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

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 285

Healthcare Finance Regulations Patient Safety Patient Experience 285

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 271

Regulations Medicaid Medicare Healthcare 271

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 255

Medicaid Regulations Integration Healthcare 255

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 105

Regulations Home Care Law Firms Medicaid 105

Home Health Care

NOVEMBER 8, 2021

Since the Centers for Medicare & Medicaid Services (CMS) released its interim emergency regulation relating to the federal government’s vaccine mandate last Thursday, more clarity has come to the surface. The post ‘Layer Upon Layer of Regulation’: Breaking Down the CMS Vaccination Mandate appeared first on Home Health Care News.

Regulations 96

Regulations Medicaid Medicare 96

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

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 98

Medicaid Home Care Medicare Regulations 98

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 284

Telemedicine Primary Care Regulations Doctors 284

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

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

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 100

Medicaid Hospitals Medicare Regulations 100

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 86

Medicaid Regulations Home Care Prevention 86

HIT Consultant

OCTOBER 22, 2024

This provided agencies with broad discretion to create and enforce regulations that often filled gaps left by legislators. Implications for Cybersecurity in Healthcare Vulnerability of Existing Regulations The immediate impact of this ruling is the increased vulnerability of existing cybersecurity regulations to legal challenges.

Healthcare 139

Healthcare Regulations Medicaid Medicare 139

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 258

Hospitals Home Care Regulations Medicaid 258

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

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 95

Medicaid Regulations Home Care Medicare 95

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

NASHP

MAY 26, 2023

It is one of the most desired caregiver services , and Medicaid is one policy lever to fund it. Through Medicaid’s federal-state partnership and under a variety of home and community-based services (HCBS) coverage authorities, states have the flexibility to design HCBS to meet the long-term care needs of their populations.

Medicaid 121

Medicaid Nursing Regulations Integration 121

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 99

Home Care Medicaid Law Firms Quality of Care 99

Healthcare It News

AUGUST 29, 2022

Galileo first launched with in-home care for Medicare and Medicaid patients, creating a framework to include social determinants of health in clinical analysis and to bridge gaps in healthcare education. Employees using Galileo avoid more expensive visits to in-person specialty, urgent or ER care 80% of the time.

Telemedicine 256

Telemedicine Primary Care Medicaid Urgent Care 256

Briggs Healthcare

DECEMBER 2, 2021

While CMS remains confident in its authority to protect the health and safety of patients in facilities certified by the Medicare and Medicaid programs, it has suspended activities related to the implementation and enforcement of this rule pending future developments in the litigation.

Medicaid 97

Medicaid Medicare Regulations Healthcare 97

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 85

Home Care Regulations Medicaid Nursing 85

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 76

Medicaid Nursing Regulations Home Care 76

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. The bulk of its business is in Medicaid. Anderson also noted that home care agencies working under Medicaid often vary in size. On Thursday, the U.S.

Medicaid 91

Medicaid Accountability Quality Assurance Home Care 91

Home Health Care

FEBRUARY 14, 2024

One way to do so would be by mirroring the regulatory model state Medicaid programs use for home- and community-based services. The report suggests that the Medicaid model is the answer. Medicaid] has always kind of relied on that regulated agency model that the states have kind of set up around caregivers entering the home.

Home Care 63

Home Care Medicaid Regulations Medicare 63

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 67

Medicaid Home Care Quality of Care Medicare 67

NCQA

JUNE 28, 2024

The Centers for Medicare & Medicaid Services (CMS) recently announced two major updates to Medicaid regulations. The Impact on Medicaid Beneficiaries CMS recognizes that outdated regulations and inconsistent delivery systems hinder access to quality care. Report on 1915(c) HCBS W aiver W ait L ists.

Medicaid 59

Medicaid Regulations Care Transition Primary Care 59

Etactics

JULY 23, 2024

These programs include Medicare, Medicaid, and many more. Two of the most well-known health programs are Medicaid and Medicare. This is because Medicare and Medicaid are crucial systems that provide coverage to millions of Americans. Table of Contents What is Medicaid? What is the Medicaid Exclusion List?

Medicaid 52

Medicaid Medicare Regulations Integration 52

Home Health Care

JANUARY 31, 2024

The Medicare enrollment process undergoes annual changes at the Centers for Medicare & Medicaid Services (CMS) to ensure it remains up to date with evolving regulations, policies and health care practices. A number of changes went into effect on Jan. 1, and several of them will affect home health agencies. They recognize that.

Medicare 117

Medicare Regulations Medicaid Home Care 117

Home Health Care

MARCH 24, 2022

Centers for Medicare & Medicaid Services (CMS) in a lawsuit filed Friday. Under the American Rescue Plan Act, Congress set aside additional funding for Medicaid home- and community-based services as a COVID-19 emergency relief measure. Broadly, the case alleges unfair distribution of funds from the American Rescue Plan Act.

Medicaid 127

Medicaid Home Care Regulations Medicare 127

HKLaw

NOVEMBER 11, 2024

The Centers for Medicare & Medicaid Services (CMS) released highly anticipated updates this month to the Medicare regulations interpreting the federal 60-day overpayment refund requirement (the Overpayment Statute).

Medicare 98

Medicare Regulations Medicaid 98

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. The cuts will be reduced because, No. 1, that’s what they’ve done for the last several years, and, No.

Regulations 108

Regulations Home Care Medicaid Medicare 108

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 102

Home Care Medicaid Regulations Prevention 102

Home Health Care

APRIL 22, 2024

The “Ensuring Access to Medicaid Services” rule has been finalized. First proposed by CMS in April of 2023 , the goal of the rule is to enhance access to HCBS for Medicaid beneficiaries. First proposed by CMS in April of 2023 , the goal of the rule is to enhance access to HCBS for Medicaid beneficiaries.

Home Care 113

Home Care Medicaid Accountability Regulations 113

Healthcare ECONOMIST

APRIL 11, 2022

State Medicaid Agencies are required to specify standards for network adequacy and enforce them for any Medicaid managed care organizations (MCOs). In the study, the authors the authors reviewed federal laws, regulations, and subregulatory guidance for both MCO and QHP programs. Acceptance of new patients.

Medicaid 105

Medicaid Regulations 105

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 216

Regulations Health Data Hospitals Medicaid 216