Sheppard Health Law

NOVEMBER 2, 2023

According to the Congressional Research Service, which analyzed data from the Centers for Medicare & Medicaid Services (“CMS”) National Health Expenditure Accounts (“NHEA”) on the personal health expenditures for LTSS by payer, in 2021, an estimated $467.4 billion was spent on LTSS. This represents 13.2% of LTSS spending. [5]

Medicaid 52

Medicaid Medicare Accountability Nursing 52

NASHP

APRIL 15, 2022

CalAIM: Leveraging Medicaid Managed Care for Housing and Homelessness Supports April 15, 2022 / by Allie Atkeson. Driven by challenges facing individuals with complex care needs, states are increasingly working to address the physical, behavioral, and social needs of their Medicaid beneficiaries. Download the report (PDF).

Medicaid 59

Medicaid Public Hospital Hospitals Nursing 59

NASHP

DECEMBER 10, 2021

The information on this map comes from a 50-state survey of a variety of stakeholders, ranging from Medicaid officials to Community Health Workers, on their states’ approaches?to?integrating?CHWs ACO Accountable Care Organizations. CDC Centers for Disease Control and Prevention. MHP Medicaid Health Plans. integrating?CHWs

Medicaid 122

Medicaid Primary Care Prevention Nursing 122

Bill Of Health

OCTOBER 27, 2023

To illustrate the issue, consider that the Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA) expressly covers genetic information as a form of health data. The FTC can also make rules to help prevent data breaches before they occur, and is in fact moving towards formal rulemaking in consumer privacy.

Biotechnology 62

Biotechnology Regulations Medical Services Health Data 62

Sheppard Health Law

JUNE 2, 2023

Thus, the Court reversed the circuit court, finding that a FCA defendant “could have the scienter required by the FCA if they correctly understood [the regulation] and thought that their claims were inaccurate. Such documentation could prevent or abbreviate investigational scrutiny and mitigate FCA disputes down the road.

Regulations 52

Regulations Accountability Medicaid Prevention 52

Briggs Healthcare

MARCH 2, 2022

“The purpose of this primer is to provide updated information to the patient safety community about the challenges of ensuring the safe care of older adults in Medicare and Medicaid certified nursing homes (NHs) associated with the COVID-19 pandemic, and the federal and state efforts taken to mitigate these challenges. Conclusion.

Nursing 98

Nursing Patient Safety Quality of Care Regulations 98

Sheppard Health Law

MAY 31, 2022

However, traditional healthcare players, subject to the Health Insurance Portability and Accountability Act (“HIPAA”), may also find themselves innovating in this space (and grappling with how to stand up a HIPAA compliance program in the metaverse). Medical Device Regulations. 1, 2021). [2]

Regulations 90

Regulations Life Sciences Medicare Healthcare 90

NASHP

MARCH 22, 2024

As major purchasers, administrators, and regulators of behavioral health treatment and supports, states play a critical role in system transformation. Invest in prevention and early intervention. In Colorado , Medicaid leverages its medical loss ratio (MLR) policies to incentivize MCOs’ performance. See the full resource guide.

Medicaid 52

Medicaid Urgent Care Primary Care Hospitals 52

NASHP

APRIL 24, 2023

State innovations in Medicaid (now the largest public payer of behavioral health care) along with strategic deployment of federal grants have provided a foundation for the behavioral health safety net. But the system remains fragmented and strained under the twin crises of mental illness and escalating overdose deaths.

Medicaid 52

Medicaid Integration Prevention Urgent Care 52

Briggs Healthcare

AUGUST 19, 2022

Lebanon had “sufficient” nursing staff to meet residents’ needs and that the facilities were operating and providing services in compliance with all applicable Federal, State, and local laws, regulations, and codes. Counts Ten through Twelve charge Gilbert and Mt.

Nursing 74

Nursing Rehabilitation Medicaid Medicare 74

NASHP

OCTOBER 20, 2022

have a special health care need, and an estimated 44 percent of CYSHCN are enrolled in Medicaid.[7] public health, Medicaid, mental health) and other stakeholders (e.g., Reimbursing parent consultants as CHWs through Medicaid, including through Medicaid managed care and fee-for-service approaches.

Medicaid 98

Medicaid Integration Accountability Quality Improvement 98

Bill Of Health

NOVEMBER 9, 2023

Despite efforts to increase access to health care and to better incentivize high-quality, value-based care, the United States’ health care system remains fragmented, largely profit-based, and predominantly disease-focused rather than prevention-focused. America is the only wealthy nation to lack universal health coverage.

Medicaid 62

Medicaid Pharmaceuticals Prevention Quality of Care 62

Etactics

DECEMBER 1, 2023

Preventing denial codes is essential if you want to keep a steady revenue flow. This is an easily preventable billing error, which we are going to go over in this blog. These codes assist healthcare workers in reporting different medical procedures and services to health insurance programs, such as Medicare and Medicaid.

Medicare 52

Medicare Medicaid Medical Services Prevention 52

Etactics

OCTOBER 27, 2023

Let’s go over what medical identity theft is, its consequences, and how to prevent it. Insurance account number or Medicare number. Exclusion from Medicare and Medicaid. How You Can Prevent Medical Theft When it comes to preventing medical identity theft, healthcare providers play an important part in safeguarding PHI.

Prevention 52

Prevention Accountability Healthcare Providers Medicare 52

Etactics

AUGUST 4, 2023

Luckily, we have the Health Insurance Portability and Accountability Act (HIPAA). HIPAA is a federal regulation that protects the privacy and security of PHI. No matter what type of media the information is on, such as on a computer or paper, your company must adhere to HIPAA rules and regulations to protect it. Audit controls.

Regulations 52

Regulations Accountability Healthcare Providers Integration 52

NASHP

NOVEMBER 29, 2021

Medicaid Reimbursement. Medicaid Reimbursement. Alabama does not reimburse for CHW services through its Medicaid program. Alaska Medicaid reimburses for CHW services through MCOs as authorized under the state plan. Arizona does not currently reimburse for CHW services through its Medicaid program.

Medicaid 52

Medicaid Primary Care Prevention Nursing 52

Bill Of Health

OCTOBER 26, 2022

In the post- Dobbs fight to safeguard reproductive healthcare, a new spotlight has been placed on two existing federal laws: the Health Insurance Portability and Accountability Act (HIPAA) and the Emergency Medical Treatment and Active Labor Act (EMTALA). . Becerra prevented the enforcement of CMS’ EMTALA Guidance in Texas.

Medicaid 73

Medicaid Medicare Hospitals Health Data 73

Briggs Healthcare

AUGUST 19, 2022

The Centers for Medicare & Medicaid Services (CMS) plays an important role in protecting the health and safety of all Americans as they journey through the health care system. There’s a lot of information in the CMS Blog. This is especially true during a pandemic, natural disaster, or other emergencies. and Arjun Srinivasan, M.D.,

Medicaid 40

Medicaid Medicare Nursing Rehabilitation 40

NASHP

DECEMBER 7, 2022

The executive and legislative branches both play a critical role in setting forth policy vision and codifying policies in statute and regulation. Department of Health and Human Services, development of federal policy recommendations, and a Government Accountability Office report on the success of the activities. In May 2022, the U.S.

Primary Care 72

Primary Care Nursing Prevention Hospitals 72

Icanotes

NOVEMBER 21, 2021

The treatment plan's purpose is to properly account for a patient's mental, psychological and emotional needs concerning substance abuse. Achievable: Attainable goals that prevent a patient from feeling overwhelmed or burdened. A patient's goals should also take their extent of substance dependence and support networks into account.

Accountability 52

Accountability Prevention Regulations Patient Experience 52

Home Health Care

DECEMBER 7, 2021

Mostly, though, the Obama-era regulation has ended up decreasing the amount of live-in care that home care agencies provide. For now, home care providers are stymied by Medicaid wages, which do not match the pay that would be needed for live-in care. The administration’s goal at the time was to raise caregiver wages.

Regulations 96

Regulations Home Care Law Firms Accountability 96

NASHP

MARCH 22, 2024

States such as Texas, Wyoming , and New Jersey are adopting Medicaid reimbursement of collaborative care services and are addressing capacity to transition to CoCM. Integration of Substance Use Services and Supports States can align long siloed approaches to primary care, mental health, and substance use services through integration efforts.

Medicaid 52

Medicaid Integration Primary Care Nursing 52

NASHP

DECEMBER 3, 2021

Strategies to Increase COVID-19 Vaccination Rates in Medicaid Enrollees: Considerations for State Leaders December 3, 2021. State-level data indicate that COVID-19 vaccination rates are lower among people covered by Medicaid than the general population. Executive Summary. percent) children. As the majority (61.1

Medicaid 98

Medicaid Primary Care Medicare Accountability 98

Etactics

AUGUST 19, 2021

This chews up lots of time for physicians and prevents them from seeing more patients. Over 50% of doctors work 50-80 hours per week (Pacific Companies) Most physicians work 51-60 hours per week, but this only accounts for 26% of physicians. Another quarter work 60-80 hours, so a majority work between 50-80 hours. hours per week.

Doctors 52

Doctors Nursing Primary Care Healthcare 52

NASHP

DECEMBER 20, 2022

States are taking steps to provide additional prevention, treatment, and recovery services to higher-risk individuals with opioid use disorder (OUD), including those in contact with the criminal legal system. Community Services and Prevention (Intercept 0). Across states, drug violations have led to most arrests in recent years.

Medicaid 52

Medicaid Prevention Integration Hospitals 52

Home Health Care

OCTOBER 31, 2022

Centers for Medicare & Medicaid Services (CMS) released its FY 2023 home health final payment rule late Monday. The Preserving Access to Home Health Act, which would prevent further home health cuts until 2026, was introduced in the House and Senate earlier this year.

Medicare 132

Medicare Medicaid Home Care Accountability 132

Home Health Care

DECEMBER 19, 2021

Occupational Safety and Health Administration (OSHA) regulation requiring workers at companies with 100 or more employees to be vaccinated against COVID-19 or undergo weekly testing has been revived. The Biden administration projects the mandate will save 6,500 lives and prevent 250,000 hospitalizations over six months.

Regulations 105

Regulations Medicaid Medicare Accountability 105

Sheppard Health Law

JANUARY 6, 2023

In addition to funding, the Act modifies certain telehealth provisions, expands and extends components of the Medicare and Medicaid programs, and supports initiatives within the behavioral health and substance use treatment spaces. Medicaid & CHIP Adjustments. Medicaid Improvement Fund. The Act provides for nearly $1.7

Healthcare 52

Healthcare Medicaid Medicare Hospitals 52

Health Populi

OCTOBER 8, 2019

Thus, administrative complexity, which includes billing and coding waste, and physician time spent reporting on quality measures, accounted for the largest component of waste in American health care. Pricing failure as a waste-factor accounted for nearly another third of total waste in U.S. medical spending. health care. patients).

Pharmaceuticals 108

Pharmaceuticals Life Sciences Medicare Accountability 108

Health Populi

JULY 2, 2024

The FAS asserts that we need regulatory frameworks, investment in AI accessibility, incentives for data collection and collaboration, and regulations for auditing and governance of AI systems used in CDS systems/tools. The FAS notes that the Medicare and Medicaid programs in the U.S.

Accountability 62

Accountability Regulations Medicaid Healthcare 62

Home Health Care

OCTOBER 11, 2021

How can we help our customers deliver the most efficient care — hence, Careficient — they can while navigating them through the stringent regulator environments we are forced to operate in today? Earlier I mentioned that our staff is nimble, and part of that is that the salesperson becomes the client’s account manager.

Home Care 98

Home Care Accountability Regulations Medicaid 98

Vie Healthcare

MAY 4, 2023

And as you know, obviously a huge percentage of healthcare spending is funded through Medicare, Medicaid, Tricare, the VA system, and these are all programs that are covered by the False Claims Act. It’s a highly regulated industry. So the actual amount of fraud is probably some multiple of that. Great point.

Healthcare 52

Healthcare Nursing Hospitals Doctors 52

Sheppard Health Law

NOVEMBER 13, 2023

On November 6, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released the contract year 2025 proposed rule for Medicare Advantage (“MA”) organizations and Part D sponsors (the “Proposed Rule”). Please refer to our January 5, 2023 , November 4, 2022 and May 16, 2022 blog posts for more information.

Medicare 59

Medicare Medicaid Regulations Integration 59

NASHP

JUNE 22, 2022

public health, Medicaid, mental health) and other stakeholders (e.g., State Medicaid agencies. Medicaid managed care contracts). By using funds from each department to support Medicaid eligible services such as behavioral health care and housing supports, the CSA draws down federal Medicaid funding. [6]

Care Transition 52

Care Transition Medicaid Doctors Regulations 52

Sheppard Health Law

AUGUST 25, 2022

Nonetheless, additional clarification in the form of regulations is anticipated, as the text of the IRA defers multiple matters to the Department of Health and Human Services (“HHS”) for implementation. Improvement of Access to Adult Vaccines under Medicaid and CHIP. Medicare Drug Price Negotiation Program. Negotiation Process.

Healthcare 52

Healthcare Medicare Pharmaceuticals Medicaid 52