Short answer What is remote patient monitoring in Medicare’s terms? Remote patient monitoring is paid for as a professional service, not as a device, and Medicare states plainly that it is not a telehealth service. That matters because the telehealth rules carry expiry dates and these do not. A blood pressure reading leaves a cuff …
Short answer Who can see your health data when AI touches it? Who can see your health data when AI touches it depends on who is holding it. The federal health privacy rule covers exactly three kinds of holder: a health plan, a clearinghouse, and a provider who bills electronically. A watch company is none …
Short answer How does state AI law reach older adults? State AI law reaches older adults without naming them. No state has written an act aimed at older people; they are covered through categories like consequential decisions about health care and housing. Colorado’s act is the furthest along, and it was repealed and reenacted in …
State AI Law and Older Adults: Reached, Not Named Read More »
Short answer What does the law mean by care at a distance? Care at a distance is not one thing in law. A technology is sorted into a benefit category first, and the category decides the rules. A service delivered by a person follows one rulebook. A thing supplied to a home follows another. A …
Short answer Who decides what Medicare and Medicaid pay for? Four separate programs decide what Medicare and Medicaid pay for, and each sets a different floor for who must sign a denial. Medicare Advantage needs a licensed clinician. Medicaid managed care needs only a person with appropriate expertise. Regular Medicaid sets no rule at all. …
SILVER SPRING, MD – There is now a written rulebook for software that suggests you may have a heart condition. The FDA published it on 11 September 2026. It took effect the same day. The rule does two things at once. It makes this kind of software easier to bring to market. And it sets …
Software That Flags a Heart Problem Now Has Its Own Rulebook Read More »
WASHINGTON – Social Security has rewritten the medical rules it uses to decide disability claims involving the heart and the blood vessels. They take effect on 30 October 2026. The new criteria will not wait for new applications. The rule names both groups. Here is the sentence that does it. “to new applications filed on …
Social Security Rewrites Its Heart Disability Rules Read More »
Short answer Where do Medicaid managed care rules actually live? Medicaid managed care rules live in title 42 of the Code of Federal Regulations, part 438, which holds eleven subparts. Grievances and appeals sit in subpart F. The rule on who may deny a service sits at section 438.210, inside subpart D. Hunting a rule …
WASHINGTON – Medicare began reviewing a list of procedures in advance in six states on 1 January 2026. The companies that grant or refuse that review are paid out of money Medicare does not spend. That is not an allegation. It is in the government’s own notice. The Federal Register notice says participants are “compensated …
What Medicare’s AI Prior Authorization Pilot Actually Does Read More »
Short answer Which five parts decide what Medicare pays? Five parts of Title 42 carry most Medicare payment questions. Part 405 holds claims and appeals, part 409 hospital benefits, part 410 doctor and outpatient benefits, part 422 Medicare Advantage, part 424 the conditions for payment. Part 424 names 409 and 410 by number. Somewhere in …
