NASHP

MARCH 24, 2025

Introduction Within the nursing home landscape, a primary role of state agencies is to oversee Medicaid payments and regulate nursing homes. As of 2022, 24 states operated Medicaid nursing home value-based payment (VBP) programs. per Medicaid resident per day depending on a facilitys STRIVE staffing ratio. Averages file.

Medicaid 52

Medicaid Nursing Quality of Care Accountability 52

Fierce Healthcare

DECEMBER 8, 2023

A House vote on transparency regulations in healthcare could occur next week, potentially having substantial ramifications on how PBMs and hospitals operate. | Bipartisan anticipation is in the air for a potential vote in the House this week that would bring transparency to PBMs and ban spread pricing in Medicaid, but hospital groups are firmly opposed (..)

Regulations 289

Regulations Medicaid Hospitals Healthcare 289

Health Care Dive

MARCH 28, 2024

It’s the “most robust and meaningful” regulation streamlining Medicaid eligibility since the Affordable Care Act was implemented a decade ago, one lawyer said.

Medicaid 154

Medicaid Regulations 154

Home Health Care

NOVEMBER 15, 2024

Medicaid standards should reflect the unique work of nurses who provide complex one-on-one care to individuals at home. Specifically, this legislation addresses continuous skilled nursing services under Medicaid. HCAOA believes that the bill is a step in the right direction. “By

Nursing 119

Nursing Quality Improvement Home Care Medicaid 119

Healthcare It News

DECEMBER 16, 2022

What does 2023 hold for healthcare technology, as innovation continues at rapid speed, policymakers and regulators try to keep up with the pace of change – and health systems large and small deal with significant budgetary shortfalls that could hamper their ability to build out their digital transformation efforts?

Healthcare Finance 344

Healthcare Finance Regulations Patient Safety Patient Experience 344

Healthcare It News

DECEMBER 29, 2023

This past week, New York Governor Kathy Hochul signed Senate Bill 1196a/Assembly Bill 1673a into law directing all state-regulated health plans, including Medicaid, to cover comprehensive biomarker testing, clearing the path for more patients to access precision medicine treatments.

Medicaid 334

Medicaid Regulations Integration Healthcare 334

Healthcare It News

OCTOBER 4, 2022

The Electronic Healthcare Network Accreditation Commission and The CARIN Alliance have partnered to bring both the CARIN Code of Conduct and EHNAC’s criteria review process to health plans, health systems, EHR vendors and others for reporting to the Centers for Medicare & Medicaid Services on their data practices and privacy protections.

Regulations 347

Regulations Medicaid Medicare Healthcare 347

Home Health Care

MARCH 11, 2025

The hearing centered on concerns regarding proposed budget cuts to Medicaid and their potential impact on the quality of care patients receive in the future. Doggett shared stories from his constituents who rely on home health care and are fearful of what might happen without Medicaid assistance. It funds long-term support for 9.3

Home Care 100

Home Care Medicaid Rehabilitation Medicare 100

Home Health Care

MARCH 10, 2025

Centers for Medicare and Medicaid Services (CMS) has revoked guidance related health-related social needs (HRSN) through Section 1115 waivers. Industry advocates say the move is indicative of the broader administration priorities to reduce Medicaid expenditures.

Medicaid 78

Medicaid Medicare Regulations Home Care 78

Healthcare It News

MAY 31, 2023

They also said clinicians reported needing more formal training on how to communicate more effectively over a virtual platform and about state regulation. Regulations that varied widely also affected their use of telehealth platforms. But the telehealth boom during the pandemic proved virtual primary care inspires several value-ads.

Telemedicine 360

Telemedicine Primary Care Regulations Doctors 360

Home Health Care

DECEMBER 18, 2024

The report emphasizes that this decades-long workforce crisis has affected community-based services due to long-term underinvestment in Medicaid, which has hindered community-based providers from offering wages that are competitive with those in hourly wage industries.

Home Care 111

Home Care Medicaid Regulations Prevention 111

Home Health Care

JULY 29, 2024

Medicaid home- and community-based services (HCBS) vary by state, in many ways. a keen understanding of the different ways state Medicaid agencies pay for services. Broadly, Medicaid is a state and federal partnership. Fee for services is one of the most common ways that HCBS are reimbursed through Medicaid.

Medicaid 115

Medicaid Home Care Medicare Regulations 115

p3care

SEPTEMBER 26, 2023

Medicare and Medicaid are the two biggest healthcare insurance programs in the United States. The federal government has made different rules and regulations applicable to eligible populations. Let’s get started with a little introduction to Medicare and Medicaid programs in general.

Medicaid 130

Medicaid Medicare Regulations Prevention 130

HIT Consultant

DECEMBER 3, 2024

The Centers for Medicare & Medicaid Services (CMS) added codes for Digital Mental Health Treatment in its 2025 Medicare Physician Fee Schedules. This means the prescription of digital mental health therapeutics can now be billed thru Medicare and Medicaid, paving the way for private insurance to do the same.

Health Technology 111

Health Technology Physical Therapy Regulations Medicare 111

p3care

MARCH 18, 2025

Value-based payment models are rising, and CMS (Centers for Medicaid and Medicare Services) incentivizes such models. Healthcare providers now need to understand and navigate new reimbursement models. It is now a battle between quality and quantity. This update refers to the more transparent medical billing services system.

Patient Safety 130

Patient Safety Healthcare Providers Regulations Healthcare Quality 130

Home Health Care

SEPTEMBER 19, 2024

have set their sights on lifting age-based restrictions in the Medicaid buy-in program. On Wednesday, the policymakers introduced the Ensuring Access to Medicaid Buy-In Programs Act. If enacted, the legislation would eliminate a restriction that blocks people living with disabilities from buying into Medicaid once they reach age 65.

Medicaid 105

Medicaid Regulations Home Care Prevention 105

Home Health Care

MARCH 24, 2025

Were no stranger to short-hour care because we have been a Medicaid provider since our inception. Caregivers who come to work for our company understand that there is unlimited demand from our Medicaid partners to staff these short-hour cases. Will more people begin to spend down their assets to qualify for Medicaid?

Home Care 116

Home Care Medicaid Nursing Regulations 116

Home Health Care

FEBRUARY 13, 2024

The issue is that — due to the caregiver shortage, the rising cost of care, Medicaid qualifications and a number of other factors — many of them won’t be able to afford it. Seniors not supported by Medicaid or Veterans Affairs (VA) are left to pay out of pocket for services that can often be very expensive.

Regulations 116

Regulations Home Care Law Firms Medicaid 116

Home Health Care

NOVEMBER 8, 2024

Depending on local regulations and availability, infusion nursing services are provided directly by the infusion pharmacy by employed nurses or through a collaboration with an affiliated nursing or home health agency. However, Medicaid coverage can have gaps in some states.

Tricare 111

Tricare Medicare Nursing Medicaid 111

Fierce Healthcare

APRIL 23, 2024

Interoperability mandates from the Centers for Medicare and Medicaid Services (CMS) have required major investments by health plans in recent years and will continue to be critical in informing ove | Facing new CMS mandates, MVP Health Care Chief Strategy Officer offers considerations to align your compliance strategy with innovation goals.

Regulations 130

Regulations Medicaid Medicare 130

Home Health Care

NOVEMBER 22, 2023

Centers for Medicare & Medicaid Services’ (CMS) Acute Hospital Care at Home waiver was a major boost for organizations hoping to implement or expand hospital-at-home programs. With this in mind, some are wondering if state Medicaid agencies could be a way to further the hospital-at-home movement.

Medicaid 119

Medicaid Hospitals Medicare Regulations 119

Healthcare It News

OCTOBER 14, 2021

"The pandemic winding down is great from a public health standpoint, but we know Congress doesn't want to just open the floodgates" with no virtual care regulations. The coalition's perspective, he said, is that regulators should "put guardrails on, but let us continue the good work."

Hospitals 317

Hospitals Home Care Regulations Medicaid 317

HIT Consultant

APRIL 19, 2024

Medicare providers in hospitals and skilled nursing facilities (SNFs) are adjusting to new split/shared services documentation and billing regulations rolled out by the Centers for Medicare and Medicaid Services (CMS) as part of the 2024 Medicare Physician Fee Schedule (MPFS) final rule.

Regulations 102

Regulations Nursing Medicare Medicaid 102

NASHP

JANUARY 30, 2025

Enhancing Regulatory Flexibility: States can explore opportunities to update regulations to allow licensed professionals to practice at the top of their licenses and enable task shifting where appropriate. During the roundtable, Utahs approach to addressing workforce development gaps was highlighted.

Integration 95

Integration Medicaid Regulations Quality Assurance 95

Home Health Care

OCTOBER 30, 2024

Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) over its drop in star ratings. The lawsuit alleges that federal regulators actions were “arbitrary and capricious” when it came to calculating Humana’s quality scores.

Medicare 105

Medicare Primary Care Regulations Medicaid 105

Home Health Care

NOVEMBER 27, 2024

Regulations for HaH care Care environment requirements associated with traditional hospitalization are waived as part of a Centers for Medicare & Medicaid Services (CMS) Acute Hospital at Home episode of care, which includes the Life Safety Code governing hospitals participating in CMS care delivery.

Hospitals 113

Hospitals Patient Safety Nursing Medicare 113

Home Health Care

MAY 11, 2023

Centers for Medicare & Medicaid Services (CMS) recent proposed rule for Medicaid may cap business for certain providers , but industry experts believe the government agency is likely foreshadowing its intentions for the final rule. Industry advocates do not believe the 80% threshold will stand in the final rule. “I

Medicaid 97

Medicaid Nursing Regulations Home Care 97

Briggs Healthcare

FEBRUARY 21, 2022

The Informational Letter is directed to Iowa Medicaid Providers, but it contains a message that I thought was worth sharing. Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare. The Iowa Department of Human Services issued IL 2315-MC-FFS-CVD on Sunday, February 20, 2022.

Regulations 104

Regulations Medicaid Healthcare 104

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 111

Home Care Medicaid Law Firms Quality of Care 111

NASHP

DECEMBER 13, 2021

State Strategies To Lower Drug Prices: New Legislative And Medicaid Models December 13, 2021/ by Sarah Lanford and Jennifer Reck. Because Medicaid receives substantial discounts under the Medicaid Drug Rebate Program, NASHP’s policy models, such as a PDAB, are likely to achieve their greatest savings outside of Medicaid.

Medicaid 105

Medicaid Pharmaceuticals Regulations Accountability 105

Home Health Care

AUGUST 14, 2023

Centers for Medicare & Medicaid Services (CMS) – which would require at least 80% of Medicaid reimbursement for home- and community-based services go toward worker compensation – received over 2,100 submissions during its public comment period. A proposed rule from the U.S.

Medicaid 98

Medicaid Regulations Home Care Medicare 98

Home Health Care

JULY 11, 2022

Many Pennsylvanians with physical disabilities are covered by Medicaid, which pays for at-home caregivers. Pennsylvania has three Medicaid managed care organizations, which receive state funding to pay for the caregivers. What the proposal does. I think it’s going to be something that SEIU attempts in other states.”.

Home Care 98

Home Care Regulations Medicaid Nursing 98

NASHP

JUNE 30, 2023

During the COVID-19 public health emergency (PHE), states instituted Appendix K amendments to 1915(c) home-and community-based waivers and 1115 demonstration waivers to ensure that Medicaid beneficiaries were able to receive needed services during the pandemic. Information was collected between May 9 and June 23, 2023. Hartford Foundation.

Medicaid 105

Medicaid Regulations Home Care Nursing 105

NASHP

NOVEMBER 11, 2024

Medicaid is the primary public source of coverage for long-term services and supports (LTSS) , funding over half of these services in 2020. In North Dakota , the state conducts LTSS Options Counseling for all Medicaid individuals over age 21 who are referred for a long-term stay in a nursing home. Rural areas need specific solutions.

Medicaid 80

Medicaid Home Care Nursing Regulations 80

Healthcare It News

JULY 11, 2024

"Right now, the regulations that we have in place have 'read' capabilities – so that allows a FHIR API to be used to be able to see information and download information," Tripathi explained.

Regulations 314

Regulations Health Data Hospitals Medicaid 314

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

OCTOBER 22, 2021

Supporting the Continuum of Care for Serious Illness in Medicaid Managed Care October 25, 2021 / by Salom Teshale, Kitty Purington, Wendy Fox-Grage, and Mia Antezzo. Delivery system transformation: Leading states such as Minnesota have long used Medicaid MCO contracts to address the needs of complex populations and those with serious illness.

Medicaid 102

Medicaid Hospice Care Regulations Integration 102