AGG Talks: Home Health & Hospice Podcast - Episode 9: The Impact of AI and Prior Authorizations on Home Health and Hospice
The CMS Interoperability and Prior Authorization Rules
Both the Centers for Medicare & Medicaid Services (CMS) and dozens of the nation’s largest insurance companies have revealed upcoming changes to their prior authorization processes. These changes aim to reduce the prevalence...more
Last week, the Government Accountability Office (GAO) published a report determining that there is a nontrivial risk that prior authorization requirements, together with internal coverage criteria, may undermine the Medicare...more
Over the past two years, federal and state government agencies have moved to regulate the deployment of artificial intelligence (AI) in the healthcare setting, including in the utilization management (UM) and prior...more
On February 8, 2024, the U.S. Department of Health & Human Services (HHS) released a final rule modifying 42 CFR Part 2 (Part 2) provisions regarding the confidentiality of Substance Use Disorder (SUD) Patient Records. The...more
When stakeholders think about prior authorization in the Medicare program, they usually focus on its use in Medicare Advantage (MA), and not how it is used in traditional Medicare. In fact, a few weeks ago, the Centers for...more
Report on Patient Privacy 23, no. 12 (December, 2023) Spring 2020 was a terrifying period in the annals of COVID-19, and New York was at the epicenter. COVID-19 cases, and deaths, already the highest in the nation, were...more
Health care providers should take heed of the $10,000 settlement announced on October 2, 2019 between the U.S. Department of Health and Human Service (HHS) Office for Civil Rights (OCR) and a small dental practice based on...more
Below is this week’s “Capitol Hill Healthcare Update,” which is posted on Mondays when Congress is in session....more
In the second episode of our series on the national opioid crisis, Gina Bertolini discusses the overlay of recent guidance concerning privacy laws such as the Health Insurance Portability and Accountability Act (HIPAA) and...more