Tag: medicare

Why Federally Mandated Electronic Prescribing for Controlled Substances will Benefit Public Health

Why Federally Mandated Electronic Prescribing for Controlled Substances will Benefit Public Health

MedCity News

Although 2022 has brought on a greater sense of normalcy, the past few years have distracted us from one of the most overlooked epidemics plaguing healthcare: prescription drug abuse.
Before Covid-19 diverted attention away from this problem, President Trump signed on to the SUPPORT for Patients and Communities Act of 2018, instating sweeping legislation for initiatives to address the opioid epidemic. The bill, among other initiatives, requires electronic prescriptions for controlled substances (EPCS) for any covered part D drug. Although the official start of the mandate was delayed two years to January 1, 2023, the importance of this federal intervention cannot be…

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Retrieving Billions in Overpayments by CMS

Retrieving Billions in Overpayments by CMS

Healthcare IT Today

Amid swirling accusations that Medicare Advantage Organizations (MAOs) are overbilling the U.S. government and calls for better oversight, the Centers for Medicare & Medicaid Services announced in early February that it would investigate overbilling by those plans. They expect to recoup 4.7 billion dollars through this program.
This article focuses on the relatively young technologies that enable CMS to uncover overbillings, whether they be errors or fraud. The article is based on an interview with Kel Pults, chief clinical officer and vice president of MediQuant. A future article will explain how Medicare Advantage plans are trying to improving data collection and reporting,…

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Q&A: How the PHE's end could affect telehealth, patient care

Q&A: How the PHE’s end could affect telehealth, patient care

MobiHealthNews

The public health emergency declared in early 2020 was put in place to provide waivers from the Centers for Medicare and Medicaid Services to ease the burden on hospitals and other providers during the pandemic. It has been extended 12 times since its implementation and is finally slated to end on May 11. Heather Meade, principal at Washington Council Ernst & Young, spoke with MobiHealthNews about how the end of the PHE could affect telemedicine companies’ funding streams and patients’ access to care.  
MobiHealthNews: What are the benefits and detriments to the PHE ending, especially for telehealth?
Meade: I mean, we need permanent policy…

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Leveraging Technology to Bridge Gaps in Compliance

Leveraging Technology to Bridge Gaps in Compliance

HIT Consultant

Sean Eaton, Senior Compliance Solutions Specialist at GHXAmerican health systems, hospitals and post-acute care providers are required to comply with hundreds of regulatory requirements. Facilitating this compliance comes with a high cost. According to the American Hospital Association, the average-sized community hospital spends nearly $7.6 million annually on administrative activities to support regulatory compliance. With the impending end of the COVID-19 public health emergency set to shake up healthcare regulations, ongoing healthcare labor shortages, and skyrocketing levels of clinician burnout, a perfect storm for non-compliance is brewing. Even with significant investments in administration to support compliance, overwhelmed providers can inadvertently leave gaps…

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Q/A: Oatmeal Health Co-Founder Talks AI-Enabled Cancer Screening for the Underserved

Q/A: Oatmeal Health Co-Founder Talks AI-Enabled Cancer Screening for the Underserved

HIT Consultant

Dr. Ty Vachon, CEO & Co-Founder at Oatmeal HealthToday, cancer is the second leading cause of death in the United States. Sadly, cancer disparities exist, with racial/ethnic minority, low-income, and uninsured populations suffering the greatest burden. That’s why routine cancer screening is critical to addressing cancer disparities as they have the potential to greatly reduce both incidence and mortality rates. To address this, Federally qualified health centers (FQHCs) are funded by the Health Resources and Services Administration to provide preventive and primary healthcare services, including cancer screening, to the nation’s most vulnerable populations We recently sat down with Oatmeal Health’s Co-Founder and…

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Digital as the Differentiator for Biopharma and Medtech

Digital as the Differentiator for Biopharma and Medtech

MedCity News

With the Inflation Reduction Act now on the books, the U.S. Centers for Medicare & Medicaid Services (CMS) will begin negotiating drug prices with the pharmaceutical industry. That, combined with other headwinds such as increased competition from me-too drugs, and ever-present pricing pressure from payers, means that pharma players now more than ever need a new and powerful tool to differentiate their products. We believe the next decade of transformation is digital.
Learning from the auto industry Almost every industry has had to confront a fundamental existential question: What is our product? Consider the automotive industry, which once was largely about hardware…

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HHS Aims To Reduce Prescription Drug Costs Through 3 New Models

HHS Aims To Reduce Prescription Drug Costs Through 3 New Models

MedCity News

The U.S. Department of Health & Human Services (HHS) unveiled three new models Tuesday that will be tested by the CMS Innovation Center and aim to lower prescription drug costs. The models include access to $2 generic drugs.
The news is in response to President Joe Biden’s executive order issued in October, which directed HHS to find ways to lower prescription drug costs and improve access to drug therapies for those enrolled in Medicare and Medicaid health plans. The models are meant to build on the Inflation Reduction Act of 2022, which includes allowing Medicare to negotiate lower prescription drug prices for…

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Why healthcare leaders should embrace home-based technologies

Why healthcare leaders should embrace home-based technologies

Healthcare IT news

Home health technologies will have an increasingly larger role to play in healthcare delivery as the silver tsunami of the aging population strain the system. And if more consumers embrace preventative care that can easily be done in the home.It’s important to understand that home health technologies are leveraged in home health settings by clinicians for home health patients, and at-home or home-based health technologies are diagnostic and/or screening tools that can be used in non-clinical settings for the purpose of understanding overall health conditions.
Home-based health technologies are any preventive care technology tool that elevates health. This includes tools like blood…

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