Category: Healthcare News

HIPAA violations

How to prevent HIPAA violations in healthcare

HIPAA violations happen when a healthcare organization fails to follow the Health Insurance Portability and Accountability Act (HIPAA) rules. HIPAA is a law that protects patients’ privacy by setting standards for securing and sharing their medical information. There are different ways a HIPAA violation can occur, but they often involve a patient’s protected health information […]
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340B modifier

Updated Guidance for 340B Modifiers from CMS in 2024 and 2025

The Centers for Medicare and Medicaid Services (CMS) recently updated guidance on the use of 340B modifiers by Medicare providers and reimbursement providers for drugs Part B biologics and the 340B Drug Enforcement Program. Published participation. The purpose of this rulemaking is to inform all provider types about the newly amended 340B requirements for 2024 […]
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TEAM: CMS’s New Value-Based Payment for Surgeries

The Centers for Medicare & Medicaid Services (CMS) is introducing a new way to pay for specific surgical procedures: Transforming Episode Accountability Model (TEAM). This mandatory model, starting January 1, 2026, will hold hospitals accountable for the cost and quality of care for 30 days after five types of surgeries: Lower extremity joint replacement Surgical […]
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IOTA Model

Kidney Disease Patients: Proposed Rule Aims to Increase Transplants

The organ transplant industry, like every other sector (kidney transplants IOTA model), is not free from racial disparities,” remarked U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra. “Black Americans face a disproportionate burden of life-threatening kidney disease, yet they receive a smaller share of kidney transplants. The Biden-Harris Administration is implementing concrete […]
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independent-medical-practices

Maximizing Medicare Reimbursement: Strategies for Independent Practices

In the wake of the COVID-19 pandemic, independent medical practices face many challenges, from adapting to new healthcare methods to major regulatory changes. The main focus of this study is to increase Medicare spending. With the right strategies, independent medical practices can achieve financial sustainability while continuing to provide quality care to their patients. This […]
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CMS Improves Outcomes & Reduces Costs with Specialty Care

Specialty care improves outcomes and reduces costs for CMS

Streamlining Specialty Care: CMS’s Innovation Center prioritizes strategies that improve personalized healthcare information, implement financial services, and support segment-based classifications. A value-based approach to care must address underlying issues and individualized care to reduce patient outcomes. CMS’s innovation strategy describes ongoing efforts to integrate personalized care into the healthcare system. Previous studies have shown that […]
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NSA Implementation

Congressional Concerns: Lawmakers Challenge CMS on NSA Implementation

NSA Implementation Shortly before Congress adjourns for 2023; lawmakers sent another in a series of letters to the Centers for Medicare and Medicaid Services (CMS) expressing “serious concerns” about the implementation of the No Surprises Act (NSA). The letter accused CMS of failing to properly implement key portions of the law and suggested that the […]
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Streamlining Prior Authorization Final Rule

The Impact of CMS-0057-F on Streamlining Prior Authorization Processes

An improved Prior Authorization Final Rule can result in shorter wait times, fewer delays in the delivery of patient care, and a reduction in costs. CMS has finalized the Interoperability and Prior Authorization Final Rule (CMS-0057-F), which was published by CMS on January 17, 2024. It will reduce the burden on patients, providers, and payers […]
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