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Senior editor covering healthcare Follow Author Jul 01, 2025, 06:30am EDT Updated Jul 1, 2025, 10:33am EDT Share Save Comment New drugs take too long to get to market because of clinical trial bottlenecks. Two cancer doctors built AI-enabled tech to speed up the process. Pi Health Only 8% of cancer patients in the U.S.
CMS Policy Changes to Reduce Costs Financial pressures are rising as CMS implements the updated Version 28 Hierarchical Condition Category (HCC) model , which introduces changes aimed at limiting types of codes that are most used for up-coding or over-coding to help rein in spending. For Star Ratings specifically, CMS spent $12.8
Since 2023, 27 states and the District of Columbia have granted NPs full practice authority (AANP, 2023). Where NPs have reduced or restricted practice authority to provide patient care, liability is often shared with supervising physicians (Candello, 2023). Documentation.
Follow Author Jun 28, 2025, 10:35am EDT Jun 28, 2025, 10:37am EDT Share Save Comment An egret flying from the lake in Anuradhapura, Sri Lanka, on September 23, 2023. Follow Author Jun 28, 2025, 10:35am EDT Jun 28, 2025, 10:37am EDT Share Save Comment An egret flying from the lake in Anuradhapura, Sri Lanka, on September 23, 2023.
Behavioral health providers managing both clinical care and business operations face unique challenges: complex prior authorization requirements, extensive documentation standards, and insurance coverage barriers. Insurers denied 19% of in-network claims in 2023 , according to the Kaiser Family Foundation.
Thursday, May 4, 2023, is World Password Day. How Long Does it Take a Hacker to Brute Force a Password in 2023. It is common for users to avoid creating unique passwords and they end up reusing the same password for multiple accounts. We recommend a minimum password length of 14 characters. Source: Hive Systems.
A settlement has been agreed to resolve a class action lawsuit against Retina Group of Washington over a March 2023 data breach that involved unauthorized access to the protected health information of 455,935 individuals. Under the terms of the settlement, a $3.6
It came up over and over again in our national survey of direct support professionals ineffective supervision results in frustrations among experienced DSPs and dissatisfaction with their job. This is 15% higher than 2023 and 14% higher than 2021, indicating a clear shift in the industry. This fell to 41% in 2025.
A settlement has been agreed to resolve class action data breach litigation against HealthEC and its clients over a 2023 hacking incident and data breach. Between July 14, 2023, and July 23, 2023, hackers accessed its network and stole files containing sensitive data. million individuals.
Practices that take a proactive stance turn claim denials into early warning indicators that speed up payments and streamline everyday operations. Industry data showed that insurers on HealthCare.gov denied about 19% of in-network claims in 2023 ; that’s $73 million out of $319 million in claims filed.
When diagnoses are reported only using enrollees’ HRAs and HRA-linked chart reviews and there are no follow-up visits, procedures, or tests, HHS-OIG is concerned that the diagnoses may be inaccurate and therefore the payments made by the CMS may be improper. In fiscal year 2023, the CMS identified $12.7
We’re yet another document into the NHS plan. Now, bearing in mind this seems to be the focus of the 10-Year Health Plan (published 3 rd July), it strikes me that they already knew what was going into it, but didn’t feel that the rest of us mere mortals deserved the heads-up. Or is this appointment in your pocket via AI?
Closely following the evolution of their industry can help these medical professionals have long careers providing effective patient care. According to a 2023 Rock Health report, telemedicine usage by patients over 55 rose by 12 percent. The ways practical nurses provide healthcare have changed with societal advancements.
According to The State of Mental Health in America 2023 , 21% of adults are currently experiencing a mental illness, which equates to over 50 million Americans. A 2023 IGNUX report states that hospital coding mistakes make up 63% of medical billing errors.
Two large data breaches were reported in April that occurred way back in 2023, a ransomware attack on the City of Long Beach and a cyberattack on Dameron Hospital in California. California was the worst-affected state with 11 data breaches, followed by Illinois with 8 breaches, and Ohio, Tennessee, and Texas, which each had 4 data breaches.
During the COVID-19 pandemic, the National Council of State Boards of Nursing (NCSBN) (2022) estimated over 100,000 registered nurses left the profession and predicted that another 800,000 nurses would follow them by 2027. link] Joint Commission (2023, August 24). link] Mcfanhn, C (2023, August 24). Some workers at U.S.
While your work experience section is typically the most important part of the document, adding volunteer experience in your resume can help you plug gaps in your work experience and include skills that would otherwise be missing. Voluntary positions can be a useful way of showcasing these skills and in particular soft, transferable skills.
Daily Dive M-F Payer Weekly Every Wednesday IT Weekly Every Thursday By signing up to receive our newsletter, you agree to our Terms of Use and Privacy Policy. In the midst of all these challenges, technologists say their innovations might hold the key to helping other manufacturers follow suit. You can unsubscribe at anytime.
Canceling services and coordinating mail forwarding are important tasks to prevent unnecessary expenses and ensure receipt of important documents. Whether you plan to sell your business, transfer ownership to a partner or simply close up shop, this decision is a deeply personal one. This is where a broker or appraiser comes in.
Mercer County Joint Township Community Hospital in Coldwater, Ohio, has suffered a significant data breach involving the electronic protected health information of up to 88,541 individuals. The post Mercer County Joint Township Community Hospital Cyberattack Affects Up to 88,500 Individuals appeared first on The HIPAA Journal.
For years, law enforcement has bypassed traditional means of securing evidence by informal requests for documents from witnesses of crimes. At some point, that practice bled over into informal requests for healthcare providers’ documents, including documents reflecting protected health information (PHI). Isn’t that entrapment?
While the plan of care is always the number one area for citations, care coordination consistently ranks right up there,” said SimiTree Compliance Senior Manager Sheila Salisbury-Sizemore. Documentation in the medical record. In the two weeks leading up to the date of recertification. Care coordination under HHVBP.
In addition to financial penalties, covered entities are required to adopt a corrective action plan to bring policies and procedures up to the standards demanded by HIPAA. . It is the responsibility of each covered entity to ensure that HIPAA Rules are understood and followed. Tier 1: Minimum fine of $100 per violation up to $50,000.
However, over time the CPGs have not sufficiently kept up with the innovations and growth of the healthcare industry. Changes will include the following: The OIG will issue a new general CPG (GCPG) that will apply to all individuals and entities in the healthcare industry. The OIG intends to publish the GCPG by December 31, 2023.
From 2018-2023, OCR observed a 102% increase in breaches affecting 500 or more individuals, with 167 million affected in 2023 alone. Comments should be identified by RIN Number 0945AA22 and can be submitted by any of the following ways: Federal eRulemaking Portal. Mail written comments to the following address: U.S.
The Journal of Nursing Education published a research article documenting the history and use of the expression, “Nurses eat their young.” According to the 2023 NSI National Health Care Retention and RN Staffing Report , the average cost of turnover for a bedside registered nurse is $52,350.
United channeled almost $52 billion of that cash into buying health-related businesses, nearly all of which end up housed inside Optum. Source: 2023 UNH 10K For most of the past decade, Optum has been driving force of incremental profit growth for United. billion in 2023 (55% of total). in the third quarter of 2023.
Between EHR documentation, inbox management, prior authorizations, and other clerical tasks, it’s a wonder physicians have time to care for patients. Now, they face growing demands associated with documentation and regulatory compliance. Nobody likes paperwork, but practicing medicine requires a lot of it.
To keep up with all of it, your staff needs constant training. Better retention As many as 58% of medical practices said that staffing is their biggest challenge for 2023, according to an MGMA Stat poll. It’s hard even for experts to keep up. But efficient follow-up is equally important,” said Hayes.
The good news for administrators is that they are permitted to submit affidavits or other documents from outside the administrative record that show that the conflict of interest played no role in the decision-making. A documented history of arbitrary claims denials by the administrator. 3d–, 2023 WL 3303865 (W.D. May 8, 2023).
On July 31, 2023, the California Office of Health Care Affordability (“OHCA”) released draft regulations concerning pre-transaction review of so-called “Material Change Transactions” as part of its legislative mandate to review transactions which could have potential impacts on the costs of health care in the State of California.
More technology is not always the best solution In a recent healthcare provider survey , half of healthcare executives said the revenue cycle is a top priority for software investment in 2023. From the least complex workflows to the highest complexity workflows, finding a minute here or there can add up quickly,” said Hermosillo.
More technology is not always the best solution In a recent healthcare provider survey , half of healthcare executives said the revenue cycle is a top priority for software investment in 2023. From the least complex workflows to the highest complexity workflows, finding a minute here or there can add up quickly,” said Hermosillo.
On June 23, 2023 the U.S. Food and Drug Administration (FDA) published a draft guidance document with foundational considerations for researchers that are developing psychedelic drugs for the treatment of medical conditions. The following provides a review of each section of the draft guidance.
Key Takeaways A need to control substance usage and reduce medication errors is driving the e-prescribing market growth during the 2023-2030 timeframe. The cost depends on the team, features, functionalities, and the time required to wrap up the development process. percent during the 2023-2030 timeframe.
This process can include patient demographics, charts, labs, and any clinical documentation that will aid in proving the necessity of the medication or service. This can include verifying information with the pharmacy and obtaining all required documentation from the patient’s health record, as mentioned above.
Some programs are very clear about not wanting anything but the primary and secondary applications, and you should always follow their instructions. There are always applicants who get later interviews, however, so don’t give up hope. Don’t give up! Second, check whether you fall within their range of accepted students.
Despite the many headaches caused by a growing clinical documentation burden, it’s great to know that the best EHR systems are improving. This list of the top 3 EHRs follows rankings from the Best in KLAS Software and Services Report. Finally, Epic’s prestigious reputation gives it a leg up in the industry.
This process can include patient demographics, charts, labs, and any clinical documentation that will aid in proving the necessity of the medication or service. This can include verifying information with the pharmacy and obtaining all required documentation from the patient’s health record, as mentioned above.
Key Statistics: As per the 2023 survey published by the CDC , the number of people younger than age 65 uninsured was 24.7 percent of the adults between the age group 18–64 were uninsured, as per the 2023 survey. percent of children younger than age 18 were uninsured, as per the 2023 survey. This takes up precious time.
The International Classification of Diseases, Tenth Revision (ICD-10) released updates for 2024 related to behavioral health, which went into effect October 1, 2023. The following changes will affect mental health coding: hepatolenticular degeneration (formerly E83.0, now E83.01) Parkinson’s disease (formerly G20, now G20.-)
The goal of PAs is to ensure patients receive the most appropriate care for their medical needs in agreement with the most up-to-date medical evidence and guidelines 1. Prior authorizations can be very time-consuming, as they require documentation and paperwork from healthcare providers to show why the patient would need the treatment.
The individuals who agree to write your letters of recommendation (LORs) are doing you a favor, so the least you can do is make their job easier by following proper LOR etiquette. If you ask for their recommendation too close to the deadline, you might end up without one. Do not give them an incomplete package of materials.
This free resource is accessible online and can play an essential part in your internal compliance program in 2023, a year of increased oversight by CMS. The report is available for the following facilities: Skilled nursing facilities. This information is critical for targeted training for staff who need to skill up in this area.
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