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Telehealth Expands to Medicare Advantage Plans

Last month, a federal bill was introduced and passed by the Senate that enables Medicare Advantage (MA) plans to reimburse for telehealth services at comparable rates to in-person services beginning in 2020. Currently, MA plans offer telehealth coverage for an additional premium; a supplemental benefit. The new bill requires Medicare Advantage plans to reimburse for telehealth services at the same rate as Medicare fee-for-service. While the adoption of this bill...

New Jersey Significantly Expands Telemedicine

Pursuant to Senate Bill 291 (S291), approved on July 21, 2017, New Jersey has expanded the potential for physicians expand their practices through telemedicine. Engaging in this practice of remote, virtual healthcare allows providers to reach more patients and develop their practice by providing health care services, such as primary and specialty care and remote patient monitoring, via videoconference rather than requiring all patients to travel to an office or...

What You Need to Know About the Medicare Appeals Process

One: Administrative Law is extremely complex and difficult to navigate Medicare rules in general, and the appeals process in particular, are codified in a complex body of regulations known as administrative law. However, many healthcare providers rely on non-lawyers, typically billing professionals, to file their Medicare appeals. This approach to tackling appeals often creates substantial risks for many providers, as the foundation of any successful appeal is a thorough understanding...

Why Accounting Firms Need HIPAA Compliance Plans

It has been over two decades since the passage of the Health Insurance Portability and Accountability Act of 1996 (HIPAA or Act), but only in the past six years have enforcement actions demonstrated the fervor with which the government intends to compel compliance. With trends leaning toward a continued increase in enforcement activities, entities governed by HIPAA must be aware of their duties under the Act. Prior to 2009, HIPAA...

Don’t Forget Annual HIPAA Breach Reporting

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires every Covered Entity that knows or should know of a breach of Protected Health Information (PHI) to notify the individuals affected by the breach as well as report the incident to the Federal government. While a breach affecting less than 500 individuals does not require immediate reporting to the Secretary of the U.S. Department of Health and Human Services,...