Providing a good overview of the 340B Program, this slide presentation outlines the benefits of 340B compliance as well as the ramifications of non-compliance.
1) The 340B program allows specified government agencies and safety net organizations to purchase outpatient drugs at discounted prices from drug manufacturers. It aims to expand access to affordable medications for low-income populations.
2) Covered entities that can purchase drugs through 340B include federally qualified health centers, Ryan White HIV/AIDS programs, and disproportionate share hospitals. They can dispense the drugs through an in-house pharmacy or contract pharmacy.
3) States aim to avoid paying Medicaid rebates on 340B drugs by identifying 340B claims. Challenges include differentiating 340B drugs when pharmacies hold both 340B and non-340B inventory. States explore solutions like requiring covered entities to purchase all
This document discusses quantitative methods for signal detection in pharmacovigilance. It describes current methods like proportional reporting ratios (PRR) that measure disproportionate reporting of adverse drug reactions. Bayesian methods and log-linear models are presented as improvements. Longitudinal health records are discussed as an alternative that avoids some biases but is difficult to implement. Future directions may include using all available data on reports and incorporating pharmacokinetic properties of drugs.
FREE Sample demand letter under consumer legal remedies act for californiaLegalDocsPro
This FREE sample demand letter under the Consumer Legal Remedies Act for California is sent pursuant to the Consumer Legal Remedies Act contained in sections 1750 through 1784 of the California Civil Code. The sample is 4 pages and contains brief instructions and must be sent by Certiified Mail, Return Receipt Requested. legal action at least 30 days before filing any legal action.
Medical necessity (CO 50) will be important denial if your DX is not matching with LCD policy. Know the basic of this denial to improve your medical billing
The document discusses interactive voice response systems (IVRS) and interactive web response systems (IWRS) which are controlled by a central computer and accessed via telephone or web interfaces. These systems can be used to register and randomize patients, manage medication supply, ensure patient compliance, and collect patient reported outcomes data in global clinical trials. They allow for automated randomization, blinding, supply management, and data collection which improves efficiency.
1) The 340B program allows specified government agencies and safety net organizations to purchase outpatient drugs at discounted prices from drug manufacturers. It aims to expand access to affordable medications for low-income populations.
2) Covered entities that can purchase drugs through 340B include federally qualified health centers, Ryan White HIV/AIDS programs, and disproportionate share hospitals. They can dispense the drugs through an in-house pharmacy or contract pharmacy.
3) States aim to avoid paying Medicaid rebates on 340B drugs by identifying 340B claims. Challenges include differentiating 340B drugs when pharmacies hold both 340B and non-340B inventory. States explore solutions like requiring covered entities to purchase all
This document discusses quantitative methods for signal detection in pharmacovigilance. It describes current methods like proportional reporting ratios (PRR) that measure disproportionate reporting of adverse drug reactions. Bayesian methods and log-linear models are presented as improvements. Longitudinal health records are discussed as an alternative that avoids some biases but is difficult to implement. Future directions may include using all available data on reports and incorporating pharmacokinetic properties of drugs.
FREE Sample demand letter under consumer legal remedies act for californiaLegalDocsPro
This FREE sample demand letter under the Consumer Legal Remedies Act for California is sent pursuant to the Consumer Legal Remedies Act contained in sections 1750 through 1784 of the California Civil Code. The sample is 4 pages and contains brief instructions and must be sent by Certiified Mail, Return Receipt Requested. legal action at least 30 days before filing any legal action.
Medical necessity (CO 50) will be important denial if your DX is not matching with LCD policy. Know the basic of this denial to improve your medical billing
The document discusses interactive voice response systems (IVRS) and interactive web response systems (IWRS) which are controlled by a central computer and accessed via telephone or web interfaces. These systems can be used to register and randomize patients, manage medication supply, ensure patient compliance, and collect patient reported outcomes data in global clinical trials. They allow for automated randomization, blinding, supply management, and data collection which improves efficiency.
O documento lista locais em Blumenau, SC que foram afetados por enchentes entre 08 e 09 de setembro de 2011. As áreas listadas incluem o Centro, bairros como Garcia e Itoupava Norte, e locais próximos ao rio como a Beira Rio, a FURB, a Praça em frente ao Hospital SC e a Rua das Palmeiras. Muitos pontos ao longo da Rua XV de Novembro também foram afetados.
Site Selection Metrics: Best Practices for Sponsors and CROsKunal Sampat
Site selection for a clinical study is a very important task. The quality of selected sites will be reflected in the clinical data, quality, recruitment rate and compliance.
Here is the step-by-step guide for an objective site selection based on data (not emotions).
Embase for pharmacovigilance: Search and validation March 22 2017Ann-Marie Roche
Scientific literature plays a critical role in Pharmacovigilance and Drug Safety workflows. Monitoring literature for mentions of adverse drug reactions (ADRs) is mandated by regulatory bodies, and marketing authorization holders (MAHs) that do not properly report ADRs can be subject to heavy fines. With an increasing volume of unstructured content to cover, along with rising labor costs, MAHs are looking for ways to make their literature monitoring more effective and efficient.
Abstract and indexing (A&I) databases play an important role in Literature Monitoring – due to the vast amount of scientific literature published daily – in order for MAH’s to locate specific articles or conference presentations that may be relevant for their products (for both benefit/risk analysis and ADR detection). Rather than reading all the literature, MAH’s create search strategies that identify the relevant records in A&I databases and execute the searches regularly. GVP module VI mandates that searches are done at least weekly, but many companies maintain a daily monitoring and review cycle.
In this webinar, Senior Product Development Manager Embase, Dr. Ivan Krstic discussed best practices for saving time, staying current, validating search strategies and mitigating risk in the face of these increasingly complex processes in literature monitoring
The document discusses evidence-based health services management and provides guidance on conducting literature searches to inform management decisions. It outlines the origins and definition of evidence-based management, describes databases like Cochrane Library and PubMed that contain systematic reviews and studies, and provides tips for developing focused search questions and strategies to efficiently find relevant evidence. Examples of search exercises are included to demonstrate these concepts.
Sample California motion to vacate judgment and enter different judgment unde...LegalDocsPro
This sample motion to set aside and vacate judgment and enter another and different judgment for California is made under Code of Civil Procedure section 663 on the grounds that the judgment is based on an incorrect or erroneous legal basis that is not consistent with or not supported by the facts or a judgment or decree is not consistent with or not supported by the special verdict. The sample document on which this preview is based is 15 pages and contains brief instructions, a memorandum of points and authorities with citations to case law and statutory authority and a proof of service by mail.
PLS 54 Demand for Production and Inspection of Documents and Other Tangible T...Joshua Desautels
This document is a demand for production of documents from the defendant Dante Driscoll in a lawsuit filed by Izabella Danielli against Normandy Meats, LLC and Driscoll. It requests documents including witness statements, drawings or photos of the accident scene, and licenses or training possessed by Driscoll at the time of the incident. The documents must be produced for inspection at the law offices of Maiolo Campbell & Wotton on February 26, 2014.
This document provides an overview and summary of the 340B Drug Pricing Program. Key points include:
- The 340B program requires drug manufacturers to provide discounts of 25-60% on outpatient drugs to eligible safety-net hospitals and clinics.
- It is overseen by HRSA and aims to help providers "stretch scarce federal resources." Eligible entities include FQHCs, children's hospitals, and some DSH hospitals.
- Compliance areas include prohibiting duplicate discounts, ensuring drugs are only dispensed to eligible patients, and properly managing contract pharmacies. Noncompliance can result in repayment obligations and removal from the program.
- HRSA audits are increasing in frequency and rigor
ACCC 340B Sherer and Guide Article May 2011Matt Sherer
The document provides information about the 340B Drug Pricing Program. It describes the program as originating from legislation in 1992 that limits drug costs for certain healthcare facilities. Safety-net providers can save 20-50% on drug costs by participating. To qualify, a disproportionate share hospital must meet requirements like having an 11.75% DSH percentage and maintaining separate drug inventories for 340B and non-340B patients. The Affordable Care Act expanded eligibility for the program and increased compliance monitoring.
Guidi Sherer Everything You Wanted to Know About 340B Oncology Issues 2011Matt Sherer
The document provides information about the 340B Drug Pricing Program. It describes the program as originating from legislation in 1992 that limits drug costs for certain healthcare facilities. Safety-net providers can save 20-50% on drug costs by participating. To qualify, a disproportionate share hospital must meet requirements like having an 11.75% DSH percentage and maintaining separate drug inventories for 340B and non-340B patients. The Affordable Care Act expanded eligibility for the program and increased compliance monitoring.
The 340B drug pricing program was created in 1992 to provide discounts of up to 50% on prescription drugs to hospitals and clinics that treat low-income patients. However, there is growing concern that the program has strayed from its original goal. Some key issues include hospitals receiving disproportionate discounts relative to the number of low-income patients served, and contract pharmacies distributing drugs to wealthier areas without passing on savings to patients. While the intent of the program was good, its implementation may be enabling unintended consequences like profiting off drug resales rather than helping vulnerable groups as intended. Oversight groups are calling for reforms to better define eligibility and ensure the program benefits those it was designed to help.
The document discusses La Clínica de La Raza's participation in the 340B Drug Pricing Program. It provides an overview of La Clínica, an introduction to the 340B program scope and requirements. It describes potential delivery models including in-house pharmacies and contract pharmacies. It notes that the 340B program can generate savings on drug purchases for covered entities of 20-50% and revenue from the price difference between what insurers reimburse and acquisition costs. However, it cautions that the 340B program also faces potential pitfalls such as ensuring accurate pricing data, avoiding duplicate discounts, and negotiating contract pharmacy fees.
The 340B Program and Implications of the Mega GuidanceCompleteRx
As the 340B Drug Pricing Program continues to undergo changes, our team has been following all the recent updates and how they impact hospital pharmacies. This presentation goes through the latest on the long awaited guidance of proposed changes that was posted by the Federal Register on August 28, 2015.
Compliatric is excited to host the first of a two part 340B webinar series, presented by Ryan DiGiovanni, an Apexus Certified Expert (ACE) Pharmacist, President of EPL Health, and 340B Program Manager, Rush University Medical Center.
This webinar will provide evaluation tactics, operational considerations and planning required for covered entities before, and potentially after, participating in the 340B ESP platform. For the C-suite, this webinar will provide an overview of impact and implications of participation. For those involved in daily 340B program management, a more detailed breakdown of 340 ESP app usage, requirements, and resources will be discussed.
This article discusses audit readiness for hospitals participating in the 340B drug pricing program. It outlines several key areas hospitals should focus on to ensure compliance, including: 1) confirming eligibility requirements for the hospital, patients, and prescribers; 2) developing comprehensive oversight strategies and compliance monitoring programs; and 3) incorporating frequent self-audits and preparing for potential audits from the Health Resources and Services Administration. The article provides tips for audit readiness, such as establishing policies and procedures, updating databases, conducting ongoing education and monitoring, and developing a community benefit plan.
Demystifying Commercial Reasonableness in Physician/Hospital TransactionsPYA, P.C.
PYA Principal Lyle Oelrich presented “Demystifying Commercial Reasonableness in Physician/Hospital Transactions” at the Georgia Society of Certified Public Accountants’ (GSCPA) 2016 Healthcare Conference, February 11, 2016, in Atlanta, Georgia.
Watch the Webinar Here: https://compliatric.com/340b-recertification-and-audit-changes/
Compliatric is excited to host the second of a two part 340B webinar series, presented by Ryan DiGiovanni, an Apexus Certified Expert (ACE) Pharmacist, President of EPL Health, and 340B Program Manager, Rush University Medical Center.
This webinar will outline requirements and updates covered entities should be made aware of heading into annual recertification, as well as highlight key changes to HRSA’s audit data submission and review process.
Investments in Behavioral Health: Drivers and Outlook - Behavioral Health Cra...Epstein Becker Green
Webinar by attorney Purvi Maniar of Epstein Becker Green - April 5, 2016. Part of the Behavioral Health Crash Course Webinar Series.
This webinar will provide:
* A discussion of the main drivers of growth in investment in behavioral health, including the focus on population health management and mental health parity laws
* The outlook for providers of behavioral health services, including an overview of areas of legal focus and potential competition
http://www.ebglaw.com/events/investme...
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
This document summarizes a panel discussion on improving utilization of prescription drug monitoring programs (PDMPs). The panel will discuss current practices for interstate sharing of PDMP data, strategies for integrating PDMP data into healthcare records, and lessons from Washington state's program providing organizations access to PDMP data. The goal is to identify best practices that can be implemented in other states to increase interoperability and utilization of PDMP data.
Multiple Contract Pharmacies in a Disproportionate Share Hospital Systemanthonylesser
This document summarizes a presentation about the Harris County Hospital District's (HCHD) use of multiple contract pharmacies through an Alternative Methods Demonstration Project (AMDP). HCHD operates three major hospitals and 15 ambulatory pharmacies serving over 1.6 million outpatient visits per year. It applied for an AMDP in 2006 to use an off-site automated central fill pharmacy in Fort Worth to increase efficiency and patient access. The central fill pharmacy now fills 70% of prescriptions using a closed formulary. HCHD realized operational efficiencies, improved wait times, and was able to reduce staff while maintaining compliance.
The 340B Drug Discount Program was enacted by Congress to provide discounted drugs to safety net hospitals serving low-income, uninsured patients. However, there is growing concern that many hospitals are using the program to increase profits by selling the discounted drugs at full prices to private insurers, rather than helping needy patients as intended. Federal oversight of the 340B program has been inadequate, allowing covered entities to serve wealthier communities and generate large profits from the sale of discounted drugs. While the Affordable Care Act expanded the program, it also doubled the expected drug purchases and increased oversight is needed to ensure the program benefits its intended patients.
O documento lista locais em Blumenau, SC que foram afetados por enchentes entre 08 e 09 de setembro de 2011. As áreas listadas incluem o Centro, bairros como Garcia e Itoupava Norte, e locais próximos ao rio como a Beira Rio, a FURB, a Praça em frente ao Hospital SC e a Rua das Palmeiras. Muitos pontos ao longo da Rua XV de Novembro também foram afetados.
Site Selection Metrics: Best Practices for Sponsors and CROsKunal Sampat
Site selection for a clinical study is a very important task. The quality of selected sites will be reflected in the clinical data, quality, recruitment rate and compliance.
Here is the step-by-step guide for an objective site selection based on data (not emotions).
Embase for pharmacovigilance: Search and validation March 22 2017Ann-Marie Roche
Scientific literature plays a critical role in Pharmacovigilance and Drug Safety workflows. Monitoring literature for mentions of adverse drug reactions (ADRs) is mandated by regulatory bodies, and marketing authorization holders (MAHs) that do not properly report ADRs can be subject to heavy fines. With an increasing volume of unstructured content to cover, along with rising labor costs, MAHs are looking for ways to make their literature monitoring more effective and efficient.
Abstract and indexing (A&I) databases play an important role in Literature Monitoring – due to the vast amount of scientific literature published daily – in order for MAH’s to locate specific articles or conference presentations that may be relevant for their products (for both benefit/risk analysis and ADR detection). Rather than reading all the literature, MAH’s create search strategies that identify the relevant records in A&I databases and execute the searches regularly. GVP module VI mandates that searches are done at least weekly, but many companies maintain a daily monitoring and review cycle.
In this webinar, Senior Product Development Manager Embase, Dr. Ivan Krstic discussed best practices for saving time, staying current, validating search strategies and mitigating risk in the face of these increasingly complex processes in literature monitoring
The document discusses evidence-based health services management and provides guidance on conducting literature searches to inform management decisions. It outlines the origins and definition of evidence-based management, describes databases like Cochrane Library and PubMed that contain systematic reviews and studies, and provides tips for developing focused search questions and strategies to efficiently find relevant evidence. Examples of search exercises are included to demonstrate these concepts.
Sample California motion to vacate judgment and enter different judgment unde...LegalDocsPro
This sample motion to set aside and vacate judgment and enter another and different judgment for California is made under Code of Civil Procedure section 663 on the grounds that the judgment is based on an incorrect or erroneous legal basis that is not consistent with or not supported by the facts or a judgment or decree is not consistent with or not supported by the special verdict. The sample document on which this preview is based is 15 pages and contains brief instructions, a memorandum of points and authorities with citations to case law and statutory authority and a proof of service by mail.
PLS 54 Demand for Production and Inspection of Documents and Other Tangible T...Joshua Desautels
This document is a demand for production of documents from the defendant Dante Driscoll in a lawsuit filed by Izabella Danielli against Normandy Meats, LLC and Driscoll. It requests documents including witness statements, drawings or photos of the accident scene, and licenses or training possessed by Driscoll at the time of the incident. The documents must be produced for inspection at the law offices of Maiolo Campbell & Wotton on February 26, 2014.
This document provides an overview and summary of the 340B Drug Pricing Program. Key points include:
- The 340B program requires drug manufacturers to provide discounts of 25-60% on outpatient drugs to eligible safety-net hospitals and clinics.
- It is overseen by HRSA and aims to help providers "stretch scarce federal resources." Eligible entities include FQHCs, children's hospitals, and some DSH hospitals.
- Compliance areas include prohibiting duplicate discounts, ensuring drugs are only dispensed to eligible patients, and properly managing contract pharmacies. Noncompliance can result in repayment obligations and removal from the program.
- HRSA audits are increasing in frequency and rigor
ACCC 340B Sherer and Guide Article May 2011Matt Sherer
The document provides information about the 340B Drug Pricing Program. It describes the program as originating from legislation in 1992 that limits drug costs for certain healthcare facilities. Safety-net providers can save 20-50% on drug costs by participating. To qualify, a disproportionate share hospital must meet requirements like having an 11.75% DSH percentage and maintaining separate drug inventories for 340B and non-340B patients. The Affordable Care Act expanded eligibility for the program and increased compliance monitoring.
Guidi Sherer Everything You Wanted to Know About 340B Oncology Issues 2011Matt Sherer
The document provides information about the 340B Drug Pricing Program. It describes the program as originating from legislation in 1992 that limits drug costs for certain healthcare facilities. Safety-net providers can save 20-50% on drug costs by participating. To qualify, a disproportionate share hospital must meet requirements like having an 11.75% DSH percentage and maintaining separate drug inventories for 340B and non-340B patients. The Affordable Care Act expanded eligibility for the program and increased compliance monitoring.
The 340B drug pricing program was created in 1992 to provide discounts of up to 50% on prescription drugs to hospitals and clinics that treat low-income patients. However, there is growing concern that the program has strayed from its original goal. Some key issues include hospitals receiving disproportionate discounts relative to the number of low-income patients served, and contract pharmacies distributing drugs to wealthier areas without passing on savings to patients. While the intent of the program was good, its implementation may be enabling unintended consequences like profiting off drug resales rather than helping vulnerable groups as intended. Oversight groups are calling for reforms to better define eligibility and ensure the program benefits those it was designed to help.
The document discusses La Clínica de La Raza's participation in the 340B Drug Pricing Program. It provides an overview of La Clínica, an introduction to the 340B program scope and requirements. It describes potential delivery models including in-house pharmacies and contract pharmacies. It notes that the 340B program can generate savings on drug purchases for covered entities of 20-50% and revenue from the price difference between what insurers reimburse and acquisition costs. However, it cautions that the 340B program also faces potential pitfalls such as ensuring accurate pricing data, avoiding duplicate discounts, and negotiating contract pharmacy fees.
The 340B Program and Implications of the Mega GuidanceCompleteRx
As the 340B Drug Pricing Program continues to undergo changes, our team has been following all the recent updates and how they impact hospital pharmacies. This presentation goes through the latest on the long awaited guidance of proposed changes that was posted by the Federal Register on August 28, 2015.
Compliatric is excited to host the first of a two part 340B webinar series, presented by Ryan DiGiovanni, an Apexus Certified Expert (ACE) Pharmacist, President of EPL Health, and 340B Program Manager, Rush University Medical Center.
This webinar will provide evaluation tactics, operational considerations and planning required for covered entities before, and potentially after, participating in the 340B ESP platform. For the C-suite, this webinar will provide an overview of impact and implications of participation. For those involved in daily 340B program management, a more detailed breakdown of 340 ESP app usage, requirements, and resources will be discussed.
This article discusses audit readiness for hospitals participating in the 340B drug pricing program. It outlines several key areas hospitals should focus on to ensure compliance, including: 1) confirming eligibility requirements for the hospital, patients, and prescribers; 2) developing comprehensive oversight strategies and compliance monitoring programs; and 3) incorporating frequent self-audits and preparing for potential audits from the Health Resources and Services Administration. The article provides tips for audit readiness, such as establishing policies and procedures, updating databases, conducting ongoing education and monitoring, and developing a community benefit plan.
Demystifying Commercial Reasonableness in Physician/Hospital TransactionsPYA, P.C.
PYA Principal Lyle Oelrich presented “Demystifying Commercial Reasonableness in Physician/Hospital Transactions” at the Georgia Society of Certified Public Accountants’ (GSCPA) 2016 Healthcare Conference, February 11, 2016, in Atlanta, Georgia.
Watch the Webinar Here: https://compliatric.com/340b-recertification-and-audit-changes/
Compliatric is excited to host the second of a two part 340B webinar series, presented by Ryan DiGiovanni, an Apexus Certified Expert (ACE) Pharmacist, President of EPL Health, and 340B Program Manager, Rush University Medical Center.
This webinar will outline requirements and updates covered entities should be made aware of heading into annual recertification, as well as highlight key changes to HRSA’s audit data submission and review process.
Investments in Behavioral Health: Drivers and Outlook - Behavioral Health Cra...Epstein Becker Green
Webinar by attorney Purvi Maniar of Epstein Becker Green - April 5, 2016. Part of the Behavioral Health Crash Course Webinar Series.
This webinar will provide:
* A discussion of the main drivers of growth in investment in behavioral health, including the focus on population health management and mental health parity laws
* The outlook for providers of behavioral health services, including an overview of areas of legal focus and potential competition
http://www.ebglaw.com/events/investme...
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
This document summarizes a panel discussion on improving utilization of prescription drug monitoring programs (PDMPs). The panel will discuss current practices for interstate sharing of PDMP data, strategies for integrating PDMP data into healthcare records, and lessons from Washington state's program providing organizations access to PDMP data. The goal is to identify best practices that can be implemented in other states to increase interoperability and utilization of PDMP data.
Multiple Contract Pharmacies in a Disproportionate Share Hospital Systemanthonylesser
This document summarizes a presentation about the Harris County Hospital District's (HCHD) use of multiple contract pharmacies through an Alternative Methods Demonstration Project (AMDP). HCHD operates three major hospitals and 15 ambulatory pharmacies serving over 1.6 million outpatient visits per year. It applied for an AMDP in 2006 to use an off-site automated central fill pharmacy in Fort Worth to increase efficiency and patient access. The central fill pharmacy now fills 70% of prescriptions using a closed formulary. HCHD realized operational efficiencies, improved wait times, and was able to reduce staff while maintaining compliance.
The 340B Drug Discount Program was enacted by Congress to provide discounted drugs to safety net hospitals serving low-income, uninsured patients. However, there is growing concern that many hospitals are using the program to increase profits by selling the discounted drugs at full prices to private insurers, rather than helping needy patients as intended. Federal oversight of the 340B program has been inadequate, allowing covered entities to serve wealthier communities and generate large profits from the sale of discounted drugs. While the Affordable Care Act expanded the program, it also doubled the expected drug purchases and increased oversight is needed to ensure the program benefits its intended patients.
Information Exchange Workgroup Provider Directory Task Force 1-24-11 Brian Ahier
The document summarizes the results of a survey conducted by CAQH and eHI regarding important data elements needed for healthcare provider directories used by health information exchanges (HIEs). Key findings from the survey include that respondents desire granular provider data and see health plans as the most authoritative source of provider data. Respondents indicated frequent provider data updates are needed and advocated for direct provider involvement in updates. A majority of respondents believe providers should control secondary use of their directory data.
This document summarizes a presentation on preparing for oversight from government agencies such as Congress, the Government Accountability Office (GAO), and the Office of the Inspector General (OIG). It discusses recent oversight hearings from Congress on drug pricing and reviews recent reports from the GAO and OIG work plans related to drug pricing and the 340B drug discount program. The presentation advises pharmaceutical companies to identify risk areas, ensure documentation is in order, and be prepared to interact with government agencies. It also suggests opportunities in the clinical laboratory industry under the Protecting Access to Medicare Act.
This document summarizes a presentation about healthcare compliance for skilled nursing facilities (SNFs). It discusses the impact of Office of Inspector General (OIG) audits finding high rates of billing errors in SNF Medicare claims. It reviews the Program for Evaluating Payment Patterns Electronic Report (PEPPER), which analyzes SNF claims data to identify outlier facilities. It emphasizes the importance of SNFs developing compliance programs to regularly audit claims and ensure appropriate billing. It also notes increased government scrutiny of healthcare fraud and changes to false claims acts that expand liability for incorrect billing.
Indegene provides competitive intelligence and analytics solutions for life sciences, payers, and providers to improve health outcomes and business performance. It offers solutions across various areas like risk and quality management, clinical effectiveness, medical solutions, marketing solutions, and population health management. Indegene leverages proprietary medical analytics frameworks, a suite of platforms, global operational expertise, and medical expertise to drive insights. It has over 3,000 employees globally with delivery centers in several countries. Indegene receives recognition from industry analysts for its capabilities in life sciences sales, marketing, and strategic consulting.
Helping Pharmas Manage Compliance Risks for Speaker ProgramsCognizant
To avoid stiff fees, reputation damage and the imposition of corporate integrity agreements (CIAs), pharmaceuticals companies need to monitor their speaker programs carefully for compliance to a suite of regulations. We identify those rules and outline a rigorous process based on relevant key performance indicators (KPIs) that will enable pharmas to head off these potential major hits to their bottom line.
“CARES Act Provider Relief Fund: Opportunities, Compliance, and Reporting”PYA, P.C.
PYA Principal Martie Ross spoke at the virtual North Carolina Healthcare Association Critical Access Hospital Statewide Meeting. The two-day event, “Quality Focus is a Finance Focus,” provided critical access hospital leaders with the opportunity to network and review data-informed strategies as well as updates to the Medicare Flexibility Program Project. It also provided guidance on federal compliance and tracking of Provider Relief Funds.
In “CARES Act Provider Relief Fund: Opportunities, Compliance, and Reporting,” Martie gave an overview of the history of distribution of those funds as well as regulations and guidelines including:
Statutory Language
Reporting Requirements
Use of Funds Calculation
Expenses
Risk Management
Martie presented Thursday, March 4, 2021.
If you would like guidance related to Provider Relief Fund regulations, or for assistance with any matter related to strategy and integration, compliance, or valuation, contact one of our PYA executives at (800) 270-9629.
PYA Presented on 2021 E/M Changes and a CARES Act Update During GHA Complianc...PYA, P.C.
The Georgia Hospital Association (GHA) Compliance Officers Roundtable, an active GHA group that meets quarterly and includes educational sessions featuring government representatives, industry experts, and other thought leaders speaking about compliance-related issues, conducted their latest meeting virtually. PYA Principals Lori Foley, Tynan Kugler, and Valerie Rock were among the presenters at this quarter’s event. In their session, they:
Described key elements associated with 2021 E/M changes, and strategies for preparation and implementation.
Explained the impact of 2021 E/M changes on physician compensation and contracting, including potential mitigation approaches.
Presented key components of Stark Law and Anti-Kickback Statute final rules.
Provided an update on the CARES Act.
The Compliance Certification Board offered CEUs for this event, which took place on Friday, December 4, 2020.
Webinar: “Trick or Treat? October 22nd Revisions to Provider Relief Fund Repo...PYA, P.C.
On October 22nd, the Department of Health and Human Services released revised Provider Relief Fund (PRF) reporting requirements. Under HHS’ September 19 directive, “lost revenue” was defined narrowly as a negative change in year-over-year patient care operating net income. Now, HHS will permit providers to use PRF funds to cover the difference between their 2019 and 2020 actual patient care revenue with some adjustments for COVID-related expenses. The October 22nd notice is available here.
PYA Principals Martie Ross and Michael Ramey hosted a complimentary 30-minute webinar, “Trick or Treat? October 22nd Revisions to Provider Relief Fund Reporting Requirements” on Thursday, October 29th.
“Regulatory Compliance Enforcement Update: Getting Results from the Guidance” PYA, P.C.
PYA Principal and Chief Compliance Officer Shannon Sumner and Consulting Senior Manager Susan Thomas presented “Regulatory Compliance Enforcement Update: Getting Results from the Guidance” at the virtual 2020 Montana Healthcare Conference. They reviewed the sources of regulatory enforcement and investigation information—guidelines, statutory updates, best practices, settlements, case studies, etc.—available to healthcare organizations. They will also discuss how to interpret and implement the guidance in order to strengthen the compliance function and protect the organization. The presentation covered:
Compliance regulatory requirements for healthcare organizations.
Guidance available for consideration in organizational compliance programs.
Internal and external reporting to ensure regulatory requirements are met.
Best practices for implementation of guidance.
Case studies for illustration of guidance implementation.
“Federal Legislative and Regulatory Update,” Webinar at DFWHCPYA, P.C.
The Dallas Fort Worth Hospital Council (DFWHC) and PYA co-hosted an exclusive complimentary webinar, “Federal Legislative and Regulatory Update,” on Wednesday, September 23.
DFWHC President/CEO Stephen Love hosted a discussion with PYA Senior Manager Kathy Reep about concerns that have dropped from the radar during the last four months of COVID-19, addressing issues for which hospitals must prepare in approaching 2021. This session focused on these key areas:
Appropriate use criteria
Transparency
Site neutral payments
The future of the Medicare Trust Fund
The federal budget
Key provisions of the final rule for the inpatient prospective payment system for FY2021 and the proposed outpatient rule for CY2021
On-Demand Webinar: Compliance With New Provider Relief Funds Reporting Requir...PYA, P.C.
On September 19, the Department of Health and Human Services (HHS) published its Post-Payment Notice of Reporting Requirements. The Notice details the reporting requirements for all Provider Relief Fund (PRF) recipients that have received $10,000 or more in aggregate payments.
Under the PRF Terms and Conditions, a recipient may use the funds only for healthcare-related expenses and lost revenue attributable to coronavirus. The Notice provides the clearest direction to date regarding permissible uses of PRF funds.
PYA offered a 45-minute complimentary webinar that explained the new reporting requirements and delved into permissible uses. While many questions remain, we provided practical advice on the next steps in the reporting process.
The webinar took place Monday, October 5 at 11 a.m. EDT.
Webinar: “While You Were Sleeping…Proposed Rule Positioned to Significantly I...PYA, P.C.
The proposed rule would significantly impact physician compensation by re-valuing outpatient E/M services. It increases reimbursement for E/M codes but reduces the conversion factor, resulting in higher payments for some specialties and lower payments for others. This redistribution could increase revenue for specialists providing many E/M services but decrease revenue for proceduralists. Employers may need to adjust physician contracts to account for these changes. The rule also introduces new E/M guidelines and codes effective 2021, requiring preparation from medical practices.
Webinar: “Cybersecurity During COVID-19: A Look Behind the ScenesPYA, P.C.
Cybersecurity breaches have been in the news almost daily for some time now. COVID-19 has amplified the problem, as “bad actors” seize upon the opportunity to take advantage of hospitals at their most vulnerable time. Given this climate and an aging HIPAA rule, it is difficult to anticipate and prepare for the future.
PYA Principal Barry Mathis presented “Cybersecurity During COVID-19: A Look Behind the Scenes,” on Wednesday, August 12, 2020. This one-hour, complimentary webinar was hosted by PYA in conjunction with the Montana Hospital Association as Part 2 of the Frontier States Town Hall Meeting.
Barry covered information related to HIPAA, cybersecurity, and a special behind-the-scenes view into the tradecraft of bad actors. This unique presentation included:
Recent enforcement trends by the Office for Civil Rights.
The current environment for ransomware.
An opportunity to watch as Barry logs onto the Dark Web and shows you first-hand how bad actors operate.
Ideas for managing cybersecurity threats.
On Friday, August 21, 2020, a webinar co-hosted by PYA prepared hospitals for a new rule taking effect on January 1, 2021, to address price transparency in healthcare. The Centers for Medicare & Medicaid Services published a rule in November 2019 requiring hospitals to establish, update, and make public a list of their standard charges for items and services they provide. In addition to the current requirement to post standard charges on their websites, the Final Rule requires hospitals to publish online, in a machine-readable format, their payer-specific negotiated rates for 300 “shoppable” services and their standard charges for all items and services provided, defined as the gross charge, payer-specific negotiated charges, discounted cash price, and the de-identified minimum and maximum charges.
As we approach January 2021, it is vital that hospitals understand the requirements of the pricing transparency rule and options for compliance. It is unlikely that this rule will “go away”–court decisions are always subject to appeal, and there is even concern that Congress is considering action that would transform these requirements from regulation to legislation.
During the complimentary webinar, PYA Senior Manager Kathy Reep discussed hospital requirements related to pricing transparency, and Chris Kenny, Partner in the Washington, D.C., office of King & Spalding, addressed concerns related to compliance and the legal challenges associated with the final transparency rule.
This webinar was presented in conjunction with:
Dallas-Fort Worth Hospital Council
Florida Hospital Association
Georgia Hospital Association
Kansas Hospital Association
Louisiana Hospital Association
Montana Hospital Association
Not a surprise to most — healthcare is making headlines on an international level. Though not front and center, still of importance to the hospital community are issues working their way through government agencies and the legislature.
As one of the keynote speakers of this year’s virtual Florida Institute of CPAs Health Care Industry Conference, PYA Senior Manager Kathy Reep presented a “Federal Legislative and Regulatory Update.” She covered a number of current issues affecting healthcare providers, including:
Price transparency.
Congressional action on surprise billing.
The Administration’s budget for 2021.
Medicare proposed rules related to hospital inpatient payments and post-acute care for FY2021.
The virtual event took place June 23-24, 2020.
Webinar: Post-Pandemic Provider Realignment — Navigating An Uncertain MarketPYA, P.C.
The COVID-19 pandemic will materially affect U.S. provider industry structure, as financial weaknesses are exposed, risk tolerances are tested, and uncertainties persist. As a result, provider mergers-and-acquisitions (M&A) activities across industry sectors will likely spike in the short- to medium-term future. Providers of all types need to be aware of, and prepared for, the changes they will face.
In this 45-minute joint webinar, PYA Principal Brian Fuller and Juniper Advisory Managing Director Jordan Shields provided a real-time assessment of the COVID-19 pandemic, as well as shared predictions for what the extending crisis means in coming years for M&A activity in the provider space.
The webinar took place Thursday, August 6, 2020, at 11 a.m. EDT.
Since March, PYA experts have closely tracked and carefully evaluated the pandemic’s impact on employed physician compensation. During this complimentary one-hour webinar, PYA Principals Angie Caldwell and Martie Ross highlighted five immediate considerations for hospitals and health systems to manage the storm. They also explored five longer-term considerations impacting future planning.
This webinar took place Friday, July 24, 2020, at 11 a.m. EDT, and was held in conjunction with:
Dallas-Fort Worth Hospital Council
Florida Hospital Association
Kansas Hospital Association
Montana Hospital Association
The COVID-19 pandemic has exposed organizational and industry weaknesses. To build a more resilient delivery system, leaders now must engage their governing boards in re-calibrating strategic plans, re-evaluating investments, and re-imagining hospitals’ and health systems’ roles in their communities.
In this 45-minute webinar, PYA Principals Martie Ross and Brian Fuller provided a framework for these critical discussions including root-cause analysis, market assessment, new realities, guiding principles, and strategic and operational priorities.
This webinar originally took place on Wednesday, June 24, 2020.
Webinar: Free Money with Strings Attached – Cares Act Considerations for Fron...PYA, P.C.
PYA, in conjunction with the Montana Hospital Association, recently co-hosted a Frontier States Town Hall Meeting webinar, “Free Money With Strings Attached: CARES Act Considerations for Frontier States’ Healthcare Provider Organizations.” Principals Lori Foley, Martie Ross, and David McMillan introduced the CARES Act Provider Relief Fund including distribution formulas, the attestation process, the verification and application process, and ongoing recordkeeping requirement. They also answered attendees’ numerous questions regarding these matters.
Webinar: “Got a Payroll? Don’t Leave Money on the Table”PYA, P.C.
Under the CARES Act, every employer with a payroll has an opportunity to retain cash–whether they have a PPP loan or not. What employers need to know right now.
The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) along with the Payroll Protection Program (PPP) offer all business owners relief, but the details can be confusing or overlooked.
Perhaps you don’t fully understand how the deferral of the employer’s share of Social Security taxes works. Maybe you wonder if the deferral even applies to you—good news, it does if you have a payroll!
Failure to fully understand your options could cost you money, at a time when “cash is king.”
As part of PYA’s ongoing commitment to sharing helpful guidance, Tax Principals Debbie Ernsberger and Mark Brumbelow outlined issues and opportunities within the CARES Act, and answered questions during a one-hour webinar that originally aired on Wednesday, May 20, 2020.
Webinar: So You Have a PPP Loan. Now What?PYA, P.C.
The CARES Act provides relief to small businesses through Paycheck Protection Program (PPP) loans, but receiving the loan is only the first part of the equation. PYA discussed what businesses need to know and do next.
Failure to fully understand the requirements for PPP loan forgiveness could cost employers money, at a time when every penny counts. Employers need to stay up-to-date on recent activities regarding the PPP loan forgiveness application, necessary documentation, and other best practices to ensure they are well-prepared for the next steps under the PPP.
As part of PYA’s ongoing commitment to sharing helpful guidance, Tax Principals Debbie Ernsberger and Mark Brumbelow outlined PPP loan forgiveness requirements and answered questions during a one-hour webinar on Wednesday, June 3, 2020.
Webinar: “Making It Work—Physician Compensation During the COVID-19 Pandemic”PYA, P.C.
What to do with your physician compensation plan in the face of the COVID-19 pandemic? It’s a question that leaves administrators searching for answers.
PYA Principal Angie Caldwell and Senior Manager Katie Culver introduced several key considerations for provider compensation during and after the COVID-19 pandemic. In PYA’s complimentary webinar, they:
Summarized the current environment impacting physician compensation associated with the pandemic.
Provided an overview of the Stark Blanket Waivers and opportunities created for physician compensation.
Described restoration and recovery strategies for physician resources.
PYA hosted this one-hour webinar Tuesday, April 28, 2020, at 11 a.m. EDT in conjunction with the Florida Hospital Association.
Webinar: “Provider Relief Fund Payments – What We Know, What We Don’t Know, W...PYA, P.C.
The document provides information on the $100 billion Provider Relief Fund established by the CARES Act to reimburse healthcare providers for expenses or lost revenues attributable to COVID-19. It summarizes that $30 billion has been distributed based on providers' 2019 Medicare billings, with no repayment obligation. It outlines the attestation process to accept funds within 30 days and confirms that providers must comply with terms including using funds only for COVID-19 care and not balance billing uninsured patients. The document advises on accounting, compliance, and tax implications of the relief funds.
Webinar: “Hospitals, Capital, and Cashflow Under COVID-19”PYA, P.C.
Hospitals and providers need to think creatively, strategically, and long-term about capital and cashflow under the pressures of the COVID-19 pandemic. A one-hour webinar hosted by PYA discussed the current state of capital markets for non-profit healthcare systems, and considerations for capital management, including the role of real estate assets.
PYA Principal Michael Ramey joined Realty Trust Group Senior Vice-President Michael Honeycutt and Ponder & Company Managing Director Jeffrey B. Sahrbeck to present “Hospitals, Capital, and Cashflow, Under COVID-19” In this webinar, they covered:
Hospital industry capital market updates and trends, including how the capital markets are responding to the crisis.
Access to capital under recent regulations.
Cash preservation techniques for hospitals considering real estate operations and assets.
The webinar took place Thursday, April 9, 2020, at 11 a.m. EDT.
PYA Webinar: “Additional Expansion of Medicare Telehealth Coverage During COV...PYA, P.C.
Late on March 30, CMS released an interim rule which, among other things, significantly expands Medicare telehealth coverage, even beyond the initial Section 1135 waivers. PYA’s complimentary one-hour webinar explained these changes and how they make telehealth an even more attractive option in response to the COVID-19 pandemic.
PYA Principals Martie Ross and Valerie Rock addressed the latest developments, including:
New reimbursement for telephone-only services.
Broader coverage for remote patient monitoring.
New payments for rural health clinics and federally qualified health centers.
Use of telehealth to meet supervision requirements.
New rules regarding coding and billing as well as the changed payment rates for telehealth services.
The webinar took place Friday April 3, 2020, at 11 a.m. EDT.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Unlocking the Secrets to Safe Patient Handling.pdfLift Ability
Furthermore, the time constraints and workload in healthcare settings can make it challenging for caregivers to prioritise safe patient handling Australia practices, leading to shortcuts and increased risks.
About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
Hypertension and it's role of physiotherapy in it.Vishal kr Thakur
This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
Dr. David Greene R3 stem cell Breakthroughs: Stem Cell Therapy in CardiologyR3 Stem Cell
Dr. David Greene, founder and CEO of R3 Stem Cell, is at the forefront of groundbreaking research in the field of cardiology, focusing on the transformative potential of stem cell therapy. His latest work emphasizes innovative approaches to treating heart disease, aiming to repair damaged heart tissue and improve heart function through the use of advanced stem cell techniques. This research promises not only to enhance the quality of life for patients with chronic heart conditions but also to pave the way for new, more effective treatments. Dr. Greene's work is notable for its focus on safety, efficacy, and the potential to significantly reduce the need for invasive surgeries and long-term medication, positioning stem cell therapy as a key player in the future of cardiac care.
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MBC Support Group for Black Women – Insights in Genetic Testing.pdfbkling
Christina Spears, breast cancer genetic counselor at the Ohio State University Comprehensive Cancer Center, joined us for the MBC Support Group for Black Women to discuss the importance of genetic testing in communities of color and answer pressing questions.
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardso...rightmanforbloodline
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK For Accounting Information Systems, 3rd Edition by Vernon Richardson, Verified Chapters 1 - 18, Complete Newest Version
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
Let's Talk About It: Breast Cancer (What is Mindset and Does it Really Matter?)bkling
Your mindset is the way you make sense of the world around you. This lens influences the way you think, the way you feel, and how you might behave in certain situations. Let's talk about mindset myths that can get us into trouble and ways to cultivate a mindset to support your cancer survivorship in authentic ways. Let’s Talk About It!
Can Allopathy and Homeopathy Be Used Together in India.pdfDharma Homoeopathy
This article explores the potential for combining allopathy and homeopathy in India, examining the benefits, challenges, and the emerging field of integrative medicine.
Under Pressure : Kenneth Kruk's StrategyKenneth Kruk
Kenneth Kruk's story of transforming challenges into opportunities by leading successful medical record transitions and bridging scientific knowledge gaps during COVID-19.
1. Tennessee Society of CPAs 2017 Health Care Conference
Tuesday, November 27, 2017
Presented by:
Shannon Sumner, CPA, CHC,® Principal
Journey to 340B Compliance