The Relentless School Nurse

MARCH 8, 2025

The Centers for Medicare & Medicaid Services (CMS) rescinded key guidance on March 4, 2025, affecting Medicaid and Childrens Health Insurance Program (CHIP) coverage for services addressing health-related social needs (HRSNs). However, it fails to consider the well-documented links between social factors and health outcomes.

Medicaid

American Nurse

JUNE 16, 2025

The disparity in this population has been extensively documented. The most frequently observed category of insurance was public Medicare/Medicaid (n = 27, 84.38%). An interesting finding showing that more education is needed is related to the human papillomavirus (HPV) vaccine. References Ali, D., O’Brien, S.,

Nurse Practitioner

American Medical Compliance

MARCH 13, 2025

Medicare and Medicaid Participants : Entities receiving payments through these federal programs. Be Documented : Maintain records of training sessions for accountability and future reference. 5. Health Insurance Providers : Companies providing health coverage plans.

Medicare

American Nurse

JULY 9, 2025

CFCNs perform assessments, implement interventions, and provide patient education. Routine foot examinations performed by a CFCN or other skilled professional, combined with education in proper foot care, can detect common foot problems, uncover functional decline, and prevent falls. www.apma.org/apmamain/document-server/?cfp=/apmamain/assets/file/public/studies/apma2014todayspodiatristsurveyallfindings.pdf

Medicare

Nurse Practitioners in Business

JULY 5, 2023

Clinical documentation audits. But it’s not the only reason payers may look at clinical documentation. We all know our documentation can protect us or get us into trouble if it’s not there. They can be educational and help you improve the quality of care you deliver and your business. Or are there liability issues?

Business

American Medical Compliance

AUGUST 7, 2024

CMS (Centers for Medicare & Medicaid Services) These regulations provide essential guidelines for healthcare providers participating in Medicare and Medicaid programs. For example, CMS requires accurate and timely documentation of patient care to ensure proper billing and reimbursement.

HIPAA

Daily Nurse

APRIL 24, 2023

Centers for Medicare and Medicaid Services. Maintain basic clinical and specialty competencies by proactively obtaining the professional information, education, and training needed to remain current regarding nursing techniques, clinical practice, medications, biologics, and equipment.

Malpractice

Relias

APRIL 28, 2022

Many participants have a role to play in the revenue cycle, and at each stage they must employ their specialized knowledge of how that patient interaction and service is documented in the patient’s health record. How Clinical Documentation Integrity Affects Revenue. CDI Affects More Than Financial Health.

Medicaid

Relias

JUNE 1, 2022

Coding and clinical documentation have never been more important in healthcare. “We You’ll need ongoing training for your staff to improve your clinical documentation and avoid the following coding disasters. The documentation and coding are appropriate on our end. Insufficient Clinical Documentation or Underreported codes.

Outpatient Clinic

Relias

JUNE 1, 2022

Coding and clinical documentation have never been more important in healthcare. “We You’ll need ongoing training for your staff to improve your clinical documentation and avoid the following coding disasters. The documentation and coding are appropriate on our end. Insufficient Clinical Documentation or Underreported codes.

Outpatient Clinic

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. Through accurate documentation, ethical billing practices, continuous education, and robust internal controls, providers can significantly lessen FWA risks.

Medicaid

American Nurse

JUNE 3, 2024

Create a care plan based on the patient’s ASD assessment, communicate it to all care team members, and document it in the patient health record. Admission history document. If the patient is ever re-admitted, the care team can retrieve and update the document as needed. See EBP recommendations.)

Communication

Relias

APRIL 18, 2022

Specialized wound care education reaps financial and human rewards that can give you a trackable return on investment. Financial rewards of wound care education flow outward from the human benefits. And your wound care education investment can help in all those areas. Results of Your Wound Care Education Investment.

Education

Consult QD

FEBRUARY 17, 2023

There are also documented misconceptions in the medical community around the ability of people experiencing homelessness to adhere to treatment plans. One common myth is that people who are homeless may be more aggressive, despite research showing that they are more likely to be victims of violence than perpetrators.

Medicaid

Relias

MAY 16, 2025

Over a decade ago, the Center for Medicaid and Medicare Services (CMS) Hospital Readmissions Reduction Program (HRRP) focused on reducing 30-day readmissions for high-volume, high-cost conditions like heart failure, pneumonia, and total joint replacements. However, HRRP was often criticized for being narrow in scope.

Self-Care

American Nurse

JULY 2, 2024

Sherri Mack Nurses are becoming an increasingly important part of the movement to educate patients, other healthcare providers, and the public about cannabis use. Cannabis nursing, a specialty nursing practice focused on providing education and guidance to healthcare consumers on the therapeutic use of cannabis, furthers this effort.

Business

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

American Medical Compliance

MARCH 15, 2024

Furthermore, it prohibits knowingly submitting false or false claims to Medicare, Medicaid, or other federally funded healthcare programs. While EHRs offer numerous benefits, including improved documentation and care coordination, they also introduce complexities and potential vulnerabilities.

HIPAA

American Nurse

MARCH 6, 2024

They then provided telephonic education to those patients about polypharmacy, the benefits of a pharmacist-led medication review, and the AWC web application. The CMs documented all referrals as a problem, goal, and intervention (PGI) in the EHR and offered to assist with scheduling appointments.

Telemedicine

IntelyCare

JANUARY 10, 2023

The RAI process is also a federal requirement from the Centers of Medicare and Medicaid Services (CMS) as outlined in section §483. Compliance The most recent ‘comprehensive’ assessment (initial or periodic assessment) is often referred to as the primary resident document and is the representation of the resident’s overall health status.

Medicaid

Capitol Beat

JANUARY 4, 2024

Not surprisingly, the main focus of advocacy is the federal Department of Health and Human Services (HHS) and its subagency, the Centers for Medicare and Medicaid Services (CMS). ANA’s regulatory engagements, though sometimes overlooked, are an important part of our advocacy on behalf of more than 5 million nurses in the U.S.

APRN

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

American Medical Compliance

FEBRUARY 15, 2023

Combating Fraud, Waste, and Abuse (FWA) Training for Dental Healthcare Providers is designed to educate dental healthcare providers (DHCP) on how to prevent, detect, and report fraud, waste, and abuse in the healthcare setting. The Centers for Medicare and Medicaid Services (CMS) require FWA training.

Medicare

American Medical Compliance

FEBRUARY 15, 2023

The EMS Fraud Waste and Abuse Training is designed to educate EMS workers on how to prevent, detect, and report fraud, waste, and abuse in the healthcare setting. The Centers for Medicare and Medicaid Services (CMS) require FWA training. Documentation of this distribution is required.

Medicare

Relias

JUNE 1, 2023

Not all process issues are best served with technology,” said Amber Hermosillo, Revenue Cycle Educator and Quality Director at Banner Health. 5 – Educate clinicians on required documentation Clinicians sometimes omit important documentation. Missing documentation can cause rework for revenue cycle staff.

Medicaid

Relias

JUNE 1, 2023

Not all process issues are best served with technology,” said Amber Hermosillo, Revenue Cycle Educator and Quality Director at Banner Health. 5 – Educate clinicians on required documentation Clinicians sometimes omit important documentation. Missing documentation can cause rework for revenue cycle staff.

Medicaid

American Nurse

FEBRUARY 16, 2024

To address patients’ needs, Bayhealth Hospital has started sending a box of food home on discharge with patients who have food insecurities per their SDOH documentation and a referral to the Delaware Food Bank. Education can be formal or informal, depending on the complexity of the patient’s needs. Karmarkar, A.,

Medicaid

Board Vitals - Nursing

AUGUST 30, 2016

Quick links are posted at the bottom of this document for your convenience. Teen pregnancy Increase access to contraceptive counseling by expanding the age and income eligibility levels for Medicaid coverage of family planning services to increase teens’ access to healthcare services, including contraception and other preventive services.

Medicaid

American Nurse

SEPTEMBER 18, 2024

Outdated language in Medicare and Medicaid regulations were written in 1965 before APRNs were providers in the U.S. Stay tuned for updates about educational opportunities and programs from the Task Force this fall! Improving Care and Access to Nurses (ICAN) (H.R. Nurse Faculty Reduction Act (H.R.

APRN

American Nurse

DECEMBER 8, 2023

Using an “all teach, all learn” approach, Project ECHO offers interactive education, peer-to-peer learning, case co-management, and collaborative problem-solving. Project ECHO’s “All teach, all learn” approach has four primary elements: interactive education, peer-to-peer learning, case co-management, and collaborative problem-solving.

Long Term Care

Relias

OCTOBER 28, 2022

Comprehensive education for home health staff is vital to boost performance under HHVBP, observed Relias Director of Post-Acute Care Solutions Trish Richardson, MSN, BSBA, RN, NE-BC, CMSRN. Documentation in the medical record. Document all coordination. If it didn’t get documented, it didn’t get done.”.

Care coordination

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

Relias

DECEMBER 8, 2022

But there is a particular educational tool that tends to fall under the radar of many healthcare organizations. Every year, the Centers for Medicare and Medicaid Services (CMS) releases the Program for Evaluating Payment Patterns Electronic Report (PEPPER). We all love free tools that help our organizations perform better.

Medicare

Relias

DECEMBER 21, 2021

For Medicare claims, you already track care quality and report it to the Centers for Medicare and Medicaid Services (CMS). Bear in mind that your rating depends on accurate documentation of your initial assessment of the patient and in your Medicare claims for the care provided.

Medicare

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

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. During the COVID-19 pandemic, many care providers considered how telehealth tools could be used in innovative ways in the care of patients. Numbers skyrocketed from 2.1

Chief Nursing Officer

Relias

NOVEMBER 4, 2021

The Centers for Medicare and Medicaid Services is planning to implement the Home Health Value-Based Purchasing (HHVBP) model nationwide in 2023. Investing in clinicians and caregivers to ensure they have specialized education and training appears to be the best way to stay compliant. Incentivize Staff Education. Palliative care.

Medicare