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Medicare Patients Win the Right to Appeal Gap in Nursing Home Coverage

Kaiser Health News

A three-judge federal appeals court panel in Connecticut has likely ended an 11-year fight against a frustrating and confusing rule that left hundreds of thousands of Medicare beneficiaries without coverage for nursing home care, and no way to challenge a denial. But it can have serious repercussions.

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HHS Issues Proposed Rule to Provide Clarity on Rights of Conscience in Healthcare

Healthcare Law Blog

BACKGROUND The Proposed Rule is the latest in a long line of federal legislation and rulemakings governing the conscience rights of healthcare providers and entities. The Church Amendments In the 1970s, the federal government enacted the Church Amendments, 42 U.S.C.

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Australia ends support for 128 telehealth items

Healthcare IT News - Telehealth

Some changes to the Medicare Benefits Schedule for telehealth items in Australia – including the termination of 128 items, amendment of 17 items, and the addition of two more items – have taken effect this week. WHAT IT'S ABOUT. The changes come following the recommendations by the MBS Review Taskforce. THE LARGER CONTEXT.

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Georgia Nursing Home Settles to Resolve Allegations of False Claims for Therapy Services

Healthcare Compliance Blog

In a March 11, 2022, release by the Northern District of Georgia’s Office of the Department of Justice, it was reported that an investigation determined a Georgia nursing home knowingly submitted claims for unreasonable, unnecessary, and unskilled services for Medicare patients. This amount was based on the nursing home’s ability to pay.

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Aspects of Social Determinants of Health: Collecting Data

Healthcare IT Today

Data can be spotty, according to Eye, who says for instance that data from Centers for Medicare & Medicaid Services (CMS) often lacks racial identifications. The service pulls together the profiles maintained by facilities and local governments and combines relevant information to display to providers.

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CMS’ Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs

Healthcare Law Blog

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). Enrollee Participation in Plan Governance (§ 422.107). and 422.107).

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How Will the “New” Health Economy Fare in a Macro-Economic Downturn?

Health Populi

.” Over 11 years ago, I listened to Dr. Toby Cosgrove, then CEO of The Cleveland Clinic, warn in his 2011 State of the Clinic annual address that, “we have to do better with less.” health care system not seen since the 1968 creation of Medicare, coupled with decreased reimbursement due to health care reform.