Relias

JULY 21, 2025

With constant changes to procedure and diagnosis codes, payer-specific requirements, industry best practices, and documentation guidelines, it’s easy for errors to slip through, especially when teams are understaffed or undertrained. In FY 2024 alone, there were 395 new ICD-10-CM diagnosis codes. CPC, CCS) are key.

Medicare

American Medical Compliance

AUGUST 29, 2024

Participants will learn about best practices in caregiving, communication strategies, and techniques to ensure safety, dignity, and improved quality of life for seniors and individuals with disabilities. Languages: American English Key features: Audio narration, learning activity, and post-assessment.

Medicaid

American Medical Compliance

MARCH 15, 2024

Let’s explore its significance, key regulations, challenges, and best practices. The Significance of FWA Compliance FWA includes activities that defraud healthcare programs, waste resources, or abuse the system. In this comprehensive guide, we delve into FWA compliance in healthcare.

HIPAA

American Medical Compliance

JUNE 21, 2024

The Department of Health and Human Services (HHS) estimated that improper payments in the Medicare and Medicaid programs exceeded $100 billion from 2016 to 2023. Fraud, waste, and abuse (FWA) in healthcare present significant challenges, causing substantial financial losses, eroding public trust, and compromising the quality of patient care.

Medicaid

Relias

APRIL 10, 2025

The Centers for Medicare and Medicaid Services (CMS) issued the Emergency Preparedness Rule to provide a national framework for healthcare organizations to improve their readiness for emergencies. This regulation established consistent emergency preparedness requirements for Medicare and Medicaid providers and suppliers of all types.

Medicaid

Relias

FEBRUARY 28, 2025

Key sources of IHS funding The IHS is primarily funded by federal appropriations, along with grants, Medicaid and Medicare reimbursements, and third-party billing. Medicaid and Medicare reimbursements Tribal health programs can enroll as Medicaid and Medicare providers to receive reimbursements for eligible services.

Medicaid

American Nurse

JUNE 3, 2024

Using best practice recommendations from CARD and the literature, the team developed a questionnaire that allows the patient and caregiver to communicate their unique needs to the healthcare team. 3W3aHFM Centers for Medicare & Medicaid Services. Autism/developmental questionnaire. J Autism Dev Disord. 2017;47(5):1510-29.

Communication

Health Leaders | Nursing

MARCH 5, 2023

A shared leadership/professional governance mindset is key to a successful practice redesign, CNE says. Gilbert spoke with HealthLeaders about how he and his organization are approaching practice redesign and best practices to implement a redesign. HealthLeaders: What is your definition of practice redesign?

Retirement

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

Relias

MARCH 5, 2025

To keep your ketamine program in compliance, ensure your providers understand the following patient safety and monitoring best-practices. Best practices include: Blood pressure checks every 20 minutes during treatment. Medicare Part D patients must: Show they are not eligible for Low-Income Subsidy (LIS).

Medicare

Healthcare Law Insights blog

NOVEMBER 10, 2023

With this integrated approach to risk, the OIG highlights best practices to help healthcare entities fulfill their commitment to compliance with a focus on company-wide involvement driven by leadership. Having a method to keep track of, and review closely, financial relationships with physicians who refer Medicare patients.

Leadership

Capitol Beat

MARCH 15, 2022

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. The survey found that these shortages exacerbated longstanding challenges in health care delivery, access to care, and health outcomes.

Medicare

Relias

MARCH 12, 2025

For example, the Centers for Medicare and Medicaid Services (CMS) mandate facility assessments in long-term care facilities to ensure that staff competencies align with the needs of the patient population. Additionally, accrediting bodies emphasize the importance of competency verification as part of their quality standards.

Long Term Care

Relias

OCTOBER 20, 2021

Telehealth has enabled providers to offer care to clients no matter where they live, without the need to break social distancing best practices. Several factors drove these concerns, such as licensing, Medicare/Medicaid?reimbursement, Telehealth technology is one great example. some providers?were?weary marginalized?communities

Medicaid

American Nurse

JANUARY 2, 2024

However, despite available best practice guidelines, nurses’ knowledge of both risk and preventive strategies varies and the incidence of pressure injuries (PIs) worldwide remains stagnant. Medicare estimates that each pressure injury adds $43,180 to a hospital stay. worldwide. •

Education

Relias

AUGUST 9, 2023

Tis the season for evaluating training programs and checking everything twice to make sure you’re on the Center for Medicare and Medicaid Services’ and The Joint Commission’s nice lists. There isn’t a test you can put in front of them to know whether they’re employing best practices.

Best Practices

Consult QD

MAY 8, 2023

3 Who to enroll in a lung cancer screening program : Guidance from the United States Preventive Services Task Force (USPSTF) has contributed to policy from Centers for Medicare & Medicaid Services and other payors for who should be screened.

Best Practices

Relias

JUNE 19, 2023

According to a 2021 report from the United States Government Accountability Office, Medicare spending on stays for severe wound care declined about 2% from $2.06 When staff is trained on wound best practices, the patients have better outcomes. billion in fiscal year 2016 to $2.01 billion in fiscal year 2018.

Long Term Care

Capitol Beat

DECEMBER 22, 2022

This law will identify and disseminate best practices to reduce and prevent mental and behavioral health conditions, suicide, and burnout, as well as increase access to evidence-based treatment for nurses and other health care professionals. Read more about the #ICAN Act here. Learn more and email your senators, here.

Medicaid

Nursing Review

APRIL 15, 2024

If we were doing best practice, sometimes things like EMDR therapy, we would be looking at two sessions a week for blocks of time – so two sessions a week. I also just want to call attention to the perinatal or pregnancy counselling rebates that Medicare allows. There's about a $40 gap between that," Ms O'Doherty said. "I

Medicare

Consult QD

MAY 11, 2023

Additionally, hospitals are not reimbursed by the Centers for Medicare & Medicaid Services for costs associated with sternal wound infections, so these infections can have a negative financial impact. DSWIs: Uncommon but impactful A DSWI is a devastating complication of cardiac surgery for the patient. healthcare system an estimated $3.5

Medicaid

American Nurse

DECEMBER 8, 2023

The Centers for Medicare & Medicaid Services doesn’t reimburse costs associated with healthcare-associated CAUTI, so prevention has financial implications. Significant contribution UTI remains an epidemiologically significant infection across all healthcare settings, especially related to growing concerns about antibiotic resistance.

Best Practices

American Nurse

FEBRUARY 29, 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. ANA also proudly supported introduction of the Educating Future Nurses Act (S.

APRN

Relias

MARCH 13, 2023

In the healthcare industry, regulations and best practices are always changing. The best way to protect your organization is to monitor your compliance risks proactively. A patient access management audit may include a review of documentation such as Medicare Secondary Questionnaires and Advanced Beneficiary Notices.

Medicare

Health Leaders | Nursing

FEBRUARY 27, 2024

The Acute Hospital Care at Home program, supported by the Centers for Medicare & Medicaid Services (CMS), took off during the pandemic and is now in place in more than 300 health systems across the country. More and more care will be in the home.

Telemedicine

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.

Chief Nursing Officer

Relias

JULY 20, 2023

­The Centers for Medicare and Medicaid Services (CMS) issued a final rule in August 2022 to improve maternal health outcomes and advance health equity — two of the Biden-Harris Administration’s key priorities. It is important to focus on clinical protocols and reduction in practice variation. Sadly, U.S. rates are continuing to rise.

Medicaid