Health Leaders | Nursing

JUNE 26, 2025

The long-term health care industry is facing a double whammy from President Donald Trump's crackdown on immigrants and the GOP's proposals to reduce Medicaid spending. Care for 6 in 10 residents is paid for by Medicaid , the state-federal health program for poor or disabled Americans. "We

Long Term Care

University of St. Augustine for Health Sciences

JUNE 23, 2025

As a member of the inaugural 2021 graduating class of the University of St. There’s a huge demand for pediatric speech therapy, especially for families on Medicaid. Kamber Covey, MS, CCC-SLP, is no stranger to charting new paths. Her transition to pediatrics revealed a community greatly underserved.

Medicaid

Relias

OCTOBER 6, 2021

The State of Medicaid Programs and the Need for Grassroots Advocacy. Commercial insurance and private pay revenue sources rarely cover services for people with IDD, leaving Medicaid as essentially the sole payer for these services. Sadly, in our 2021 DSP Survey Report, we found that these sentiments continued to resonate with DSPs.

Medicaid

Daily Nurse

JUNE 30, 2023

NPs provide high-quality healthcare to Medicare and Medicaid patients across all geographic areas and healthcare settings. Yet, despite the high-quality healthcare NPs provide to Medicare and Medicaid beneficiaries, barriers still exist within the programs that prevent the effective and efficient delivery of care.

Medicare

Consult QD

MAY 16, 2023

A new policy from the Centers for Medicare & Medicaid Services (CMS) vastly expands coverage for continuous glucose monitoring (CGM), putting better type 2 diabetes management within reach for millions more patients. In Ohio, Medicaid recently started covering CGM for all people with diabetes, regardless of what medications they take.

Medicaid

American Nurse

JUNE 5, 2023

DME = durable medical equipment, OT = occupational therapy, PT = physical therapy Between November 1, 2020, to May 31, 2021, 1,788 patients were discharged from the unit (1,552 discharged home and 236 discharged to a facility). A noticeable decrease in discharge times occurred from November 1, 2020, to May 31, 2021. December 1, 2021.

Medicare

Healthcare Law Insights blog

FEBRUARY 27, 2025

How Medicaid Fraud Accusations Turned into PPP Loan False Statements In April of 2020, like many other healthcare providers, an Idaho-based home health agency applied for a PPP loan during the early days of the COVID-19 pandemic. Two years later, in 2022, the defendant was charged with and pled guilty to Medicaid fraud.

Medicaid

Relias

OCTOBER 25, 2021

Taking advantage of the changed rules will allow home health agencies to more efficiently use the first visit, which has positive implications for clinical outcomes and the agency’s bottom line, observed Karen Vance, BSOT, discussing the CoP update in a recent Relias webinar.

Medicare

Council of Public Health Nursing Organizations

MARCH 8, 2024

To increase access to healthcare in rural areas and to respond to the hospital closures, in 2021 congress passed the Consolidated Appropriations Act ( Public Law 116-260 ). Centers for Medicare & Medicaid Services. CMS (2022) created rural emergency hospitals (REH) as a separate provider designation effective January 1, 2023.

Medicaid

Healthcare Law Insights blog

APRIL 25, 2022

Prior to the pandemic a Centers for Medicare and Medicaid pilot study yielded positive results with respect to hospital readmission rates and follow-up emergency department visits. A survey in September 2021 showed that patients who received ACHAH care were highly satisfied (88%) and were likely to recommend it to friends and family (85%).

Medicaid

Relias

FEBRUARY 2, 2023

The 2023 Home Health Final Payment Rule , which the Centers for Medicare and Medicaid Services (CMS) released in October, increases Medicare payments for home health agencies by 0.7%, or $125 million, compared to 2022. While this seems like a treat, William A.

Medicare

Healthcare Law Insights blog

MARCH 25, 2022

The Emergency Temporary Standard (ETS) for Occupational Exposure to COVID-19 for healthcare and healthcare support service workers (OSHA Healthcare ETS) was originally published on June 21, 2021. Potential changes in the OSHA Healthcare ETS. OSHA is not considering mandating vaccines for employees.

Medicaid

Capitol Beat

NOVEMBER 4, 2022

The ICAN Act would remove unnecessary and outdated barriers to providing care for APRNs across the country so they can better care for their patients who are enrolled in Medicare and Medicaid programs. Nurse Advocates stand with Rep. Lucille Roybal-Allard to announce the ICAN Act in September.

APRN

Healthcare Law Insights blog

JANUARY 9, 2025

Dr. Perwaiz sidestepped Medicaids 30-day waiting period for elective sterilization by backdating forms. Dr. Perwaiz was sentenced in May 2021. Chesapeake Regional then billed Medicaid and other healthcare programs. Javaid Perwaiz was indicted and convicted following trial in federal court of healthcare fraud.

Medicaid

Consult QD

JULY 18, 2023

Origins and COVID-19 impact The program arose from Cleveland Clinic’s desire to leverage technology to make emergency care more accessible and from the healthcare system’s initial experience with a Centers for Medicare and Medicaid Services payment model called Emergency Triage, Treat, and Transport (ET3).

Medicare

American Nurse

JULY 5, 2023

The Centers for Medicare and Medicaid Services (CMS) provides federal oversight of care quality in all U.S. hospitals that receive Medi­care and Medicaid funding. Hospitals that accept patients with Medicare or Medicaid insurance (approximately 61.4 Doi: 10.51256/ANJ072339 Reference Centers for Medicare and Medicaid Services.

Medicaid

American Medical Compliance

DECEMBER 26, 2023

On December 27, 2020, the United States Congress adopted the No Surprises Act (NSA) as part of the Consolidated Appropriations Act of 2021, which has various provisions to assist in protecting customers against unexpected costs beginning January 1, 2022. The following course highlights the NSA and how it impacts healthcare.

Health Insurance

Relias

JANUARY 11, 2023

But momentum will continue, since the Centers for Medicare and Medicaid Services (CMS) announced in 2021 that it plans to transition fully to value-based reimbursement by 2030. By 2005, the Centers for Medicare and Medicaid Services (CMS) began piloting value-based care programs that linked payment to quality measures.

Medicare

Healthcare Law Insights blog

MAY 17, 2023

One study of cosmetic surgery data found that body procedures like tummy tucks, buttock augmentation, and liposuction increased by 63 percent from 2020 to 2021. [1] billion on aesthetic procedures in 2021 with surgical revenues increasing by 63 percent. [4] 12, 2021, available at [link]. 1] Facelifts were up 54 percent. [2]

Medicare

American Nurse

MARCH 6, 2024

Silver Spring, MD: American Nurses Association ; 2021. doi:10.1136/bmj.m865 Centers for Medicare and Medicaid Services. 2021; 16(5):e0252151. August 24, 2021. Br J Clin Pharmacol. 2020; 86(1):29-38. doi:10.1111/bcp.14164 14164 American Nurses Association. Nursing: Scope and Standards of Practice. Backhouse A, Ogunlayi F.

Telemedicine

Health Leaders | Nursing

OCTOBER 16, 2024

He joined the health system in 2021 as executive vice president for physician enterprise, where he oversaw physician and advanced practice provider employment and alignment models with accountability for advancing clinical integration and population health management. We are also one of the largest Medicaid providers," McGinn says. "We

Patient Satisfaction

Relias

AUGUST 15, 2022

Centers for Medicare and Medicaid Services (CMS) proposes a decrease in Medicare reimbursement for home health agencies by 4.2% CMS uses 2021 data to recalibrate case-mix weights, including functional levels, comorbidity adjustment subgroups, and LUPA thresholds. Cap on Negative Wage Index. Mandatory Telehealth Reporting.

Medicare

American Nurse

JUNE 3, 2024

3W3aHFM Centers for Medicare & Medicaid Services. Indianapolis, IN: Sigma Theta Tau International; 2021. J Autism Dev Disord. 2017;47(5):1510-29. doi:10.1007/s10803-017-3040-5 Center for Autism Related Disabilities. University of South Florida. HCAHPS: Patients’ perspectives of care survey. J Autism Dev Disord.

Communication

American Nurse

DECEMBER 8, 2023

The Geriatrics ECHO data consist of information from September 2019 to May 2022; the Nursing Home STRONG ECHO, from November 2020 to September 2022 (which includes Agency for Healthcare Research and Quality [AHRQ] COVID-19 Action Network ECHO sessions held from November 2020 to August 2021). 2021 profile of older Americans.

Long Term Care

American Nurse

JULY 2, 2024

Research roadblocks In a 2021 position statement, ANA declared its support for the review and reclassification of marijuana’s status from a federal Schedule I controlled substance to facilitate urgently needed clinical research that informs patients and providers on the efficacy of mariju-ana and related cannabinoids.

Business

American Nurse

FEBRUARY 16, 2024

In 2012, the Centers for Medicare and Medicaid Services implemented the Hospital Readmissions Reduction Program (HRRP). Prescription Opiates [link] Centers for Medicare and Medicaid Services (n.d) [link] Li, C. Education can be formal or informal, depending on the complexity of the patient’s needs. Karmarkar, A.,

Medicaid

Relias

SEPTEMBER 1, 2022

With the successes reaped during the pilot of the Home Health Value-Based Purchasing (HHVBP) program, the Centers for Medicare and Medicaid Services (CMS) aims to accelerate the results nationwide. The program started in 2016 as a pilot to determine the impact of financial incentives on home health agencies in nine states. million decrease.

Medicare

Relias

DECEMBER 8, 2022

Every year, the Centers for Medicare and Medicaid Services (CMS) releases the Program for Evaluating Payment Patterns Electronic Report (PEPPER). Most states’ retrieval rates of the 2021 home health agencies PEPPER stood at 40% to 59%. We all love free tools that help our organizations perform better.

Medicare

Minority Nurse

MARCH 19, 2024

The United States Government Accountability Office reported a 15-fold increase over the prepandemic level in telehealth use among Medicaid beneficiaries. million from March 2020 to February 2021. Numbers skyrocketed from 2.1 million in the year before the pandemic to 32.5 Teresa Rincon, PhD, RN, FCCM, is a pioneer in virtual nursing.

Chief Nursing Officer

Relias

OCTOBER 20, 2021

In our 2021 State of Healthcare Training and Development Report , 33%?of Several factors drove these concerns, such as licensing, Medicare/Medicaid?reimbursement, Medicaid beneficiaries use telehealth services. SoonerCare Medicaid program. amount of telehealth adoption prior to the COVID-19 pandemic,?some some providers?were?weary

Medicaid

Celayix

FEBRUARY 7, 2023

billion in health care fraud settlements and judgments in 2021. There is also the patient family, and the patient insurance provider, or the government in the case of Medicare or Medicaid. Fraud is unfortunately, very common in home healthcare. In fact, the federal government saw a return of nearly $1.9 There is of course, the patient.

Home Healthcare

Relias

APRIL 18, 2022

For home health agencies, wounds are one of 12 clinical groupings the Centers for Medicare and Medicaid Services (CMS) identifies under the Patient-Driven Groupings Model. Editor’s note: This post was originally published in January 2021 and updated. Therefore, this score affects the PDPM reimbursement calculation.

Education

Relias

DECEMBER 13, 2021

The increased pressure of the COVID-19 pandemic has presented never-before-seen growth opportunities for home health agencies and their workforce, as Bill Dombi, President of the National Association of Home Care and Hospice (NAHC), noted in a December 2021 webinar titled The State of Home Health.

Professional Development

Relias

JUNE 1, 2022

Another case alleged that a health system defrauded the Centers for Medicare and Medicaid Services of $1 billion because doctors were pressured to add diagnosis codes to medical records that were nonexistent or unrelated to the visit. Many providers were noncompliant with 2021 E/M coding documentation guidelines.

Retirement

Relias

JUNE 1, 2022

Another case alleged that a health system defrauded the Centers for Medicare and Medicaid Services of $1 billion because doctors were pressured to add diagnosis codes to medical records that were nonexistent or unrelated to the visit. Many providers were noncompliant with 2021 E/M coding documentation guidelines.

Retirement

Capitol Beat

MARCH 15, 2022

Nursing Title VIII Nursing Workforce Development programs received $280.472 million, which is a $16 million increase over Fiscal Year 2021. The bill, which also includes Ukraine emergency spending attached, was signed into law on March 15, 2022. Agencies Health and Human Services : $108.3 billion in total spending, an increase of $11.3

Medicare

Consult QD

JUNE 16, 2023

Many laboratories have alternative options for low-cost or no-cost testing that do not involve a third-party sponsor and have financial assistance programs (based on a sliding income-based scale) and laboratory billing policies (such as no balance-billing for those with Medicaid). Front Neurol 2021; 12:663911. Suther S, Kiros G-E.

Pharmaceutical