Relias

OCTOBER 25, 2021

OTs working in home health can initiate the start of care in more situations beginning in 2022 under changes to the Medicare conditions of participation (CoPs). Under previous rules, an OT was not authorized by Medicare to conduct an initial assessment in home health. OTs Can Conduct Medicare Initial Assessment.

Medicare

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

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. 2021; 325 (22):2262-2272) Previously, CGM was covered only for those who required mealtime insulin.

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

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

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. The final rule includes a 4.1% net inflation rate update.

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. Rural Hospital Closures. Retrieved March 6, 2024. link] NC Rural Health Research Program. Government.

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. The Acute Care Hospital at Home model (ACHAH) provides traditional hospital inpatient acute-level services at home.

Medicaid

Relias

JANUARY 11, 2023

For example, less than 20% of Medicare spending is currently value-based. 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. Here’s what you need to know about value-based payments.

Medicare

Relias

AUGUST 15, 2022

Centers for Medicare and Medicaid Services (CMS) proposes a decrease in Medicare reimbursement for home health agencies by 4.2% The act mandates a six-year monitoring period for the Patient-Driven Groupings Model ( PDGM), the home health payment model implemented for Medicare in 2020. Cap on Negative Wage Index.

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 million have Medicare, Parts A and B, and 75.8 March 2023.

Medicaid

American Nurse

JUNE 3, 2024

3W3aHFM Centers for Medicare & Medicaid Services. cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalHCAHPS. Indianapolis, IN: Sigma Theta Tau International; 2021. J Autism Dev Disord. 2017;47(5):1510-29. University of South Florida. J Autism Dev Disord.

Communication

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

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]. 12, 2021, available at [link].

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

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

DECEMBER 8, 2022

Every year, the Centers for Medicare and Medicaid Services (CMS) releases the Program for Evaluating Payment Patterns Electronic Report (PEPPER). Utilizing data from the most recent three calendar years, the PEPPER offers providers specific Medicare data statistics for discharges or services that may be vulnerable to improper payments.

Medicare

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.

Medicare

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

APRIL 18, 2022

Medicare payment models in skilled nursing and home health provide incentives for clinicians to be well versed in specialty areas such as skin and wound care. Chronic wounds affect about 15% of Medicare beneficiaries each year. Editor’s note: This post was originally published in January 2021 and updated.

Education

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. 2020;368:m865.doi:10.1136/bmj.m865

Telemedicine

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

Home Healthcare

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

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 Committee requests a report within 180 days of enactment of this Act addressing the role of Medicare funding in supporting the training of nursing and allied health professionals.

Medicare

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

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

Medicaid

University of St. Augustine for Health Sciences

DECEMBER 15, 2023

1 Individuals covered by Medicaid (28.3%) and Medicare (26.8%), those who are Black (26.1%) and those earning less than $25,000 (26.4%) have the highest rates of telehealth visits. 1 83% of patients who had a telemedicine visit in the previous year said they want to continue or increase their use of telemedicine in the future.

Telemedicine

American Nurse

SEPTEMBER 5, 2024

According to Chaffee (2021), the evidence connects cannabis use to poor oral health. Missouri skilled nursing facility residents (N=253) reported that 49% of residents rely on staff to clean their mouth, many have no Medicare dental coverage, and Medicaid covers a limited number of dental services (The Oral Health of Adults, 2022).

Medicare

American Nurse

APRIL 2, 2024

Influential efforts such as the 2021 National Academy of Medicine report, Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity, and the Department of Health and Human Services Healthy People 2030 initiative prioritized SDOH. The COVID-19 pandemic laid bare the effects of social determinants of health (SDOH).

Health Insurance

Health Leaders | Nursing

SEPTEMBER 5, 2023

of full-time NPs seeing Medicare patients and 82% seeing Medicaid patients. Senate in April and would allow NPs, physician assistants, and other APRNs to provide particular services under Medicare and Medicaid. Medicare is about 46% and Medicaid is about 14%.

Medicare

American Nurse

MAY 8, 2023

Takeaways: To help patients and their families make informed decisions about choosing health care, the Centers for Medicare and Medicaid Services (CMS) publicly reports quality performance measures. In addition to informing patients, public reporting can drive providers to improve performance.

Medicare

American Nurse

SEPTEMBER 27, 2023

Despite the evils of the pandemic, one important change was the expansion of private insurance reimbursement for telehealth services as well as Medicare and Medicaid expansion to reduce previously prohibitive barriers of telehealth services. References Centers for Medicare & Medicaid Services. March 17, 2020.

Medicare

American Nurse

JULY 18, 2024

According to the Center for Medicare Advocacy and Lu and Lu, ownership and sponsorship type have been shown to significantly impact the quality of care in nursing homes, with for-profits generally having lower staffing levels and poorer patient outcomes. It saves money for Medicare and Medicaid, and it’s exactly what the people want.

Business

Scrubs

JUNE 16, 2023

In fall 2021, staffers at Johnson Memorial Health were hoping they could finally catch their breath. One study found that cyberattacks on the nation’s health care facilities more than doubled from 2016 to 2021 — from 43 attacks to 91. But on Oct. 1 at 3 a.m., a Friday, the hospital CEO’s phone rang with an urgent call. “My

Military

Minority Nurse

JANUARY 27, 2023

She notes that four states moved to full practice authority through the pandemic: Delaware and Massachusetts in 2021 and New York and Kansas in 2022. In the past few years, the pace has “really picked up as we have seen more and more states move to full practice authority,” according to Kapu.

Nurse Practitioner

Minority Nurse

NOVEMBER 18, 2022

She notes that four states moved to full practice authority through the pandemic: Delaware and Massachusetts in 2021 and New York and Kansas in 2022. In the past few years, the pace has “really picked up as we have seen more and more states move to full practice authority,” according to Kapu.

Nurse Practitioner