and is a team in care decisions. This becomes a specific reason for comprehensible improvements in patient care.

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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 Promotes Competition, Transparency, Health Equity and More in the CY2025 Medicare Advantage and Part D Proposed Rule

Sheppard Health Law

On November 6, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released the contract year 2025 proposed rule for Medicare Advantage (“MA”) organizations and Part D sponsors (the “Proposed Rule”). Please refer to our January 5, 2023 , November 4, 2022 and May 16, 2022 blog posts for more information.

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Biden-Harris Administration Makes More Medicare Nursing Home Ownership Data Publicly Available, Improving Identification of Multiple Facilities Under Common Ownership

Briggs Healthcare

Today, in another effort to improve nursing home transparency, safety and quality, and accountability, the U.S. President Biden has made clear that we must improve the quality of care in our nation’s nursing homes – and we are taking unprecedented steps to deliver on his call to action,” said HHS Secretary Xavier Becerra.

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Why Avoiding Costly Coding Mistakes Is More Critical Than Ever

HIT Consultant

Hilton Hudson, MD, FACS, and CEO of HPC International In May 2022, a California doctor was sentenced to nearly eight years in prison for his involvement in a $12 million Medicare fraud scheme. million in reimbursements from Medicare over a three-year period. He received $4.5

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Improving Non-Emergency Medical Transportation: Driving Better Outcomes for Patients and Health Plans

HIT Consultant

Andy Auerbach, Chief Revenue Officer of SafeRide Health As the healthcare industry continues to evolve, there is a growing need for innovative solutions that not only improve the quality of care but also make care more accessible. adults without access to a vehicle or public transportation skipped needed medical care last year.

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CMS Issues Proposed Rule Requiring Nursing Homes to Disclose Additional Ownership Information, Including Ties to Private Equity and REITS

Sheppard Health Law

On February 15, 2023, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule that would require nursing homes enrolled in Medicare and Medicaid to disclose new information about their ownership and management structures. Finally, CMS proposed a number of other definitions (e.g.,

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