The telehealth market has thrived during the current coronavirus pandemic. This platform allows physicians to meet with patients while maintaining social distancing, a practice that can be beneficial to all involved. Health insurance companies often cover these visits, but the rate of pay is not always comparable to an in-person visit.
The United States Department of Health and Human Services Office of Inspector General (OIG) recently released the findings from a study that focused on the Centers for Medicare and Medicaid Services (CMS) provision of unsupported risk adjustment payments. The OIG questioned the CMS' failure to support the risk adjustment payment requests from Medicare Advantage organizations (MAOs) when the MAO failed to provide evidence it conducted a face-to-face appointment to support the requested payment.
Texas and states throughout the country are in the midst of a nursing shortage. The problem is so serious, that the dean of the Texas A&M College of Nursing recently testified before a U.S. committee. The testimony included a discussion on innovations within academic nursing. Hospitals throughout the state are struggling to find nurses to provide quality care to patients. According to this educational leader, one potential answer to this shortage is increased reliance on technological innovations.
The United States Centers for Medicare and Medicaid Services (CMS) investigates hospitals throughout the country to check for compliance. A poor investigation can result in serious ramifications, including the inability to receive funding through CMS.
The Department of Health and Human Services (HHS) has stated that changes to the physician self-referral system are likely in the near future. The Trump administration is considering changes to the Stark law with a goal of encouraging coordinated care. An official with the Trump administration expects changes by the end of the year.
The United States Federal Bureau of Investigation (FBI) has ramped up investigations of allegations of illegal medical kickbacks to physicians and health care businesses in the Dallas area. Since May, the agency has raided at least four separate, local health care businesses.
A recent article in a home health care industry publication lays out a compelling argument against a bounty system that punishes individuals and companies that have done nothing wrong. Their "crimes" are often little more than bookkeeping errors, insufficient documentation or simply being in the wrong place at the wrong time and getting pulled into one of many investigations launched in pursuit of big paydays from whistleblower lawsuits.
In mid-January, the Centers for Medicare & Medicaid Services published a home health agency final rule outlining new minimum standards for home health agencies participating in Medicare and Medicaid.
Just like with any other business, the owners of health care companies may wish to expand by purchasing related organizations, or they may wish to sell to a potential buyer. Additionally, individuals may want to get into the health care industry by purchasing an already existing organization.