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 109

Regulations Home Care Law Firms Medicaid 109

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 The Impact on Medicaid Beneficiaries CMS recognizes that outdated regulations and inconsistent delivery systems hinder access to quality care.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

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 105

Medicaid Hospitals Medicare Regulations 105

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 288

Regulations Medicaid Hospitals Healthcare 288

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 97

Regulations Medicaid Medicare 97

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 97

Medicaid Regulations Home Care Medicare 97

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 67

Home Care Medicaid Regulations Medicare 67

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 104

Home Care Medicaid Law Firms Quality of Care 104

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 71

Medicaid Home Care Quality of Care Medicare 71

Readiness Rounds

OCTOBER 3, 2023

The Tightening Grip of CMS Regulations 2. The rules of unannounced visits from regulatory bodies have been significantly tightened by the Centers for Medicare & Medicaid Services (CMS) making it crucial for healthcare facilities to be constantly prepared. Headlines: 1. Key Takeaways 5.

Regulations 52

Regulations Performance improvement Patient Safety Hospitals 52

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 80

Medicaid Nursing Regulations Home Care 80

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

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 317

Medicaid Regulations Integration Healthcare 317

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

NCQA

JUNE 27, 2023

More states are contracting with managed care organizations (MCO) to provide Medicaid long-term services and supports (LTSS). In July, NCQA will update these programs to further align with best practices and federal regulations. Increase Alignment with Federal Provisions: LTSS Distinction helps MCOs meet HCBS waiver regulations.

Medicaid 52

Medicaid Care Transition Quality Improvement Regulations 52

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

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

MAY 4, 2023

Centers for Medicare & Medicaid Services’ (CMS) latest proposed rule , which includes a provision that would require at least 80% of Medicaid payments to go toward compensation for personal care workers. The heightened attention on personal care services leads to necessary sophistication, oversight and regulation.

Medicaid 73

Medicaid Regulations Accountability Medicare 73

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 89

Home Care Regulations Medicaid Nursing 89

Sheppard Health Law

JANUARY 20, 2023

To add uniformity to this practice, CMS codified this flexibility in the 2016 Medicaid and Children’s Health Insurance Plan (CHIP) managed care final rule by authorizing coverage for “In Lieu of Service or Settings” (ILOS). [i] ILOSs must advance the objectives of the Medicaid program. ILOSs must be cost effective.

Medicaid 52

Medicaid Regulations Federal Healthcare Hospitals 52

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 94

Medicaid Accountability Quality Assurance Home Care 94

Triage Health Law

JANUARY 11, 2023

Pursuant to federal regulations that took effect on January 1, 2023, individuals who lose Medicaid coverage will be granted a special enrollment right to enroll in Medicare Part B coverage. [1] This is however changing and Ohio is an example.

Medicaid 59

Medicaid Medicare Regulations Doctors 59

HIT Consultant

AUGUST 31, 2023

Adimika Arthur, Executive Director, HealthTech 4 Medicaid Manisha Sharma, Senior Medical Director, Promise Health Plan Blue Shield of California During the pandemic, Medicaid enrollment grew by nearly 30% to cover more than 93 million Americans , due in large part to COVID-19 provisions that included continuous Medicaid enrollment.

Medicaid 64

Medicaid Prevention Health Data Quality of Care 64

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 338

Healthcare Finance Regulations Patient Safety Patient Experience 338

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 112

Regulations Home Care Medicaid Medicare 112

NASHP

AUGUST 19, 2022

Emerging State Innovations in Developing a Medicaid Community-Based Palliative Care Benefit August 19, 2022 / by Salom Teshale and Wendy Fox-Grage. Research has found relationships between palliative care consultation and lower hospital costs for Medicaid beneficiaries, indicating that palliative care can contain costs.

Medicaid 59

Medicaid Regulations Medicare Integration 59

NASHP

APRIL 15, 2022

Midwife Medicaid Reimbursement Policies by State April 15, 2022. You can also download the charts on Certified Nurse-Midwife State Medicaid Reimbursement Policy and Midwife Licensing and State Medicaid Reimbursement Policy. Certified Nurse-Midwife State Medicaid Reimbursement Policy. Medicaid Reimbursement.

Medicaid 64

Medicaid Nursing Medical Practitioners Regulations 64

Healthcare ECONOMIST

NOVEMBER 21, 2021

Where does the Centers for Medicare and Medicaid Services see Medicaid and the Children’s Health Insurance Program (CHIP) heading in the future. Medicaid coverage is a difficult proposition. Not only that, 70% of Medicaid beneficiaries are covered by private plans that States pay to administer the benefit.

Medicaid 64

Medicaid Regulations Medicare 64

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

p3care

AUGUST 19, 2024

Frequent Changes in Billing Rules Healthcare regulations are constantly evolving, and OB/GYN billing is no exception. The Centers for Medicare & Medicaid Services (CMS) and private insurers frequently update billing guidelines, making it difficult to stay up-to-date for practitioners.

Regulations 130

Regulations Medicaid Medicare Healthcare Providers 130

Briggs Healthcare

MARCH 22, 2023

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare The OIG has posted its annual report on Medicaid fraud for FY2022. The 29-page report highlights: Here’s the Table of Contents: Reducing Medicaid fraud is a top priority for OIG, and its role in overseeing MFCUs helps achieve that priority.

Medicaid 52

Medicaid Regulations Accountability Healthcare 52

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 341

Telemedicine Primary Care Regulations Doctors 341

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

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 329

Regulations Medicaid Medicare Healthcare 329

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.” Medicaid Models. Massachusetts Health Policy Commission: Final Regulation for Drug Pricing Review.

Medicaid 52

Medicaid Regulations Prevention Pharmaceuticals 52

NASHP

DECEMBER 23, 2022

With more than 40 percent of births financed by Medicaid, the Centers for Medicare & Medicaid Services (CMS) has developed an action plan that corresponds with goals outlined in the White House blueprint. Implement Medicaid benefit. Identify community assets, engage the provider community, and build infrastructure.

Medicaid 59

Medicaid Nursing Regulations Hospitals 59

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