Briggs Healthcare

JULY 6, 2022

On September 30, 2019, the Centers for Medicare & Medicaid Services (CMS) published the final rule Medicare and Medicaid Programs; Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction Final Rule , which included revisions for the hospital Conditions of Participation (CoP) for 42 CFR §482.42

Prevention 98

Prevention Hospitals Regulations Medicaid 98

HIT Consultant

JANUARY 27, 2025

This capability helps flag individuals at risk of chronic conditions like heart disease or diabetes, allowing for earlier intervention and preventive strategies that improve outcomes and reduce costs. Physicians can then intervene earlier with preventive measures, improving patient outcomes while reducing healthcare costs.

Healthcare 99

Healthcare Life Sciences Pharmaceuticals Public Hospital 99

NASHP

OCTOBER 28, 2024

States play a central role in supporting access to contraceptive care through the administration of state Medicaid and public health programs, as well as through regulation of public (Medicaid and Children’s Health Insurance Program) and private health insurance.

Medicaid 52

Medicaid Regulations Prevention 52

NASHP

NOVEMBER 1, 2021

Nevada Pilots Innovative Program to Increase Access to Preventive Oral Care for Children November 1, 2021 / by Ella Roth and Carrie Hanlon. In fact, 50 percent fewer dental health services were provided for children covered by Medicaid and CHIP from March to July 2020 compared to 2019 data.

Prevention 98

Prevention Medicaid Regulations Nursing 98

Healthcare It News

FEBRUARY 5, 2024

However, depending on the state and its regulations, patients may need to, at times, be seen in person. As the public health emergency of COVID is ending, state regulations are changing and fortunately telepsychiatry will still exist as part of a hybrid model.

Regulations 311

Regulations Telemedicine Remote Care Prevention 311

Home Health Care

APRIL 23, 2024

This article is a part of your HHCN+ Membership On Tuesday, Centers for Medicare & Medicaid Services (CMS) officials vehemently backed the thought process behind the “80-20” wage mandate in home- and community-based services (HCBS). Providers and advocates, on the other hand, continued to argue that the policy could be disastrous.

Home Care 110

Home Care Medicaid Law Firms Quality of Care 110

Briggs Healthcare

AUGUST 2, 2022

“Selected nursing homes may not have complied with Federal requirements for infection prevention and control and emergency preparedness. Specifically, 28 of the 39 nursing homes had possible deficiencies. This is the opening statement for brief of the OIG Report published July 26, 2022. “(OIG)

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Prevention Nursing Regulations Patient Safety 98

Home Health Care

MARCH 10, 2025

Addressing social determinants of health (SDoH) is becoming increasingly important due to new regulations from the Centers for Medicare & Medicaid Services (CMS) and the shift toward value-based care payment models. Engaging a social worker early can help mitigate issues and prevent a crisis from arising.

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Home Care Integration Medicare Rehabilitation 124

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 98

Regulations Home Care Law Firms Accountability 98

Home Health Care

APRIL 22, 2024

The White House teased the finalized Medicaid Access Rule early Monday, and the Centers for Medicare & Medicaid Services (CMS) later revealed more intricate details attached to the rule. Firstly, the timeline of the rule is now clear. Ultimately, providers’ ability to operate is obviously paramount to greater access to HCBS.

Medicaid 84

Medicaid Home Care Quality of Care Medicare 84

NASHP

JUNE 10, 2024

Under the Affordable Care Act (ACA), states have the option to implement a BHP, which offers health coverage to residents whose incomes are too high for Medicaid but who are otherwise eligible to enroll in coverage through the health insurance marketplace. This regulation will go into effect on November 1, 2024.

Medicaid 102

Medicaid Regulations Prevention 102

Sheppard Health Law

FEBRUARY 3, 2023

New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R. Part 521 governing the implementation and operation of effective compliance programs for certain “required providers,” including, now for the first time, Medicaid managed care organizations (MMCOs). [1]

Medicaid 52

Medicaid Regulations Prevention Accountability 52

p3care

OCTOBER 20, 2023

Let’s narrow down and explore some of the key reimbursement methodologies in nephrology: Value-Based Care Reimbursement Fee-For-Service Reimbursement Bundled Payments Medicare and Medicaid Reimbursement Private insurance Reimbursement Capitation Billing Value-Based Care Reimbursement It’s a modern and widely implemented reimbursement model.

Medicaid 130

Medicaid Medicare Regulations Healthcare Providers 130

Home Health Care

APRIL 12, 2024

In past years, Medicare-certified home health agencies and Medicaid personal care services providers have been big focus areas for government watchdogs. Once implemented, EVV could increase the risk that Medicaid beneficiaries’ needs are not being met, potentially compromising their health and safety,” OIG’s work plan states.

Medicaid 105

Medicaid Medicare Home Care Regulations 105

p3care

NOVEMBER 14, 2022

Pass-through Billing has serious effects, taking preventive measures is important so you don’t fall into this trap. The Centers recommend for Medicare and Medicaid Services (CMS) that you don’t need to follow the Compliance Program; however, implementing it does reduce the threats of unlawful conduct. Documentation.

Regulations 100

Regulations Prevention Medicare Medicaid 100

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

NASHP

OCTOBER 31, 2024

Introduction and Background Many states have adopted policies requiring public insurance coverage and/or state-regulated private health insurance coverage of an extended supply of certain hormonal contraceptives methods (e.g., Medicaid, Children’s Health Insurance Plans), state-regulated private health insurance, or both.

Medicaid 40

Medicaid Regulations Patient Safety Prevention 40

Home Health Care

JANUARY 22, 2025

The expanded HHVBP model builds on the success of the original model, which improved total performance scores among home health agencies by an average of 4.6%, according to the Center for Medicare and Medicaid Services (CMS). This expanded model builds upon the original model’s success.

Medicare 76

Medicare Hospitals Quality of Care Nursing 76

NASHP

DECEMBER 13, 2021

Toolkit: New Legislative and Medicaid Models to Lower Drug Prices. For additional information and greater detail, see NASHP’s brief “ State Strategies to Lower Drug Prices: New Legislative and Medicaid Models.” Resources: Model legislation: “An Act to Prevent Excessive and Unconscionable Prices for Prescription Drugs ”.

Medicaid 52

Medicaid Regulations Prevention Pharmaceuticals 52

Home Health Care

DECEMBER 7, 2023

Daniel Gottschalk​​​​, Co‑CEO of Family Tree Private Care Balancing the need for appropriate home care regulations while preventing overregulation is crucial for the industry. Baseline regulations that set forth good business practices to keep clients and caregivers safe are essential.

Home Care 121

Home Care Regulations Nursing Prevention 121

HIT Consultant

SEPTEMBER 6, 2023

By transitioning to dedicated hardware in a data center, you regain full control over your servers and can chart your own course when it comes to updates and implementing security and privacy measures mandated by HIPAA regulations. HIPAA and GDPR are not the only regulators in the space either. Getting data security wrong is expensive.

Regulations 122

Regulations Medicaid Medicare Prevention 122

Triage Health Law

JULY 27, 2023

CMS interpreted the regulatory definition to allow marketing materials to address or include a wide range of benefits available, including vision, dental, premium reduction, and hearing, without being subject to Medicare marketing regulations. What led to the Change in Definition?

Medicare 98

Medicare Regulations Medicaid Prevention 98

Home Health Care

JULY 19, 2024

“What makes a bad actor is a party that gets into home health care for purposes of stealing from Medicare, Medicaid and others. Put simply, the bad actor is the type of provider that regulators want to drive out of home health care, and the type that industry peers work to avoid being associated with.

Regulations 115

Regulations Home Care Quality of Care Medicaid 115

NASHP

MARCH 20, 2023

There are many health and economic benefits of preventing unintended pregnancy with contraception, with different types of providers creating access to these services. Community Health Workers More than half of states reimburse for community health workers or provide services through Medicaid managed care.

Medicaid 52

Medicaid Nursing Prevention Primary Care 52

NASHP

SEPTEMBER 28, 2021

State Medicaid Financing of Home Visiting Services in Seven States Eddy Fernandez. Other areas of savings include a reduction of unnecessary emergency department visits and decreased use of public assistance programs such as Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), and Medicaid.

Medicaid 52

Medicaid Nursing Prevention Regulations 52

Home Health Care

APRIL 1, 2025

Care recipients often go without necessary services, leading, in some cases, to preventable hospitalizations or admissions to nursing facilities costly outcomes for both the individuals receiving care and taxpayers. PHA called for a $550 million raise to the Medicaid reimbursement rates, bringing it to $25.42

Home Care 52

Home Care Nursing Medicaid Quality of Care 52

HIT Consultant

JUNE 16, 2022

The purpose of the No Surprises Act is to prevent surprise out-of-network bills, often for emergency services. As a result, the Centers for Medicare and Medicaid Services (CMS) has since issued new guidance regarding the IDR process for disputing parties. healthcare system. In fact, more than half of all U.S. About Lynne Rinehimer.

Regulations 52

Regulations Hospitals Medicaid Medicare 52

HIT Consultant

JUNE 9, 2022

New government regulations, like the Centers for Medicare & Medicaid Services’ interoperability rules and the Fast Healthcare Interoperability Resources (FHIR) standard enforcement, have finally been passed that support a seamless flow of medical information. Yet, the tides are turning.

Healthcare 98

Healthcare Regulations Prevention Medicaid 98

HIT Consultant

OCTOBER 30, 2023

This may result in a healthcare provider being removed from an ACO or prevented from joining an ACO. “HHS To ensure appropriate sharing and the protection of patient privacy and preferences, the information blocking regulations include exceptions, such as the Privacy Exception.

Medicare 98

Medicare Accountable Care Healthcare Providers Regulations 98

p3care

MAY 1, 2023

We understand the paramount necessity of identifying and preventing healthcare fraud and abuse. It’s crucial to guarantee that audits are carried out fully, and objectively following relevant rules or regulations. Well, we have a simple solution to avoid such things, i.e., depend on medical billing outsourcing companies.

Patient Safety 130

Patient Safety Healthcare Regulations Medicaid 130

Home Health Care

AUGUST 24, 2021

On Thursday, the New York Department of Health, Codes Committee of the Public Health and Health Planning Council (PHHPC) will meet to consider implementing an emergency regulation regarding “Prevention of COVID-19 Transmission by Covered Entities.”. CMS raises payment rates for at-home vaccinations.

Regulations 98

Regulations Home Care Medicare Medicaid 98

Home Health Care

MAY 30, 2022

Additionally, physician-reviewers determined that 43% of the harm events could have been prevented if patients had been provided better care. A similar OIG effort in 2010 found that 27% of hospitalized Medicare patients experienced harm during stays in October 2008, with nearly half of those events preventable.

Hospitals 104

Hospitals Medicare Prevention Home Care 104

HIT Consultant

APRIL 7, 2025

You wont have longitudinal data on patients with changes in coverage, gaps in claims data availability by payer, which will include Medicare and Medicaid, unless you are an ACO or other payment models that provide claims data. It is a mishmash of services and charges that is codified for billing purposes and not cost-of-care management.

Medicare 52

Medicare Population Health Prevention Primary Care 52

Etactics

FEBRUARY 14, 2025

Including the claims data from the Centers for Medicare and Medicaid Services (CMS). This helps to prevent further denials due to a patients inactive insurance policy or outdated coverage. Keep CMS regulations, commercial payer policies, and NCCI edits at your companys forefront.

Prevention 52

Prevention Integration Healthcare Providers Regulations 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. Eviction prevention.

Medicaid 59

Medicaid Public Hospital Hospitals Nursing 59

Home Health Care

OCTOBER 11, 2024

That was the one-word response a home health provider left for the Centers for Medicare & Medicaid Services’ (CMS) during the comment period on the 2025 home health proposed payment rule. Every year we are fighting for survival and every year CMS is proposing to cut reimbursement and adding more regulations.

Medicare 110

Medicare Nursing Hospitals Regulations 110

NASHP

AUGUST 5, 2024

CHWs are key to engagement, care coordination, and increasing access to clinical and support services for Medicaid enrollees from their communities. As such, states increasingly are pursuing Medicaid reimbursement options as part of a comprehensive CHW service financing approach, which is currently reliant on expiring grant programs.

Medicaid 52

Medicaid Primary Care Prevention Accountability 52