Sheppard Health Law

JANUARY 2, 2024

At long last, the cost and market impact review (CMIR) regulations promulgated by the California Office of Health Care Affordability (OHCA) have been approved by the California Office of Administrative Law (OAL). Who is subject to the CMIR process?

Regulations 59

Regulations Healthcare Primary Care Hospitals 59

HIT Consultant

MAY 2, 2023

Andy Auerbach, Chief Revenue Officer of SafeRide Health As the healthcare industry continues to evolve, there is a growing need for innovative solutions that not only improve the quality of care but also make care more accessible.

Medicaid 96

Medicaid Regulations Medicare Integration 96

Briggs Healthcare

MARCH 2, 2022

population live in long-term care facilities (e.g., cases, older adult residents in NHs accounted for 37% of COVID-19 deaths overall until the vaccines became available in December 2020 ( CMS COVID-19 Nursing Home Data website ). NHs and pointed out some potential gaps in the survey processes meant to insure quality of care.

Nursing 75

Nursing Patient Safety Quality of Care Regulations 75

Best Medical Billing Company | Physicians Revenue Group, Inc.

MARCH 16, 2023

As such shady operations are the biggest cause of revenue drops, in addition to the quality of care provided to patients. Compliance Confirmation With the Latest Healthcare Rules Medical practitioners must ensure their service and practice comply with the latest healthcare rules and regulations. Physicians Revenue Group, Inc.

Prevention 98

Prevention Medical Practitioners Regulations Quality of Care 98

NCQA

DECEMBER 18, 2024

Goal 2: Equip health care systems and expand effective and sustainable interventions. Lack of standardized performance measures makes it difficult to hold health systems and clinicians accountable for equitable care. NCQA believes that high-quality care is equitable care.

Quality Assurance 52

Quality Assurance Accountability Quality Improvement Pharmaceuticals 52

NCQA

JUNE 27, 2023

LTSS Distinction, for MCOs, and Case-Management for LTSS (CM-LTSS), for community-based organizations (CBO)— increase oversight of care for this vulnerable population. In July, NCQA will update these programs to further align with best practices and federal regulations. Why Should MCOs Earn LTSS Distinction?

Medicaid 52

Medicaid Care Transition Quality Improvement Regulations 52

NASHP

DECEMBER 14, 2021

As major payers of health care for those enrolled in public programs and for government employees, states have a financial interest in and justification for taking action to rein in high prices. Additionally, in their role as market regulators, policymakers recognize the need to protect consumers from unchecked hospital price growth.

Hospitals 114

Hospitals Primary Care Regulations Accountability 114

Briggs Healthcare

APRIL 7, 2022

“Nursing homes play a unique dual role in the long-term care continuum, serving as a place where people receive needed health care and a place they call home. The 1986 Institute of Medicine report Improving the Quality of Care in Nursing Homes identified a range of challenges to the quality of care in nursing homes.

Nursing 52

Nursing Quality of Care Quality Assurance Home Care 52

NASHP

JANUARY 31, 2022

Health insurance carriers and regulators are considering what the permanent adoption of telehealth policies could mean for their networks. One official noted that while telehealth visits had grown by 25 percent for specialty care, they had seen a 65 percent increase in remote behavioral health services.

Ambulatory Care 78

Ambulatory Care Quality of Care Regulations Prevention 78

Home Health Care

APRIL 23, 2024

Amid Medicaid changes, the most relevant news to home care providers is the aforementioned 80-20 provision, which will force HCBS providers to direct 80% of reimbursement to direct care workers. “We We heard many, many comments on this provision.

Home Care 99

Home Care Medicaid Law Firms Quality of Care 99

Briggs Healthcare

MARCH 10, 2022

nursing homes failed to meet the total care staff threshold (4.10 Contract staff accounted for 7.1% LTCCC focuses on systemic advocacy, researching national and state policies, laws, and regulations in order to identify relevant issues and develop meaningful recommendations to improve quality, efficiency, and accountability.

Nursing 52

Nursing Quality of Care Accountability Regulations 52

NASHP

JANUARY 12, 2024

D-SNP care coordinators can also help individuals avoid or delay admissions to nursing homes and better support members transitioning from nursing homes and institutions to community living. million annual appropriation for interagency collaboration on long-term care integrity and oversight.

Medicaid 64

Medicaid Nursing Accountability Integration 64

Home Health Care

JANUARY 9, 2023

She shares some best practices for building a wound care management program in today’s operating environment, and she also discusses the key ways in which providers can cut costs without sacrificing quality of care. Home Health Care News: What career experiences do you most draw from, in your role today?

Regulations 82

Regulations Nursing Medicare Quality of Care 82

NASHP

OCTOBER 22, 2021

Arizona’s End of Life and Advanced Care Planning benefit is referenced in its MCO contracts and further described in state regulations. In Rhode Island, MCO plans of care must include “interventions to address special needs (e.g., Enhance federal advance care planning requirements. Quality and performance measures.

Medicaid 102

Medicaid Hospice Care Regulations Integration 102

Icanotes

APRIL 2, 2024

As a behavioral health clinician, others come to you seeking guidance on how to better take care of themselves, set healthy boundaries, and learn to regulate their emotions. But how do you prioritize caring for yourself when you’re constantly taking care of others? Facebook Twitter Linkedin 4.

Regulations 52

Regulations Quality of Care Accountability Healthcare 52

NASHP

OCTOBER 20, 2022

High-quality, integrated care requires strong system-level partnerships, information and data sharing, and family-centered practices. In spite of these barriers, and to help address them, states have implemented innovations to improve integrated care coordination for CYSHCN. Leveraging Data and Technology.

Medicaid 98

Medicaid Integration Accountability Quality Improvement 98

NASHP

NOVEMBER 8, 2024

A growing trend in state health policy is developing capitated managed care programs to provide long-term services and supports (LTSS) to Medicaid beneficiaries who are older and/or have disabilities. Facilities can also earn 10 bonus points for qualifying awards or accreditations, which display a commitment to quality improvement processes.

Medicaid 52

Medicaid Nursing Quality Improvement Accountability 52

Sheppard Health Law

JULY 7, 2022

prevent HCSPs or insurers from providing provider-specific cost or quality of care information to referring providers, the HCSPs or insurer sponsors, enrollees, insureds or eligible enrollees or insureds of the HCSPs or insurers.

Healthcare 52

Healthcare Quality of Care Doctors Healthcare Providers 52

Home Health Care

AUGUST 30, 2024

They may burden the company with additional costs to stabilize the growth profile or pay a lower multiple to account for the risk of reigniting growth. These organizations often have similar objectives regarding employees, quality of care and access to care. Preparation is key.

Home Care 57

Home Care Quality Assurance Accountability Quality of Care 57

NASHP

SEPTEMBER 30, 2022

One of these contributors, hospital consolidation, has played an outsized role in making health care less affordable for consumers and employers. The model also gives a state’s insurance commissioner or attorney general the ability to add other clauses through regulation that may result in anticompetitive effects.

Hospitals 52

Hospitals Accountability Regulations Quality of Care 52

Icanotes

APRIL 2, 2024

As a behavioral health clinician, others come to you seeking guidance on how to better take care of themselves, set healthy boundaries, and learn to regulate their emotions. But how do you prioritize caring for yourself when you’re constantly taking care of others? Facebook Twitter Linkedin 4.

Regulations 40

Regulations Quality of Care Accountability Healthcare 40

Briggs Healthcare

AUGUST 29, 2023

Federal regulations require nurse staff availability 24 hours a day, but do not specify a minimum staffing level. Recent literature underscores the relationship between nursing home staffing and quality outcomes, such as reduced pressure ulcers, emergency department visits, rehospitalizations, and outbreaks and deaths related to COVID-19.

Nursing 52

Nursing Medicaid Medicare Accountability 52

Bill Of Health

NOVEMBER 9, 2023

health system In considering how the Principles can contribute to a new vision for America’s health care system, we must face several harsh realities. The dire state of the U.S. First, while the U.S. America is the only wealthy nation to lack universal health coverage. The Principles help draw a line in the sand between how the U.S.

Medicaid 64

Medicaid Pharmaceuticals Prevention Quality of Care 64

Icanotes

APRIL 13, 2021

The clearinghouse should use a secure connection compliant with the Health Insurance Portability and Accountability Act (HIPAA). That efficiency saves you time and allows you to provide a higher quality of care to the people you treat. Consistency and Accountability with 835s. Do you bill electronically?

Accountability 59

Accountability Healthcare Providers Quality of Care Regulations 59

Etactics

DECEMBER 1, 2023

These codes provide data about the quality of care given. Regulatory Compliance All organizations that work with protected health information (PHI) must comply with the Health Insurance Portability and Accountability Act (HIPAA). Anesthesia. Laboratory. Category 2: This category contains optional performance measurement codes.

Medicare 52

Medicare Medicaid Medical Services Prevention 52

NASHP

MARCH 22, 2024

North Carolina’s InCK program , led by Duke University and the University of North Carolina at Chapel Hill, brings together partners from Medicaid, behavioral health, child welfare, juvenile justice, education, Title V, mobile crisis, and more to coordinate care and address the health and social needs of children in five counties.

Medicaid 52

Medicaid Integration Primary Care Nursing 52

Briggs Healthcare

AUGUST 22, 2022

In February 2022, President Biden announced a comprehensive set of reforms to improve the safety and quality of nursing home care, hold nursing homes accountable for the care they provide, and make the quality of care and facility ownership more transparent so that potential residents and their loved ones can make informed care choices. [1]

Nursing 75

Nursing Medicaid Quality of Care Medicare 75

Sheppard Health Law

FEBRUARY 27, 2023

Background The proposed rule is part of the Biden administration’s broader attempt to improve nursing home care, while increasing transparency and accountability. CMS believes that more transparency will help the public evaluate and compare facilities, and help regulators monitor bad actors.

Nursing 52

Nursing Medicaid Medicare Regulations 52

NASHP

JUNE 22, 2022

This section of the guide outlines considerations, examples, and resources for: Identifying stakeholders and establishing partnerships across care coordination and child-serving systems. Assessing care coordination system capacity, gaps, and process improvements. Financing care coordination systems. Meet quality requirements.

Care Transition 52

Care Transition Medicaid Doctors Regulations 52

NASHP

DECEMBER 23, 2022

Trainings must include community-based and cultural competency for delivering person-centered care and facilitating access to community-based resources. Doulas must also be trained in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPPA) and adult and infant CPR. As of 2019, the majority (85.52

Medicaid 59

Medicaid Nursing Hospitals Regulations 59

Home Health Care

DECEMBER 2, 2024

Urban residents generally have more choices regarding providers and facilities, while those in rural areas face challenges such as longer travel distances, limited provider availability and potential concerns about the quality of care.

Telemedicine 96

Telemedicine Home Care Medicare Nursing 96

Sheppard Health Law

NOVEMBER 13, 2023

Enhance Guardrails for Agent and Broker Compensation Over the last few years, CMS has issued new regulations and subregulatory guidance intended to address abusive marketing practices by third party marketing organizations (“TPMOs”) that sell MA and Part D plans.

Medicare 59

Medicare Medicaid Regulations Integration 59

Sheppard Health Law

OCTOBER 7, 2021

AB 1042 (Jones Sawyer): Related Party Accountability. Related parties will be liable for unpaid state monetary penalties for citations and unpaid Quality Assurance Fees. AB 849 (Reyes): Nursing Home Resident Rights. Restores facility liability to up to $500 for each violation of a resident’s rights. We will be watching! FOOTNOTES. [1]

Nursing 52

Nursing Quality Assurance Quality of Care Regulations 52

KHN

NOVEMBER 14, 2022

Private equity-backed groups have even set up special “obstetric emergency departments” at some hospitals, which can charge expectant mothers hundreds of dollars extra for routine perinatal care. At least 300 of the comments were from doctors or other health care workers.

Doctors 145

Doctors Tricare Medicaid Medical Services 145

KHN

NOVEMBER 14, 2022

Private equity-backed groups have even set up special “obstetric emergency departments” at some hospitals, which can charge expectant mothers hundreds of dollars extra for routine perinatal care. At least 300 of the comments were from doctors or other health care workers.

Doctors 52

Doctors Tricare Medicaid Medical Services 52

Briggs Healthcare

SEPTEMBER 28, 2022

Today, in another effort to improve nursing home transparency, safety and quality, and accountability, the U.S. President Biden has made clear that we must improve the quality of care in our nation’s nursing homes – and we are taking unprecedented steps to deliver on his call to action,” said HHS Secretary Xavier Becerra.

Nursing 40

Nursing Medicare Quality of Care Regulations 40

Briggs Healthcare

NOVEMBER 15, 2023

These actions continue to build on the Biden-Harris Administration’s unwavering commitment to improving the safety and quality of care in the nation’s nursing homes and President Biden’s historic Executive Order on Promoting Competition in the American Economy.

Nursing 40

Nursing Quality of Care Accountability Medicare 40