The healthcare system assists in the cure of diseases, the extension of lives, and the improvement of the well-being of communities. With the use of secure health information technology, healthcare will benefit…
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There are so many challenges that we are currently facing in the world of healthcare, that possibly adding another one is overwhelming to think about. AI automation is still so new that it’s hard…
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In June, the United States Supreme Court abandoned nearly 50 years of precedent and, for the first time in this nation’s history, eliminated a fundamental right: the right to choose. This decision, Dobbs v….
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There’s widespread consensus that payments to Medicare Advantage Organizations (MAOs) are a mess. These programs, which care for more than 30 million of the nearly 64 million Medicare enrollees, operate on the cutting edge…
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The following is a guest article by Kate Barecchia, Global Data Privacy Officer at Imperva.
For many of us, change is hard. In cybersecurity, change is essential to defeat two of the most common causes…
Ashish Kachru, CEO, DataLinkThe new healthcare realm of value-based care (VBC), designed to reward healthcare providers with incentive payments for the quality of care and patient outcomes not simply the volume of services provided,…
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A recent study showed that rates of follow-up care are lacking among children with mental health emergencies, underscoring the need for stronger patient engagement after hospitalization. These findings come in the midst of the…
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Zero Trust and NIST SP 800-207The National Institutes of Standards and Technology brought private and public partnerships together to discuss how to develop a framework to defend against attacks. On Aug. 11, 2020, NIST…
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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…
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,…
