Home Health Care

OCTOBER 25, 2024

This article is a part of your HHCN+ Membership The Federation of American Hospitals (FAH) released a statement Thursday regarding recent investigations into Medicare Advantage (MA) plans. Those investigations included concerns around claim denials, as well as discrepancies between MA plan practices when compared to traditional Medicare.

Medicare 88

Medicare Accountability Hospitals Regulations 88

Healthcare It News

MARCH 18, 2022

In fact, digital health companies only account for less than $10 billion of that $4 trillion in spending. Compared with Medicare or other populations, Medicaid patients often have more complex social determinants of health and can cycle in and out of beneficiary status.

Medicaid 332

Medicaid Telemedicine Hospitals Clinical Practice 332

p3care

MAY 31, 2024

An ACO (Accountable Care Organization) works for the better care of patients. Regulatory Compliance ACOS must adhere to rules set forth by government bodies such as CMS (Centers for Medicare and Medicaid Services). Complying with all these regulations helps in avoiding penalties.

Quality of Care 130

Quality of Care Doctors Medicare Patient Experience 130

Home Health Care

APRIL 28, 2023

Centers for Medicare & Medicaid Services (CMS) proposed a new rule that would make major changes to the way that home care workers are compensated under Medicaid. It’s a step towards additional transparency and accountability, including state, payer and provider,” he told HHCN. “I On Thursday, the U.S.

Medicaid 91

Medicaid Accountability Quality Assurance Home Care 91

Home Health Care

JULY 22, 2024

Even with a prediction of a “less draconian” final payment rule, NAHC is still gearing up to fight against home health cuts and the Centers for Medicare & Medicaid Services’ (CMS) payment-setting methodologies. They were telling us that because they believed [providers] were making too much profit in the Medicare program.

Regulations 108

Regulations Home Care Medicaid Medicare 108

p3care

JULY 12, 2023

Check 1: Check Your HARP Account Make sure you have an HCQIS Authorized Roles and Profile (HARP) account before beginning the procedure. This account is necessary for MIPS participants to access their organization on the official QPP website. If you do not have an account, it’s the right time for you.

Accountability 130

Accountability Regulations Healthcare Providers Medicare 130

p3care

DECEMBER 19, 2022

Persons such as Doctors, Dentists, Lawyers, Accountants, Veterinarians, Contractors, and Subcontractors who work in an independent trade, or business and provide their services to the public are generally independent contractors and self-employed. Hiring an accountant, attorney, or consultant is frequently tax-deductible benefits.

Accountability 130

Accountability Doctors Medicare Regulations 130

Health Populi

JUNE 17, 2024

You would assume that most people over 50 would be worried about the financial future of Medicare to cover health care as those middle-aged Americans age. See that the stats on pessimism running high for the prospects of wellbeing — financial, quality of life, and physical health — are greater when accounting for people under 65.

Medicare 71

Medicare Medical Services Integration Regulations 71

Briggs Healthcare

JANUARY 31, 2023

Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), finalized the policies for the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program, which is CMS’s primary audit and oversight tool of MA program payments.

Medicare 40

Medicare Accountability Regulations Medicaid 40

NASHP

AUGUST 30, 2023

The Centers for Medicare and Medicaid Services (CMS) promulgated final regulations for REHs at 87 Fed.Reg. The designation also allows REHs to offer outpatient services for Medicare patients that are approved by the secretary of the U.S. 1395x(kkk)(2). 71748 (November 3, 2022) and 88 Fed.Reg. 58640 (August 28, 2023).

Hospitals 121

Hospitals Regulations Medicare Medicaid 121

Bill Of Health

OCTOBER 26, 2021

One of the most discussed provisions in the omnibus bill would expand Medicare benefits to include hearing, vision, and dental care. Currently, millions of Americans are forced to go without the types of care that the proposed Medicare expansion would address. Still, there is no reason that history has to be destiny.

Medicare 69

Medicare Regulations Accountability Medicaid 69

HIT Consultant

APRIL 1, 2024

Improperly billed for services: The government alleges that TRG billed Medicare for radiology services performed by a radiologist located in the UK, which violates program regulations. Attorney Damian Williams.

Quality of Care 97

Quality of Care Regulations Federal Healthcare Healthcare Providers 97

Home Health Care

OCTOBER 18, 2024

The Senate Homeland Security Permanent Subcommittee on Investigations (PSI) released a report on Thursday revealing that the nation’s three largest Medicare Advantage (MA) insurers have significantly increased the rate at which they denied seniors’ post-acute care from 2020 to 2023. Founded in 1966, the Washington D.C.-based

Rehabilitation 105

Rehabilitation Regulations Medicare Hospitals 105

Briggs Healthcare

AUGUST 19, 2022

Medicare requires that a reported amount be the lower of either the actual cost to the related organization or the market price for comparable services, facilities, or supplies, thereby removing any incentive to realize profits through these transactions. This information is found here.

Nursing 104

Nursing Medicare Regulations Accountability 104

Home Health Care

FEBRUARY 8, 2024

The Centers for Medicare & Medicaid Services (CMS) wants 100% of traditional Medicare beneficiaries and the “vast majority of Medicaid beneficiaries” in accountable care relationships by 2030. Oak Street Health, which is now also owned by CVS Health, is one of these risk-bearing delivery organizations.

Medicare 108

Medicare Accountable Care Accountability Primary Care 108

HIT Consultant

MAY 2, 2023

For decades, the industry lacked a patient-centric approach focused on efficiency, reliability, and accessibility for all populations, especially those enrolled in Medicare Advantage and Medicaid plans. In a recent study , 21% of U.S. adults without access to a vehicle or public transportation skipped needed medical care last year.

Medicaid 96

Medicaid Regulations Medicare Integration 96

Home Health Care

APRIL 22, 2024

A blanket rule that fails to take into account the different factors affecting HCBS in different markets across the country was – while well intended – a poor measure, according to some of the top home-based care leaders in the country. This is a developing story.

Home Care 113

Home Care Medicaid Accountability Regulations 113

Home Health Care

MAY 24, 2024

What is surprising is that the program they continually target in budget cutbacks has an impressive record of saving the government billions: Medicare-certified home health care. Government-funded health care programs like Medicare, Medicaid and Medicare Advantage (MA) home health are closely connected in how they are financed.

Medicare 112

Medicare Medicaid Nursing Home Care 112

HIT Consultant

OCTOBER 30, 2023

Under the Medicare Shared Savings Program, a healthcare provider that is an Accountable Care Organization (ACO), ACO participant, or ACO provider or supplier would be deemed ineligible to participate in the program for a period of at least one year. “We

Medicare 98

Medicare Accountable Care Healthcare Providers Regulations 98

HIT Consultant

OCTOBER 18, 2023

Hilton Hudson, MD, FACS, and CEO of HPC International In May 2022, a California doctor was sentenced to nearly eight years in prison for his involvement in a $12 million Medicare fraud scheme. million in reimbursements from Medicare over a three-year period. He received $4.5

Regulations 105

Regulations Accountable Care Prevention Medicare 105

Home Health Care

OCTOBER 31, 2022

Centers for Medicare & Medicaid Services (CMS) released its FY 2023 home health final payment rule late Monday. aggregate decrease in 2023, which would have marked one of the steepest home health Medicare cuts in years. For providers with a Medicare certification date prior to Jan. The agency had initially floated a 4.2%

Medicare 131

Medicare Medicaid Home Care Accountability 131

Healthcare ECONOMIST

APRIL 19, 2022

First, some background on the Dutch health system: The Netherlands has organized its basic health insurance scheme according to the model of regulated competition (van de Ven et al., Also, “…Dutch regulation allows insurers to offer ‘group arrangements.’ Marketing and customer service.

Regulations 81

Regulations Accountability Pharmaceuticals Medicare 81

Home Health Care

MARCH 30, 2023

Conversely, home health care’s voices advocated with a more somber tone, concerned about worsening patient access and businesses shuttering if the Centers for Medicare & Medicaid Services (CMS) doesn’t renege on payment cuts promised for next year and beyond. Another cut incoming In CY2023, home health providers saw a 0.7%

Medicare 106

Medicare Accountability Hospitals Home Care 106

p3care

MAY 2, 2022

MIPS (Merit-based Incentive Payment System) was launched by the Quality Payment Program (QPP) for the Medicare Part B healthcare providers. Each performance category accounts for a particular percentage of the overall MIPS score, which determines how much payment adjustment a clinician will receive for the following year’s performance.

Nursing 130

Nursing Prevention Quality Improvement Regulations 130

Healthcare Success

JULY 5, 2022

You're selling a product or service regulated by the state (or county). Understanding how these compensation models may influence your target doctors and account for them is essential. You’re selling a product or service with significant state or local competition.

Doctors 157

Doctors Private Practices Accountability Hospitals 157

Home Health Care

JUNE 17, 2022

Centers for Medicare & Medicaid Services (CMS) released its FY 2023 home health proposed payment rule late Friday. It comes with a decrease to payment rates by 4.2%, or $810 million less compared to 2022 rates. That has been made clear to CMS in the 2021 rulemaking and in multiple discussions since.”

Accountability 108

Accountability Medicaid Home Care Medicare 108

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.

Regulations 90

Regulations Life Sciences Medicare Healthcare 90

Healthcare ECONOMIST

APRIL 13, 2023

Generalized risk-adjusted cost-effectiveness (GRACE) is a new method that takes into account these concerns by aligning estimates with patient preferences. Specifically, GRACE accounts for the fact that people value health gains most when facing very poor quality of life. “At

Regulations 81

Regulations Accountability Pharmaceuticals Medicare 81

Home Health Care

JANUARY 26, 2022

Centers for Medicare and Medicaid Services (CMS) stopped reimbursing InnovAge for new clients. We are committed to restoring trust with our regulators to being the leading steward of the PACE program. PACE is a Medicare and Medicaid program that helps keep people in their communities instead of nursing homes.

Regulations 89

Regulations Care Transition Medicaid Medicare 89

KHN

DECEMBER 21, 2023

” As the recall played out, federal regulators discovered that Medtronic had delayed acting — and warning patients of possible hazards with the pumps — despite amassing tens of thousands of complaints about the rings, government records show. . “No, it hasn’t,” Sharlin said.

Regulations 144

Regulations Doctors Patient Safety Accountability 144

Sheppard Health Law

MAY 16, 2022

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). With a few exceptions, the Final Rule is a wholesale codification of the proposed rule.

Medicare 52

Medicare Medicaid Accountability Integration 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 75

Nursing Patient Safety Quality of Care Regulations 75

Home Health Care

AUGUST 23, 2023

Centers for Medicare & Medicaid Services (CMS) decides to do with its home health final payment rule , industry experts believe providers need to drastically improve their cost reporting data. Over the years, Maxim said she has seen providers cutting corners firsthand when hiring accountants to put together cost reports.

Law Firms 82

Law Firms Medicaid Hospice Care Regulations 82

Sheppard Health Law

FEBRUARY 22, 2023

The Rebate Programs are administered as part of the prescription drug affordability provisions of the Inflation Reduction Act (the “IRA”), which is aimed at “lower[ing] out-of-pocket drug costs for people with Medicare and improv[ing] the sustainability of the Medicare program for current and future generations.” [1]

Medicare 52

Medicare Medicaid Pharmaceuticals Public Health services 52

HIT Consultant

AUGUST 28, 2023

Eyal Feldman is Founder & CEO of Stampli Is Accounts Payable the weakest link in your medical facility’s growth strategy? Why poor Accounts Payable practices can hinder medical facility growth Making the AP process efficient and scalable is important in any industry.

Accountability 103

Accountability Regulations Medicaid Medicare 103

HIT Consultant

NOVEMBER 29, 2022

For example, the Coronavirus Aid, Relief, and Economic Security (CARES) Act included a payment parity requirement for Medicare; and many private insurers followed suit implementing similar regulations in their commercial plans. Serrah Linares is the vice president of partner sales at Change Healthcare. About Rachel Mack Robinson.

Telemedicine 98

Telemedicine Medicaid Regulations Medicare 98

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