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. How will the 2023 final rule affect your business? While this seems like a treat, William A.

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Medicare Medicaid Business 52

American Nurse

FEBRUARY 22, 2024

Missouri’s maternal mortality rates are double the national average, placing the state 38th in the United States (Nickelson, 2023). Additionally, rates of chronic conditions such as obesity, diabetes, and hypertension continue to rise among women of childbearing age (Health in Rural Missouri Biennial Report, 2022-2023). Margiotta, C.,

Medicaid 52

Medicaid Mental Health Health Insurance Promotion 52

American Nurse

APRIL 30, 2024

In this role, she leads projects and advises within the agency aimed at improving care for Medicaid beneficiaries in Texas. Rocha and her team translate that clinical language into policy, determining needs for Medicaid recipients and bringing in specialty clinicians when necessary. Learn more at nursingworld.org/ancc/.

Medicaid 115

Medicaid APRN Health Literacy Nurse Practitioner 115

Capitol Beat

APRIL 4, 2022

Recently, the Biden Administration released its Fiscal Year (FY) 2023 budget proposal. Title VIII Nursing Workforce Development Programs received $294.972 million for FY 2023. billion in discretionary funding for Centers for Medicare and Medicaid Services, a 8% increase from FY 22 $9.9 decrease from FY 22 $4.3

Medicaid 40

Medicaid Medicare Mental Health Nurse Educator 40

Health Leaders | Nursing

FEBRUARY 24, 2023

That provision, along with another to include non-medically directed CRNA services as a mandatory benefit under the Medicaid program, is being cheered by the American Association of Nurse Anesthesiology (AANA).

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Medicaid Medicare 105

Health Leaders | Nursing

SEPTEMBER 11, 2023

Editor’s note: This article appeared in the July-September 2023 edition of HealthLeaders magazine. 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.

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Nurse Practitioner APRN Medicare Medicaid 144

Healthcare Law Insights blog

APRIL 28, 2023

The Department of Health and Human Services (HHS) has announced its plan to end the Federal Public Health Emergency (PHE) for COVID-19 on May 11, 2023. Some of these changes have become permanent or extended beyond the end of the PHE due to Congressional action, while some waivers will expire on May 11, 2023. Reimbursement A.

HIPAA 52

HIPAA Medicare Medicaid Telemedicine 52

Capitol Beat

FEBRUARY 28, 2023

The COVID-19 Public Health Emergency (PHE) that was declared in March 2020 is set to end on May 11, 2023, as the President has announced there will be no more extensions to the PHE. The end of the PHE will also have an effect on the Medicaid program. That means that this will end on December 31 of this year. Anesthesia Services.

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APRN Medicaid Medicare Resume 101

Council of Public Health Nursing Organizations

MARCH 8, 2024

CMS (2022) created rural emergency hospitals (REH) as a separate provider designation effective January 1, 2023. Hospitals within a rural area with not more than 50 beds or that closed after December 27, 2020, can seek designation as a REH as long as they meet the conditions of participation to participate in Medicare and Medicaid programs.

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Medicaid Medicare Emergency Care Promotion 52

American Nurse

MARCH 5, 2024

Recently, I had the privilege of meeting with Governor Kelly and several healthcare organizations in Kansas to discuss strategies for passing legislation on Medicaid expansion for the state. We delved into the impact of neighboring states expanding Medicaid, drawing Kansas residents for healthcare services, leading to revenue loss.

Medicaid 52

Medicaid Leadership Business 52

Healthcare Law Insights blog

JULY 7, 2023

A handful of FCA circuit court decisions issued in 2023 are noteworthy as well. The Sixth Circuit further agreed the amended complained faced another problem: neither the hospital nor the eye care center’s owner submitted claims for Medicare or Medicaid reimbursement for items or services “resulting from” the AKS violation.

Pharmaceutical 52

Pharmaceutical Medicare Medicaid Communication 52

Scrubs

JUNE 22, 2023

In all cases, the majority were Medicaid enrollees. States across the rural Southeast have not expanded Medicaid coverage to larger numbers of lower-income residents, which often means lower shares of patients have health coverage. South Dakota voters adopted Medicaid expansion in late 2022 and will implement it this summer.

Medicaid 75

Medicaid Education 75

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. 2023; 18(5). ahrq.gov/cahps/surveys-guidance/index.html Centers for Medicare & Medicaid Services. March 8, 2023.

Medicare 52

Medicare Medicaid Patient Experience Home Healthcare 52

American Nurse

MARCH 13, 2024

In fact, the drug is still free for those who are uninsured or enrolled in Medicare, Medicaid, or other federal health programs, including those for veterans. billion in Paxlovid and covid vaccine sales in 2023, after a $57 billion peak in 2022. Pfizer reported $12.5

Medicare 109

Medicare Medicaid Senior Living Long Term Care 109

IntelyCare

MAY 1, 2024

Nearly eight months have passed since The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule to set minimum staffing standards for nursing homes. At the time, the proposed CMS staffing mandate was met with criticism from all sides. The dust has settled — for now.

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Long Term Care Licensing Medicaid Medicare 95

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. link] Zemlak, J.

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Medicare Telemedicine Medicaid Communication 114

Healthcare Law Insights blog

DECEMBER 11, 2023

A hospital that receives what it suspects to be an improper transfer must report their suspicions to the Centers for Medicare and Medicaid Services or the relevant state survey agency within 72 hours of when the hospital suspects they have received an improperly transferred individual. Ass’n, AMA Principles of Med. Ethics: II: 9.4.2

Medicaid 59

Medicaid Medicare Licensing 59

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 2023; 18(7). March 2023. 2023 Comprehensive Accreditation Manual.

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Medicaid Medicare Promotion Leadership 52

Healthcare Law Insights blog

NOVEMBER 22, 2022

The Affordable Care Act mandated that the Centers for Medicare and Medicaid Services (“CMS”) establish risk categories for Medicare enrollment, which are used by CMS to determine what level of scrutiny to give provider enrollment applications, which includes initial enrollment, change of ownership (“CHOW”) applications, and revalidations.

Medicare 52

Medicare Medicaid Mental Health 52

Daily Nurse

JULY 31, 2023

The American Nurses Association (ANA) underscores the urgency for Congressional leaders, the Centers for Medicare & Medicaid Services (CMS), and other key stakeholders to advance efforts in implementing safe staffing standards , including minimum nurse-to-patient ratios.

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Medicaid Medicare Nurse Shortage 82

American Medical Compliance

FEBRUARY 13, 2023

Interoperability of Telehealth The Centers for Medicare and Medicaid Services (CMS) is coming up with a process for improving the exchange of electronic healthcare information and interoperability. Reference Health IT News (2023, January 23). What’s ahead for health IT policy and legislation in 2023. course today.

Medicaid 52

Medicaid Medicare 52

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 88

Medicaid Medicare Education 88

American Nurse

FEBRUARY 16, 2024

Forward to 2023, Nurse’s now utilize the SDOH (Social Determinants of Health) to assess areas that can be affecting the patient’s safety and overall health, such as housing, safe environments free from abuse, access to transportation, and money to afford food and medications. link] Association of Rehabilitation Nurses (n.d.) Karmarkar, A.,

Medicaid 52

Medicaid Medicare Long Term Care Self-Care 52

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 behavioral adjustment proposed for 2023 would permanently reduce the 30-day payment rate by 7.69%. decrease in pay for 2023 is the net effect. The proposed 4.2% Mandatory Telehealth Reporting.

Medicare 52

Medicare Medicaid 52

American Medical Compliance

FEBRUARY 15, 2023

The Centers for Medicare and Medicaid Services (CMS) require FWA training. CMS FWA Training 2023 The CMS requires both Part D plan sponsors and MA organizations to annually communicate certain compliance and FWA requirements to FDRs or first-tier, downstream, and related entities. Prescription Drug Plans (PDP) provides such coverage.

Medicare 52

Medicare Medicaid Pharmaceutical Federal healthcare 52

American Medical Compliance

FEBRUARY 15, 2023

The Centers for Medicare and Medicaid Services (CMS) require FWA training. CMS EMS Fraud Waste and Abuse Training 2023 The CMS requires both Part D plan sponsors and MA organizations to annually communicate certain compliance and FWA requirements to FDRs or first-tier, downstream, and related entities.

Medicare 52

Medicare Medicaid Pharmaceutical Federal healthcare 52

Empowered Nurses

SEPTEMBER 7, 2023

I was so excited to see that the Centers for Medicare and Medicaid Services (CMS) issued minimum staffing standards for long-term care facilities. Your comments to this proposed rule are invited through November 6, 2023. This proposed rule seeks to establish comprehensive nursing staffing requirements.

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Long Term Care Medicaid Medicare 52

Consult QD

DECEMBER 29, 2023

Study results were published in the July 2023 issue of Kidney International Reports. Moreover, Black patients were more likely to “no show” to scheduled appointment(s) or not submit specimens for genetic testing compared with white patients (24.1% vs. 6.7%).

Medicaid 52

Medicaid Education 52

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.

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Telemedicine Communication Medicaid Medicare 52

Healthcare Law Insights blog

MAY 17, 2023

DOJ’s Latest False Claims Act Complaint On May 9, 2023, the U.S. 6] Specifically, the government’s complaint gives examples of giving patients “tummy tucks” following the patients’ “interest in body contouring,” but billing Medicaid for “hernia repairs.” [7] May 9, 2023) (government’s complaint in intervention). [7]

Medicare 52

Medicare Medicaid 52

American Nurse

FEBRUARY 21, 2024

Introduction SOUTH CAROLINA is predominately a rural state that consistently demonstrates poor health rankings, due to the lack of Medicaid expansion, healthcare deserts, and a decreasing physician supply. 2023, January 18). Retrieved March 2023. Preprint posted online October 24, 2023. Journal of Health Economics.

APRN 52

APRN Nurse Practitioner Clinical Nurse Specialist Medicare 52

Capitol Beat

DECEMBER 6, 2022

Recently, the Centers for Medicare & Medicaid Services (CMS) issued a Request for Information (RFI) entitled Make Your Voice Heard: Promoting Efficiency and Equity Within CMS Programs. These recommendations also support ANA’s legislative advocacy as we encourage lawmakers to support H.R.

APRN 52

APRN Medicaid Medicare Licensing 52

Consult QD

DECEMBER 7, 2023

After launching Cleveland Clinic Hospital Care At Home (HCAH) in April 2023 to serve patients requiring acute care at Cleveland Clinic Indian River Hospital in Vero Beach, Florida, Cleveland Clinic expanded the pilot to Cleveland Clinic Tradition Hospital in December with rollout to its remaining three Florida hospitals scheduled for 2024.

Medicaid 57

Medicaid Medicare Communication Promotion 57

Consult QD

APRIL 6, 2023

In 2023, there should be no reason that we don’t have enough scientific evidence to guide decision-making in pediatric heart failure and heart transplant. Here are their findings in summary: Those in distressed communities were more likely to be Black and Hispanic, listed as Status 1A and have Medicaid insurance.

Medicaid 112

Medicaid Promotion Education 112

IntelyCare

MARCH 2, 2023

It shouldn’t be a huge surprise that many senior living communities have told McKnight’s that they will have to increase agency use this year , especially in light of the Centers for Medicare and Medicaid Services (CMS) potentially moving forward with a new minimum staffing standard in 2023.

HIPAA 52

HIPAA Senior Living Medicaid Best Practices 52

American Nurse

APRIL 2, 2024

More recently, in November 2023, the White House released a playbook for addressing SDOH. ANA considers these numbers a first step toward direct reimbursement for nursing services from Medicare and Medicaid. RNs and advanced practice RNs are eligible for NPIs, which remain valid when nurses move to other states.

Health Insurance 52

Health Insurance Chief Nursing Officer Medicaid Medicare 52

American Nurse

JANUARY 3, 2024

The Centers for Medicare and Medicaid Services (CMS) worked with purchasers, physicians, healthcare organizations, and consumers to identify evidence-based process measures (core measures) to reduce morbidity, mortality, variability, and cost while improving quality outcomes. Several recent developments aim to address these issues.

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Chief Nursing Officer Medicare Medicaid Best Practices 52