Retrieving Billions in Overpayments by CMS

Retrieving Billions in Overpayments by CMS

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,…

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Several Louisiana hospitals face online tracking lawsuits

Several Louisiana hospitals face online tracking lawsuits

The class action lawsuits filed by Herman Herman & Katz allege Meta Pixel code potentially analyzed, gathered and shared the sensitive medical data of hundreds of thousands of patients across the LCMC Health Systems and Willis-Knighton Health System networks.WHY IT MATTERS
Pixel technology uses a Java tracking script to send an organization’s data to the technology owner, which in this case, is Meta, owner of Facebook, Instagram and WhatsApp. Tracked data could be shared with network marketing partners who target individuals with offers and advertisements.
The new class action lawsuit alleges that visitors to the health system websites may have had their protected…

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2021 Tech Forum: Integrating SDOH Data Into Clinical Systems & Connecting with Human Services

2021 Tech Forum: Integrating SDOH Data Into Clinical Systems & Connecting with Human Services

September 10, 2021Providers are increasingly capturing SDOH data from patients as part of a clinical encounter and using this data to help inform clinical care delivery and to support social care referrals in the community. Existing and emerging health IT standards and codes sets specific to SDOH enable this data to be integrated into a care record and exchanged to support referrals aligned with an individuals’ social need(s). This session will outline technical workflows and use cases for integrating SDOH data into an EHR and as part of a shared care plan and will describe the applicable standards and codes sets…

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