Complying With Evolving Cannabis Law In Hospitals And Healthcare Education

Some states have legalized marijuana for recreational or medical use, but there are still legal issues in healthcare and other industries because marijuana is illegal under federal law. This conflict between state and federal laws is especially important when it comes to patients using marijuana in ... View More

CMS Final Rule Impacting Medicare Part C, Part D, and Health Information Te

The Centers for Medicare and Medicaid Services (CMS) has made significant changes to Medicare Advantage (MA) and Medicare Part D plans. These changes are outlined in the Contract Year 2025 Final Rule, published on April 23 and effective June 3, 2024. This rule updates existing policies, introduces n... View More

Medicare Drug Price Negotiation Program

Healthcare costs in the United States have been a topic of intense debate and concern for decades, with prescription drug prices being a particularly contentious issue. The introduction of the Medicare Drug Price Negotiation Program represents a significant step towards addressing this problem, aimi... View More

Medicare Advantage Two-Midnight Rule Contributing To Higher Outpatient Reve

The expansion of the two-midnight rule by the Centers for Medicare and Medicaid Services (CMS) to include Medicare Advantage plans has led to increased inpatient volumes and revenue growth in the first quarter of the year, according to a report by Strata Decision Technology. This rule impacts inp... View More

Navigating New Challenges in Medicare Rx Drug Billing

As people in the United States grow older at an incredible rate, with 10,000 new seniors every day, healthcare providers are facing significant challenges with Medicare billing. The Inflation Reduction Act (IRA) helps by limiting Medicare Part D costs, but it also complicates things. Providers need ... View More

Streamlining Prior Auth Workflows Under the New CMS Rule

CMS has finalized a new rule aimed at shortening prior authorization timelines and streamlining processes to remove barriers to patient care, according to a press release. The rule mandates that prior authorization decisions be sent within 72 hours for urgent requests and 7 days for standard request... View More

2024 Elections and Health Policy What You Need to Know

Election changes everything from policies to people's lifestyles, and as you know, elections are everywhere in the United States. However, different political parties come up with different agenda and healthcare is one of their top priorities. Healthcare issues are one of the major concerns at b... View More

Why PECOS Required for Medicare Enrollment?

If you wonder how to enroll in the Medicare program, you should be informed that there are two ways to enroll. The first one is by completing the Medicare paper application form appropriately, and the second one is PECOS. PECOS stands for Provider, Enrollment, Chain, and Ownership System, and it all... View More

Credentialing Webinars

Provider credentialing is essential for ensuring that healthcare providers meet necessary standards. Here, we have elaborated on different elements of credentialing that will help healthcare professionals navigate several challenges related to credentialing. Hospital DEI: Bias in Credentialing ... View More

Professional (Mis) Behavior: What Codes Of Conduct Can Do

When creating an annual budget, addressing workplace ethics is often overlooked. However, the Association of Certified Fraud Examiners (ACFE) reports that businesses can lose up to five percent of annual revenue to fraud. For large companies, corruption is a major issue, while smaller businesses fac... View More

NATIONAL PRACTITIONER DATA BANK(NPDB): EXPANDED REPORTING PARAMETERS

The Health Care Quality Improvement Act (HCQIA) of 1986 created the National Practitioner Data Bank (NPDB), which collects essential information about healthcare providers, such as disciplinary actions and malpractice claims. Congress established HCQIA to address the rise in medical malpractice case... View More

New Privacy Requirements Imposed on Providers by Reproductive Healthcare Ru

The HIPAA Privacy Rule just got a significant upgrade, especially when it comes to safeguarding reproductive health information. Now, anyone handling this sensitive data needs to get up to speed with the latest changes. These include stricter rules on how PHI can be used and shared, a new requiremen... View More

Nursing Home versus Home Care: How Medicaid Cuts Shift the Balance