Shelly Asbury
Federal bureau unveils proposals to remove medical debt from credit reports
The Consumer Finance Protection Bureau on Sept. 21 outlined proposals aiming to end "coercive debt collection tactics, clean up...
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Kennedy Neghan Healthcare Resources, LLC
Shelly Asbury
- Sep 19
- 1 min
Prior Authorization - UnitedHealthcare
UnitedHealthcare is cutting 20 percent of its prior authorizations in two waves. The first cuts take effect Sept. 1 and the second phase...
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Shelly Asbury
- Sep 14
- 2 min
Healthcare Fraudsters in the news
Recent healthcare fraudsters in the news: 1. Bridgeport, Conn.-based federally qualified health center Optimus Health agreed to pay more...
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Shelly Asbury
- Sep 7
- 3 min
3 payers halting policies after pushback
Humana, UnitedHealthcare and Cigna changed or paused policies this year after receiving criticism from medical groups and other...
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Shelly Asbury
- Sep 1
- 1 min
Monitoring government enforcement actions is one way to mitigate potential high-risk
If you have a “HIPAA COMPLIANT” badge on your website or have a business associate with this type of badge, the FTC may not approve, as...
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Shelly Asbury
- Aug 28
- 1 min
Humana ends controversial prior authorization policy in Georgia
Humana ended a cataract surgery prior authorization policy for Medicare Advantage beneficiaries in Georgia that had been criticized by...
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Shelly Asbury
- Aug 25
- 1 min
Healthcare Fraudsters in the News
1. Suburban Chicago physician John Greager, MD, and his ASC will pay more than $757,000 to settle allegations he submitted fraudulent...
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Shelly Asbury
- Aug 22
- 1 min
Colorado bill eliminates physician supervision requirement for PAs
Physician Assistant Collaboration Requirements Concerning an expansion of a physician assistant's ability to practice, and, in connection...
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Shelly Asbury
- Aug 17
- 1 min
Stark law changes ramp up in 2023
CMS updated its voluntary self-referral disclosure laws Jan. 23, including an updated version of the self-referral disclosure protocol...
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Shelly Asbury
- Aug 8
- 1 min
CMS again pauses out-of-network billing arbitration after judge sides with providers
The Centers for Medicare & Medicaid Services (CMS) has again suspended arbitration of out-of-network payment disputes between providers...
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Shelly Asbury
- Aug 8
- 1 min
United Healthcare provides $11.1 million in grants to tackle Social Detriments of health issues.
UnitedHealthcare tapped 66 not-for-profit organizations spread over 12 states to receive grant funding to help expand access to care. The...
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Shelly Asbury
- Jul 3
- 1 min
OIG Audit of Medicare Advantage High-Risk Diagnosis Codes
Miscoded diagnoses may cause CMS to pay Medicare Advantage (MA) organizations improper amounts. To emphasize the need for accurate coding...
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Shelly Asbury
- Jul 3
- 2 min
State Policy's Role in Prescribing
Last month the Drug Enforcement Administration (DEA) clarified that it would be extending the public health emergency (PHE) allowances...
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Shelly Asbury
- Jun 30
- 1 min
Modifier JZ
July 1, 2023 CMS Requires Modifier JZ for Zero Discarded Drugs Know the Difference Between JZ & JW Medicare claims filed billing...
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Shelly Asbury
- Jun 23
- 1 min
Physician Assistant Guity of $10 Million Fraud Scheme
Colby Edward Joyner, a North Carolina PA, signed fraudulent prescriptions for medically unnecessary genetic testing. Trial evidence...
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Shelly Asbury
- Jun 13
- 1 min
Value-Based Primary Care Pilot Progam
The Centers for Medicare & Medicaid Services (CMS) aims to advance value-based primary care, especially in rural areas and among...
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Shelly Asbury
- May 31
- 1 min
Do I Need a Professional Patient Advocate?
Individuals experiencing illnesses can benefit from having someone attend appointments with them and support their best interests. Often,...
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Shelly Asbury
- May 4
- 1 min
Healthcare Fraudsters in the News
Beverly Hills Plastic Surgeon Agrees to Pay Nearly $24 Million to Settle False Claims Act Allegations A plastic surgeon in Beverly Hills,...
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Shelly Asbury
- Mar 27
- 1 min
Fiscal Year 2022 False Claims Act Settlements and Judgments Exceed $2 Billion
In the Fiscal Year ending September 30, 2022, settlements and judgments under the False Claims Act exceeded $2.2 billion. That $2.2...
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Shelly Asbury
- Mar 8
- 1 min
Why is Advocacy Important in Health Care?
Examining healthcare policy and patient support roles makes it easy to understand why advocacy is important in health care. Large-scale...
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