On May 21, 2025, the Centers for Medicare and Medicaid Services (“CMS”) announced a significant expansion of its auditing efforts with respect to Medicare Advantage (“MA”) plans....more
SB 1120 (the “Bill”), which takes effect on January 1, 2025, amends existing California law to adopt guardrails around the use of artificial intelligence tools for the purpose of utilization management. As discussed in a...more
12/24/2024
/ Algorithms ,
Anti-Discrimination Policies ,
Artificial Intelligence ,
Audits ,
California ,
Centers for Medicare & Medicaid Services (CMS) ,
CMIA ,
Health Insurance ,
Health Insurance Portability and Accountability Act (HIPAA) ,
Healthcare ,
Medical History ,
Medicare Advantage Organizations (MAOs) ,
New Legislation ,
Personal Information ,
Physicians ,
Policies and Procedures ,
Software
On April 22, 2024, the Office for Civil Rights (OCR) for the United States Department of Health and Human Services issued a Final Rule amending the Privacy Rule of the Health Insurance Portability and Accountability Act...more
6/24/2024
/ Attestation Requirements ,
Audits ,
Covered Entities ,
Department of Health and Human Services (HHS) ,
Dobbs v. Jackson Women’s Health Organization ,
False Claims Act (FCA) ,
Final Rules ,
Health Insurance Portability and Accountability Act (HIPAA) ,
HIPAA Privacy Rule ,
HIPAA Violations ,
Medicaid ,
Medicare ,
OCR ,
OIG ,
Patients ,
PHI ,
Popular ,
Reproductive Healthcare Issues ,
SCOTUS