Health Leaders | Nursing

FEBRUARY 6, 2023

Growing demand for nurse practitioners (NPs) is among the profession’s key trends for 2023, its national organization says. Indeed, at the recent 2023 AANP Health Policy Conference, attendees heard from Jennifer Kiggans , an NP serving her first term in the U.S. The perspective of the NP is very important.”

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Nurse Practitioner Mental Health Medicare APRN 140

American Nurse

MAY 5, 2023

NPIs provide a means for 
advanced practice RNs to 
bill most insurance providers, including Medicare and Medicaid. The post ANA Enterprise News, May 2023 appeared first on American Nurse. This content is for Digital Access and Print Plus subscribers only. Visit the site and log in/register to read.

Medicaid 52

Medicaid Medicare Professional Development 52

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.

Medicare 52

Medicare Medicaid Business 52

IntelyCare

DECEMBER 27, 2022

In 2023, you expect deeper conversations and more guidance on the legality of gig worker classification. Staffing Minimums Will Test Strategic Planning Regulations around staffing minimums are shifting, and post-acute leaders will feel the pressure ramp up in 2023. These models have cut costs from benefits, payroll taxes, etc.,

Leadership 52

Leadership Medicare Travel Nursing Education 52

Nurse Practitioners in Business

JULY 5, 2023

Heads up, though… If you are listening to this before July 20th, 2023 , you’ll have time to get on a webinar with NPBO and Susan Montana , who, among other things, is a Certified Medical Practice auditor. On July 20, 2023, Susan Montana will discuss what to expect in an audit. Would you rather listen?

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Business Medicaid Medicare Self-Care 370

Health Leaders | Nursing

FEBRUARY 6, 2023

The hospital association says it is focusing advocacy on workplace violence, Medicare residency slots, the nursing shortage, and workforce diversity. Strengthening the healthcare workforce is one of the top priorities of the American Hospital Association's advocacy agenda for 2023.

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Medicare Nurse Shortage Retirement Education 105

Healthcare Law Insights blog

JUNE 22, 2023

On June 14, 2023, a federal jury found that a Georgia physician knowingly violated the False Claims Act following a two-week trial on allegations that he made false claims to the Medicare Program. The false diagnosis codes submitted to Medicare likely took this case from an instance of mere overpayment to knowing false claims.

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Medicare 52

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

Capitol Beat

APRIL 30, 2024

That is why we are pleased about a recent regulatory win—the Centers for Medicare & Medicaid Services (CMS) issued a final rule aimed at bolstering nurse staffing at long-term care (LTC) facilities. Achieving safe staffing levels for nurses across care settings remains a top priority for ANA.

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Long Term Care Medicaid Medicare Licensing 92

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. Medicare 1.

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HIPAA Medicare Medicaid Telemedicine 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.

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Pharmaceutical Medicare Medicaid Communication 52

Healthcare Law Insights blog

DECEMBER 28, 2023

Ron Elfenbein, a physician, billed Medicare and private payors a Level 4 E/M for patients receiving COVID-19 tests. But on December 21, 2023, the federal judge who presided over that trial granted Dr. Why Was This Physician Acquitted Following Conviction at Trial? 21, 2023), at 81. [2] 1] United States v.

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Medicare 64

American Nurse

FEBRUARY 29, 2024

Here’s a look at progress made in 2023 and priorities for 2024. This bill would establish a permanent funding stream in Medicare for hospitals to partner with schools of nursing, community-based care settings, and other hospitals to increase clinical education for APRN students.

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APRN Medicare Long Term Care Medicaid 52

Healthcare Law Insights blog

AUGUST 15, 2023

Large managed care plans have been squarely in DOJ’s crosshairs for years, but a late July 2023 Justice Department settlement agreement with one regional healthcare provider’s Medicare Advantage Plan offers a glimpse into an issue health systems and providers with their own managed care plans need to track. million for her share. [3]

Medicare 52

Medicare 52

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

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 116

Health Leaders | Nursing

FEBRUARY 24, 2023

The recent bipartisan Save America’s Rural Hospitals Act includes a provision to permanently remove physician supervision of Certified Registered Nurse Anesthetists (CRNAs), under Medicare Part A conditions of participation. This legislation would permanently end Medicare cuts that have devastated small-town hospitals,” said U.S.

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Medicaid Medicare 105

American Nurse

MARCH 13, 2024

A recent JAMA Network study found that sick people 85 and older were less likely than younger Medicare patients to get covid therapies like Paxlovid. 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. Pfizer reported $12.5

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Medicare Medicaid Senior Living Long Term Care 111

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. Much of Medicare is in statute, and as a result the Administration has limited authority to expand telehealth absent Congressional action. 42 CFR §482.12(c)(1)–(2)

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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

Health Leaders | Nursing

JANUARY 27, 2023

more Black Medicare beneficiaries than Black NPs in non-FPA states. That’s significant because a nursing workforce that reflects its patient demographic makes healthcare more comfortable for every patient, several studies, including a Joint Commission report on cultural diversity, have shown.

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Nurse Practitioner Medicare Business 119

Healthcare Law Insights blog

JUNE 5, 2023

In the 25 years since, the OIG has issued multiple and specific CPGs that apply to particular segments of the healthcare industry including Medicare Advantage organizations, hospitals, home health agencies, nursing homes, and clinical laboratories. The OIG intends to publish the GCPG by December 31, 2023.

Medicare 52

Medicare Federal healthcare Communication 52

Health Leaders | Nursing

SEPTEMBER 5, 2023

Editor’s note: This article appears 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. What will it take?

Medicare 116

Medicare Medicaid Telemedicine Nurse Practitioner 116

Healthcare Law Insights blog

MAY 4, 2022

In the Federal omnibus spending bill signed in March 2022, Congress extended current Medicare reimbursement waivers applicable to telehealth services for five months beyond the end of the PHE. Medicare will continue to cover certain audio-only telehealth services. Bipartisan bills (i.e.

Medicare 52

Medicare Mental Health 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 act mandates a six-year monitoring period for the Patient-Driven Groupings Model ( PDGM), the home health payment model implemented for Medicare in 2020. decrease in pay for 2023 is the net effect.

Medicare 52

Medicare Medicaid 52

Healthcare Law Insights blog

MARCH 13, 2024

The proposal follows a number of significant cyberattacks on healthcare organizations in recent years; Senator King noted that approximately 133 million people, or nearly one in three Americans, had their personal information compromised in 2023 alone. Cybercriminals are not just targeting hospital systems and other healthcare providers.

Medicare 59

Medicare 59

Consult QD

MAY 1, 2023

Ballroom B (Hynes) Laryngology/Bronchoesophagology TRIO Session Trends in Medicare Reimbursement for Laryngology Procedures between 2000-2021 Author List: Nicole Maronian, MD; Todd Otteson, MD, MPH; Robert Lorenz, MD, MBA ; Michael Lerner, MD; Paul Bryson, MD, MBA 4:05-4:20 P.M. Byrne, MD, MBA – Presenter 9:00-9:40 A.M. May 4, 9:00 A.M.-7:00

Medicare 40

Medicare 40

American Medical Compliance

FEBRUARY 15, 2023

The impact of these losses and risks magnifies as Medicare continues to serve a growing number of beneficiaries. Even organized crime groups infiltrate the Medicare Program and operate as Medicare providers and suppliers. The Centers for Medicare and Medicaid Services (CMS) require FWA training.

Medicare 52

Medicare Medicaid Pharmaceutical Federal healthcare 52

American Medical Compliance

FEBRUARY 15, 2023

The impact of these losses and risks magnifies as Medicare continues to serve a growing number of beneficiaries. Even organized crime groups infiltrate the Medicare Program and operate as Medicare providers and suppliers. The Centers for Medicare and Medicaid Services (CMS) require FWA training.

Medicare 52

Medicare Medicaid Pharmaceutical Federal healthcare 52

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

Health Leaders | Nursing

JUNE 6, 2023

I went to the agency SeniorsPlus to learn about Medicare and also learned about all the other wonderful work they do, including keeping people safe in their homes when a nursing home is the alternative. I didn’t even know long-term home health care existed until I retired. One way they do this is by getting them a nurse to visit.

Long Term Care 52

Long Term Care Medicare Retirement 52

Health Leaders | Nursing

FEBRUARY 8, 2023

Under the Medicare program, NPs are authorized to be reimbursed for the treatment of patients with diabetes, yet they are not authorized to certify their patients’ need for diabetic shoes. Current federal law imposes an additional burden on federal employees who may have to travel great distances to receive care from an approved provider.”

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Nurse Practitioner Medicare APRN Licensing 59

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

Healthcare Law Insights blog

MAY 17, 2023

DOJ’s Latest False Claims Act Complaint On May 9, 2023, the U.S. Vascular surgeons soliciting these patients who are seeking only to improve their appearance, but then claim medical conditions necessitating treatment that Medicare covers, run a tremendous risk of DOJ scrutiny. May 9, 2023) (government’s complaint in intervention). [7]

Medicare 52

Medicare Medicaid 52

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 accept patients with Medicare or Medicaid insurance (approximately 61.4 million have Medicare, Parts A and B, and 75.8 2023; 18(7). March 2023. 2023 Comprehensive Accreditation Manual.

Medicaid 52

Medicaid Medicare Promotion Leadership 52

Relias

DECEMBER 8, 2022

Every year, the Centers for Medicare and Medicaid Services (CMS) releases the Program for Evaluating Payment Patterns Electronic Report (PEPPER). This free resource is accessible online and can play an essential part in your internal compliance program in 2023, a year of increased oversight by CMS. Why should you read the PEPPER?

Medicare 52

Medicare Medicaid Self-Care Education 52

Relias

NOVEMBER 4, 2021

Keeping an eye on your case mix is important with Medicare reimbursement shifting to value-based purchasing. The Centers for Medicare and Medicaid Services is planning to implement the Home Health Value-Based Purchasing (HHVBP) model nationwide in 2023. Why Focus on Enhancing Home Health Specializations.

Medicare 52

Medicare Business Medicaid Professional Development 52