ACA

Hospital Pays $2.2 Million HIPAA Penalty for Reality Show Participation

Article by Mary Butler. This article was originally published on the Journal of AHIMA website on May 18, 2016 and is republished here with permission. New York Presbyterian Hospital was slapped with a $2.2 million fine for allowing a network reality show film the death of a trauma patient without seeking permission from the patient’s family. The…

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Healthcare CEO Faces Life in Prison for Fraud That Led to 2 Patient Deaths

By Ayla Ellison for Becker’s Hospital Review The CEO and co-owner of a Maryland diagnostics company is facing life in prison after a federal jury convicted him of two counts of healthcare fraud that resulted in death, according to the Department of Justice. On Wednesday, a federal jury found 67-year-old Rafael Chikvashvili, PhD, guilty of healthcare…

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Whistle-Blower Claims 33 Hospitals Submitted More Than $1B in Fictitious Costs

By Ayla Ellison for Becker’s Hospital Review A whistle-blower recently defended the viability of a federal complaint he filed, saying 33 hospitals in North Carolina, South Carolina and Georgia benefited from fictitious cost report claims submitted to Medicare and Medicaid. The whistle-blower, Joseph Vincoli, first brought suit against Charlotte, N.C.-based Carolinas HealthCare System and North Carolina…

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Grappling With the End of Physician ICD-10 Coding Grace Period

Article by Mary Butler. This article was originally published on the Journal of AHIMA website on May 19, 2016 and is republished here with permission. October 1, 2016, will mark the end of a one-year “grace period” that allowed unspecified ICD-10-CM codes on certain physician Medicare claims. The grace period was a joint initiative between the Centers…

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Highmark to Pay More for Better Diagnostic Documentation

By Joseph Goedert for Health Data Management Highmark Inc., a Blues plan serving Pennsylvania, Delaware and West Virginia, is giving physicians a financial incentive to increase documentation of diagnostic codes in the electronic health record of patients insured under Medicare Advantage or health insurance exchange programs. Too often, physicians enter a core diagnosis following a…

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HHS Awards $260 Million to Health Centers Nationwide

By HMT Mag for Health Management Technology HHS Secretary Sylvia M. Burwell announced over $260 million in funding to 290 health centers in 45 states, the District of Columbia, and Puerto Rico for facility renovation, expansion, or construction. Health centers will use this funding to increase their patient capacity and to provide additional comprehensive primary…

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CMS Drops Two-Midnight Rule’s Inpatient Payment Cuts

By Virgil Dickson for Modern Healthcare The CMS will not continue to impose an inpatient payment cut to hospitals under the two-midnight rule following ongoing industry criticism and a legal challenge. It will provide a onetime bump to hospitals to offset the cuts. The agency imposed the cut because it estimated the two midnight policy would…

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Justice Scalia’s Death Leaves Healthcare Cases in Limbo

By Lisa Schencker and Adam Rubenfire for Modern Healthcare The death of U.S. Supreme Court Justice Antonin Scalia, who famously said the Affordable Care Act should be called “SCOTUScare,” leaves in limbo a number of healthcare-related cases. The news also quickly sparked a debate over who would replace him amid the presidential campaign. Scalia died Friday,…

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2016 Election Candidates’ Stances on Health Care

By Matt O’Connor for (H&HN) Hospitals & Health Networks Here are the 8 presidential election candidates’ stances on health care, taken directly from their websites. Jeb Bush: Website ObamaCare is a government takeover of more than one-sixth of the American economy, and it epitomizes why Americans are so fed up with Washington. To win on repeal, conservatives…

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