American Nurse

FEBRUARY 29, 2024

Takeaways: The 1990 Federal Patient Self Determination Act requires that Medicare- and Medicaid-funded healthcare organizations follow state laws related to advance directives. Advance directives are legal documents that allow adults to record their wishes related to serious illness or end-of-life care. See Patient self-determination.

Self-Care 59

Self-Care Medicaid Medicare Nurse Practitioner 59

Daily Nurse

AUGUST 7, 2023

“For example, an analysis by McKinsey & Co found that telehealth accounted for less than 1% of Medicare services before the onset of the pandemic, but by July of 2021, telehealth services accounted for about 13-17% of claims submitted to Medicare.

APRN 92

APRN Licensing Medicare HIPAA 92

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

Healthcare Law Insights blog

OCTOBER 17, 2023

To best position the nursing home for the most successful outcome at the appeal hearing, the facility must follow specific rules and requirements as it discharges or transfers the resident and the facility must ensure it documents all necessary facts along the way. What documentation is required before sending the notice of discharge?

Long Term Care 59

Long Term Care Medicaid Medicare Communication 59

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). CMS is strengthening the Medicare Diabetes Prevention Program (MDPP) , which ANA supports.

APRN 73

APRN Medicare Long Term Care Medicaid 73

Daily Nurse

APRIL 24, 2023

Centers for Medicare and Medicaid Services. Document your patient care assessments, observations, communications, and actions in an objective, timely, accurate, complete, and appropriate manner. Remind patients to seek emergency treatment if a condition worsens, and document this action.

Malpractice 136

Malpractice Nurse Practitioner Long Term Care Medicaid 136

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

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. 2] To join OIG’s listserv, visit [link].

Medicare 52

Medicare Federal healthcare Communication 52

American Medical Compliance

DECEMBER 26, 2023

What you will learn: Situations where the No Surprises Act applies Specific requirements for compliance with the No Surprises Act Billing and payment processes under the No Surprises Act The importance of accurate documentation Details Course length: 45 minutes.

Health Insurance 52

Health Insurance Medicaid Medicare 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. Providing documentation of its financial commitment to staffing. At the time, the proposed CMS staffing mandate was met with criticism from all sides.

Long Term Care 95

Long Term Care Licensing Medicaid Medicare 95

Nurse.com

OCTOBER 12, 2023

Be sure to take pertinent documents with you to the consultation, including copies of the old policies and procedures. In addition, Medicare and Medicaid certification may be threatened if the policies are not managed correctly.

Medicaid 52

Medicaid Medicare 52

Relias

APRIL 18, 2022

Providing consistent, evidence-based care and thorough documentation. Avoiding penalties and legal risks that go along with inaccurate assessments, incomplete documentation, and preventable pressure injuries. Chronic wounds affect about 15% of Medicare beneficiaries each year. Build Your Reputation as a Specialist.

Education 52

Education Medicare Promotion Medicaid 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). 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 52

Medicare Medicaid Self-Care Education 52

American Nurse

MARCH 6, 2024

The CMs documented all referrals as a problem, goal, and intervention (PGI) in the EHR and offered to assist with scheduling appointments. CM adherence The documentation of referrals in the EHR allowed the project manager to track nurse CM adherence with the referral process and determine the need for process changes.

Telemedicine 98

Telemedicine Health Insurance Health Literacy Promotion 98

American Nurse

DECEMBER 8, 2023

The Centers for Medicare & Medicaid Services won’t reimburse hospitals for the care of this condition and may apply a value-based penalty fee. Comprehensive documentation of any dysfunction in skin integrity aids early diagnosis and prompt treatment to improve overall outcomes.

Clinical Nurse Specialist 98

Clinical Nurse Specialist Medicaid Medicare Communication 98

Relias

SEPTEMBER 23, 2022

The percentage of Medicare hospice beneficiaries dying with a diagnosis of dementia or Parkinson’s disease, some of whom have dementia, has increased from 9% in 2002 to almost 21% in 2019, according to the National Hospice and Palliative Care Organization’s Facts and Figure Report 2021 Edition. Document care preferences in advance.

Medicare 52

Medicare Communication Education 52

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. In 2012, the Centers for Medicare and Medicaid Services implemented the Hospital Readmissions Reduction Program (HRRP).

Medicaid 52

Medicaid Medicare Long Term Care Self-Care 52

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 105

HIPAA Self-Care Health Insurance Best Practices 105

Relias

APRIL 28, 2023

The Centers for Medicare and Medicaid Services (CMS) requires all health facilities in the Medicare program to track and report data reflecting pressure injury development on all clients. All such checks should be documented as well.

Medicare 98

Medicare Long Term Care Medicaid Promotion 98

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

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. In 2020, PDGM changed reimbursement by focusing more on patient characteristics.

Medicare 52

Medicare Business Medicaid Professional Development 52

Relias

FEBRUARY 26, 2024

” The Centers for Medicare and Medicaid Services (CMS) defines care coordination more holistically as “the process of ensuring that the patient’s health needs and preferences for health information and services are met across the continuum of care.”

Care coordination 52

Care coordination Patient Satisfaction Self-Care Emergency Care 52

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 52

Medicaid Medicare Mental Health Licensing 52

Celayix

FEBRUARY 7, 2023

There is also the patient family, and the patient insurance provider, or the government in the case of Medicare or Medicaid. It can help to document everything so that you can review this with your patient later. This helps to ensure that the complaint is properly addressed, and that the resolution is documented for future reference.

Home Healthcare 52

Home Healthcare Medicaid Business Medicare 52

Relias

DECEMBER 21, 2021

For Medicare claims, you already track care quality and report it to the Centers for Medicare and Medicaid Services (CMS). Those quality ratings appear on Medicare’s Care Compare website and inform prospective clients how well you’re achieving positive outcomes. Improve Your Quality Ratings.

Medicare 52

Medicare Medicaid Staff Training Home Healthcare 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 Doi: 10.51256/ANJ072339 Reference Centers for Medicare and Medicaid Services.

Medicaid 52

Medicaid Medicare Promotion Leadership 52

Relias

JANUARY 30, 2024

Healthcare organizations receive scores from the HCAHPS survey , which according to the Centers for Medicare and Medicaid Services, is “the first national, standardized, publicly reported survey of patients’ perspectives of hospital care.” The data is then tabulated to create the HCAHPS score.

Patient Satisfaction 52

Patient Satisfaction Patient Experience Medicare Self-Care 52

Hospital Recruiting | Nursing

APRIL 1, 2020

The emergency decision by the Center for Medicare and Medicaid Services (CMS) on March 17, 2020 (and retroactively in effect beginning March 6, 2020) to pay for telehealth visits outside of rural areas has eased physician concern.

Telemedicine 72

Telemedicine Medicaid Medicare Licensing 72

Relias

OCTOBER 28, 2022

The Centers for Medicare and Medicaid Services (CMS) is ramping up survey scrutiny for hospice this year, training surveyors to focus on interdisciplinary group care planning and coordination of care as part of an emphasis on meeting four core Conditions of Participation. Documentation in the medical record.

Care coordination 52

Care coordination Communication Medicaid Medicare 52

IntelyCare

MARCH 3, 2023

It’s estimated that 37% of those who allegedly purchased fake documents passed the test and went on to obtain licensure. Over 7,600 diplomas were purchased by Registered Nurse (RN) and Licensed Practical/Vocational Nurse (LPN/LVN) candidates who were then able to take the national nursing board exam.

Licensing 93

Licensing HIPAA LPN Medicaid 93

Healthcare Law Insights blog

JULY 7, 2023

Importantly, although the court assumed the relator engaged in some protected activity, the court found that in many of her communications she, at most, characterized discrepancies in therapy documentation as mistakes or possible computer glitches, not fraud. Another noteworthy FCA decision is out of the Sixth Circuit.

Pharmaceutical 52

Pharmaceutical Medicare Medicaid Communication 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

Healthcare Law Insights blog

AUGUST 28, 2023

Elfenbein’s drive-through testing sites billed over $30 million to payors for E/M claims accompanying COVID-19 tests, according to the Justice Department. [3]

Medicare 52

Medicare 52

American Nurse

APRIL 2, 2024

Waite called on nurses to remember that social justice is a core tenet of ANA foundational documents, including the Code and Scope and Standards of Practice. ANA considers these numbers a first step toward direct reimbursement for nursing services from Medicare and Medicaid.

Health Insurance 52

Health Insurance Chief Nursing Officer Medicaid Medicare 52

Consult QD

OCTOBER 24, 2023

Patients with planned TAVR and documented AF who were tolerant of oral anticoagulants were eligible. We are reaching out to the Centers for Medicare & Medicaid Services (CMS) to encourage reimbursement of the combined procedures,” Dr. Kapadia says. All patients in the TAVR+LAAO group received the Watchman 2.5

Medicaid 97

Medicaid Medicare 97

American Nurse

JULY 5, 2023

During the pandemic, about 230,000 APRNs treated Medicare patients, and approximately 40% of Medicare beneficiaries received care from APRNs. Certain other restrictions also were lifted. Now however, the state has reverted to its restrictive pre-pandemic APRN scope of practice regulations with some modifications.

APRN 52

APRN Medicare Nurse Practitioner Licensing 52