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Code Red: Healthcare Cybersecurity in a Post-Chevron World

HIT Consultant

This provided agencies with broad discretion to create and enforce regulations that often filled gaps left by legislators. Implications for Cybersecurity in Healthcare Vulnerability of Existing Regulations The immediate impact of this ruling is the increased vulnerability of existing cybersecurity regulations to legal challenges.

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TRG Settles for $3.1M Over Alleged Improper Billing Practices

HIT Consultant

Misrepresented service providers: The lawsuit alleges that TRG submitted claims to federal health programs where the radiologist listed on the claim was not the one who actually reviewed the scans. Proper interpretation of radiology scans is crucial for accurate diagnosis and treatment of patients. Attorney Damian Williams.

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How to Avoid Pass-Through Billing Pitfalls in 2022 & 2023

p3care

It is observed that pass-through billing mostly occurs in rural healthcare facilities, as they do not generate considerable revenue; that’s why they participate in fraudulent billing schemes to increase their revenue by claiming reimbursements for the services they don’t even perform. Get to know the Rules & Regulations.

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Model Rural Emergency Hospital Act

NASHP

Drafting Note : Rural emergency hospitals are defined in accordance with federal regulations, 87 Fed Reg. Definitions For the purposes of this Act: “Beds” means the number of available bed days during the most recent cost reporting period divided by the number of days in the most recent Medicare cost reporting period.

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Rural Emergency Hospitals: Guide to Legislative and Regulatory Considerations for States

NASHP

Drafting Note : Rural emergency hospitals are defined in accordance with federal regulations, 87 Fed Reg. Definitions For the purposes of this Act: “Beds” means the number of available bed days during the most recent cost reporting period divided by the number of days in the most recent Medicare cost reporting period.

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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. The judgment further alleged that the defendant falsified forms related to Medicare enrollment.