Home Health Care

NOVEMBER 21, 2024

Humana is one of the largest insurers in the country, and has about 6 million Medicare Advantage (MA) members underneath its health plans. Brent’s experience working with state and federal healthcare policy makers and managed care organizations will be invaluable as we continue to grow and execute our strategic plans.

Medicaid 45

Medicaid Medicare Home Care Performance improvement 45

p3care

NOVEMBER 14, 2022

It is observed that pass-through billing mostly occurs in rural healthcare facilities, as they do not generate considerable revenue; that’s why they participate in fraudulent billing schemes to increase their revenue by claiming reimbursements for the services they don’t even perform. Implementation of The Compliance Program.

Regulations 100

Regulations Prevention Medicare Medicaid 100

HIT Consultant

MARCH 8, 2022

The end of the PHE is one of those rare events where everyone—ranging from hospitals, insurers, and the Centers for Medicaid and Medicare to federal and state marketplaces, human services agencies, and advocacy groups—is in this together, with one common mission: All Americans must have affordable health insurance, so society, as a whole, prospers.

Medicaid 98

Medicaid Primary Care Care Transition Federal Healthcare 98

NASHP

AUGUST 30, 2023

Definitions For the purposes of this Act: “Beds” means the number of available bed days during the most recent cost reporting period divided by the number of days in the most recent Medicare cost reporting period. Rural Hospital” means a hospital designated as a rural hospital under federal and state law.

Hospitals 97

Hospitals Regulations Federal Healthcare Nursing 97

Health Populi

DECEMBER 6, 2018

In 2006, Medicare Part D launched, which may have boosted consumers’ faith in Federal healthcare programs. Two-thirds of Republicans do not believe the government should be responsible for ensuring that all Americans have healthcare, and only 13% think it should be a government-run system.

Tricare 73

Tricare Healthcare Medicaid Federal Healthcare 73

Etactics

FEBRUARY 2, 2024

The List of Excluded Individuals/Entities is the database that contains the organizations and individuals banned from participating in federal healthcare programs. The Medicare and Medicaid Patient and Program Protection Act of 1987 set the framework for two different types of exclusions. Other than Medicare or Medicaid.

Federal Healthcare 52

Federal Healthcare Medicaid Medicare Healthcare 52

HIT Consultant

SEPTEMBER 14, 2022

Access also improved – a Johns Hopkins University study found that Medicare beneficiaries in poor neighborhoods increased their use of telemedicine during the pandemic. Federal agencies: catalysts of change. These agencies serve a large portion of the U.S. population and are dedicated to patient-centered, evidence-based care.

Telemedicine 52

Telemedicine Doctors Federal Healthcare Integration 52

Etactics

JANUARY 24, 2023

You see, a judge sentenced Fernandez to three years in prison for her role in the conspiracy to commit healthcare fraud. She was also indicted for making a false statement in a situation involving a federal healthcare benefit program. The judgment further alleged that the defendant falsified forms related to Medicare enrollment.

Healthcare 52

Healthcare Physical Therapy Doctors Medicare 52

Sheppard Health Law

JANUARY 20, 2023

In Lieu of Services and Settings Background Though federal healthcare programs generally excluded non-clinical services from reimbursement, the evolution of value-based care prompted managed care plans to provide alternative benefits to enrollees under flexibilities in their risk-based contracts.

Medicaid 52

Medicaid Regulations Federal Healthcare Hospitals 52

NASHP

AUGUST 30, 2023

Definitions For the purposes of this Act: “Beds” means the number of available bed days during the most recent cost reporting period divided by the number of days in the most recent Medicare cost reporting period. Rural Hospital” means a hospital designated as a rural hospital under federal and state law.

Hospitals 52

Hospitals Regulations Federal Healthcare Nursing 52

Sheppard Health Law

FEBRUARY 16, 2022

On December 21, 2021, the Centers for Medicare & Medicaid Services (“CMS”) issued guidance on the Good Faith Estimate and the Patient-Provider Dispute Resolution (“PPDR”) process for people without insurance or who plan to pay the costs themselves.

Physical Therapy 52

Physical Therapy Hospitals Federal Healthcare Regulations 52

Etactics

SEPTEMBER 22, 2022

But things become tricky when involving Federal healthcare programs. million to resolve its civil healthcare fraud case. Phantom Billing Example 2 In January 2015, Benjamin Sabido had to pay $700,545 in fines for billing Medicare for services that weren't provided. Kickbacks Example 1 January of 2021 , athenahealth Inc.

Healthcare 59

Healthcare Physical Therapy Medicare Accountability 59

Sheppard Health Law

SEPTEMBER 23, 2021

Department of Health and Human Services (“ HHS ”) the authority to negotiate directly with pharmaceutical companies in order to lower drug prices in Medicare Part B and Medicare Part D (the “ Proposal ”). Most Democrats are in Favor of Medicare Negotiating Drug Prices to Lower Costs. times those in 32 peer counties. [2].

Pharmaceuticals 52

Pharmaceuticals Medicare Prevention Federal Healthcare 52

Sheppard Health Law

SEPTEMBER 22, 2021

Department of Health and Human Services (“HHS”) the authority to negotiate directly with pharmaceutical companies in order to lower drug prices in Medicare Part B and Medicare Part D (the “ Proposal ”). Most Democrats are in Favor of Medicare Negotiating Drug Prices to Lower Costs. times those in 32 peer counties. [3].

Pharmaceuticals 52

Pharmaceuticals Medicare Prevention Federal Healthcare 52

Sheppard Health Law

JULY 27, 2021

On July 13, 2021, the Centers for Medicare & Medicaid Services (“ CMS ”) unveiled a proposal to temporarily extend Medicare coverage for particular telehealth services granted during the COVID-19 public health emergency (the “ Pandemic ”), in order to evaluate which services should be covered permanently.

Medicare 52

Medicare Medicaid Hospitals Federal Healthcare 52

Patient Safety Movement

SEPTEMBER 7, 2023

The report cites that according to recent data, approximately one in four Medicare patients experience adverse events during their hospitalizations, with many resulting in catastrophic outcomes, including death. C Develop Federal Healthcare Delivery Systems’ Capacities and Showcase Results as Exemplars for Safer Healthcare.

Patient Safety 133

Patient Safety Prevention Federal Healthcare Hospitals 133

Sheppard Health Law

JANUARY 26, 2023

Medicaid and Medicare The Balanced Budget Act of 1997, Public Law 105–33, 111 Stat. The Medicaid and Medicare statutes also contain conscience provisions related to the performance of advanced directives, religious nonmedical healthcare providers and their patients. The proposed regulation 45 C.F.R.

Healthcare 105

Healthcare Federal Healthcare Medicaid Regulations 105

Sheppard Health Law

JANUARY 6, 2023

trillion in funding across a range of domestic initiatives, including certain appropriations to healthcare and related programs. The Act extends certain flexibilities for Medicare coverage and payment for telehealth services through December 31, 2024. Medicare Extension & Adjustments. The Act provides for nearly $1.7

Healthcare 52

Healthcare Medicaid Medicare Hospitals 52

Patient Safety Movement

SEPTEMBER 30, 2023

The report cites recent data indicating approximately one in four Medicare patients experience adverse events during their hospitalizations, with many resulting in catastrophic outcomes, including death. C Develop Federal Healthcare Delivery Systems’ Capacities and Showcase Results as Exemplars of Safer Healthcare.

Patient Safety 52

Patient Safety Prevention Hospitals Healthcare 52

Healthcare It News

AUGUST 7, 2023

Healthcare IT News wanted to dig deep into the new law and its promises, so we sat down with Kamala Green, social drivers of health program manager at National Government Services. National Government Services empowers federal healthcare agencies to deliver care to millions of Americans through outcomes-driven innovation.

Primary Care 246

Primary Care Telemedicine Accountability Remote Care 246

Sheppard Health Law

JANUARY 5, 2022

HHS would resume federal review of network adequacy of QHPs offered on federally-facilitated exchanges in 2023 (HHS previously had done so from 2015-2017). The time and distance standards would apply to a specified set of provider and facility specialty types.

Primary Care 52

Primary Care Quality Improvement Accountability Healthcare Quality 52