Kaiser Permanente

JANUARY 1, 2022

Medicaid and the Children’s Health Insurance Program (CHIP) have served as critical supports to children, pregnant women, parents, seniors, and individuals with disabilities – covering 80 million individuals during the COVID-19 pandemic. Since February 2020, Medicaid enrollment has grown sharply to cover an additional 9.9

Medicaid 92

Medicaid Medicaid Medicare Medicare 92

Electronic Health Reporter

MARCH 5, 2019

The article America’s Physician Groups Responds to CMS MA 2020 Advance Notice appeared first on electronichealthreporter.com. The article America’s Physician Groups Responds to CMS MA 2020 Advance Notice appeared first on electronichealthreporter.com.

Medicare 89

Medicare Medicare Medicaid Medicaid 89

Bill of Health

MAY 22, 2023

The selections feature topics ranging from an analysis of government and industry investments for recently approved drugs, to a discussion of court decisions on mifepristone, and an examination of the added therapeutic benefit associated with the top-selling brand-name drugs in Medicare. Galkina Cleary E, Jackson MJ, Zhou EW, Ledley FD.

Pharmaceutical Industry 157

Pharmaceutical Industry Medicare Medicare Medicaid 157

HIT Consultant

NOVEMBER 9, 2023

Director of Healthcare Strategy, LexisNexis Risk Solutions During the peak of the Covid-19 pandemic, over 10 million Americans enrolled in Medicaid – nearly a 14% increase from the beginning of 2020. A month before the public health emergency ended on May 11, 2023, 87 million individuals were enrolled in Medicaid.

Medicaid 64

Medicaid Medicaid Health Insurance Health Outcomes 64

Bill of Health

MARCH 24, 2023

The selections feature topics ranging from an analysis of the approval and marketing of biosimilars with a skinny label and their associated Medicare savings, to a discussion of the Philips Respironics recall and the need for reforms to U.S. Characteristics of Prior Authorization Policies for New Drugs in Medicare Part D. 2023 Feb 23.

Medicare 144

Medicare Medicare Medicaid Medicaid 144

Electronic Health Reporter

APRIL 18, 2019

The Centers for Medicare & Medicaid Services (CMS) released the final annual Notice of Benefit and Payment Parameters for the 2020 benefit year, also known as the 2020 Payment Notice. This article is copyrighted strictly for Electronic Health Reporter. Illegal copying is prohibited.

Medicaid 89

Medicaid Medicaid Medicare Medicare 89

Healthcare IT News - Telehealth

MARCH 30, 2022

Department of Health and Human Services Office of Inspector General released a study examining how Medicare beneficiaries used telehealth during the first year of the COVID-19 pandemic. "Telehealth was critical for providing services to Medicare beneficiaries during the first year of the pandemic," read the report.

Medicare 146

Medicare Medicare US Department of Health and Human Services COVID-19 146

Innovaare Compliance

FEBRUARY 19, 2024

On January 31, 2024, the Centers for Medicare & Medicaid Services (CMS) released a draft of the 2025 Advance Notice describing the Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ahead of the final notice to be published on April 1, 2024.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Innovaare Compliance

FEBRUARY 19, 2024

On January 31, 2024, the Centers for Medicare & Medicaid Services (CMS) released a draft of the 2025 Advance Notice describing the Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ahead of the final notice to be published on April 1, 2024.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Electronic Health Reporter

MARCH 19, 2021

1, 2020, the Centers for Medicare and Medicaid Services (CMS) released its final ruling on policy and payment changes to the Medicare Physician Fee Schedule […]. Illegal copying is prohibited. By Devin Partida, technology writer and the editor-in-chief, ReHack.com.

Medicare 171

Medicare Medicare Medicaid Medicaid 171

Medisys Compliance

MAY 19, 2022

The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. During the COVID-19 public health emergency, any health care provider who is eligible to bill Medicare can bill for telehealth services regardless of where the patient or provider is located. Eligible services.

COVID-19 52

COVID-19 Medicare Medicare Medical Billing 52

HIPAA Journal

SEPTEMBER 29, 2022

The Government Accountability Office (GAO) recently conducted a review of Medicare telehealth services provided during the COVID-19 pandemic, when a waiver was in place that greatly expanded access to telehealth and virtual visits. Between April and December 2019, 5 million Medicare telehealth visits were conducted.

Medicare 74

Medicare Medicare COVID-19 HIPAA 74

Healthcare IT Today

DECEMBER 31, 2020

To further support clinicians during the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services (CMS) has extended the deadline for COVID-19 related 2020 Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances Exception applications to February 1, 2021.

COVID-19 52

COVID-19 Payment Systems Medicaid Medicaid 52

Healthcare IT News - Telehealth

NOVEMBER 10, 2020

Prepare Now for Anticipated Changes to Medicare and Private Payer Rules. The Centers for Medicare and Medicaid Services (CMS) is expected to issue new rules for telehealth in the release 2021 Physician Fee Schedule later this year. Today, Medicare reimburses for specific services when delivered via live video. ii] [link].

Public Health 148

Public Health Medicare Medicare COVID-19 148

HIPAA Journal

OCTOBER 17, 2022

The investigation also uncovered unauthorized access to email accounts, with the email accounts accessed by unauthorized individuals at various points over the preceding 8 months, between December 22, 2020, and July 15, 2021. This post will be updated when the scale of the breach is known.

Licensing 57

Licensing HIPAA Health Insurance Medicaid 57

Healthcare Law Blog

MAY 16, 2022

More than 13 million people were enrolled in Medi-Cal in California in September 2021, making it the largest Medicaid program in the nation. In 2015, DHCS launched the WPC Pilots as part of its Medi-Cal 2020 Section 1115 Demonstration.

Medicaid 59

Medicaid Medicaid Nurses Health Care Access 59

Hall Render

JULY 28, 2023

Starting on August 1, 2023, Medicare validation edits will be activated to require service location addresses on the UB-04 hospital claim form to match exactly with the service location enrolled in Medicare’s Provider Enrollment, Chain, and Ownership System (“PECOS”).

Medicare 40

Medicare Medicare Compliance COVID-19 40

Healthcare IT News - Telehealth

OCTOBER 21, 2020

Data released this past week from the Centers for Medicare and Medicaid Services show that more than 34.5 million services were delivered via telehealth in Medicare and in the Children's Health Insurance Program from March through June. As of June 2020, said CMS, more than 91.8 ON THE RECORD.

Medicaid 208

Medicaid Medicaid Medicare Medicare 208

Redox

MARCH 24, 2021

But in 2020, necessity was the mother of adoption , and by this, I mean technology, especially as it relates to telehealth. In one of my recent Forbes columns, I took a slightly different approach to the usual predictions, focusing more on lessons learned from 2020 to then help guide these four forward-looking prescriptions: .

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Health Care Law Brief

APRIL 3, 2023

On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ( Rate Announcement ). 1395w-23): Medicare Advantage Organizations (MAOs) are paid a base rate by CMS. Risk Adjustment.

Medicare 52

Medicare Medicare Overpayments Overpayment 52

Health Populi

FEBRUARY 14, 2018

In 2020, national health expenditures (NHE) in the United States will exceed $4 trillion to cover 334.5 Three factors will drive healthcare costs to 2026: prices for medical goods and services, changes in income growth, and shifting enrollment from private health insurance to Medicare — driven by the aging of Boomers.

Health Insurance 79

Health Insurance Medicare Medicare Medicaid 79

HIT Consultant

SEPTEMBER 30, 2022

What You Should Know: – Behavioral health company, Grow Therapy secures $75 million in series B funding to expand insurance coverage including Medicare and Medicaid in all 50 states. Medicare/Medicaid Coverage Expansion.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Innovaare Compliance

JANUARY 19, 2021

It has become evident by changes to the Centers for Medicare & Medicaid Services (CMS) Star Rating formulas over the past several years—and especially with changes implemented for the 2021 Plan Year—that member experience and medication adherence is of utmost importance to the CMS. Medicare Star Ratings 2021 Changes.

Medicare 52

Medicare Medicare COVID-19 Compliance 52

Health Law Attorney

APRIL 22, 2021

The Act extends the temporary suspension of certain mandatory Medicare FFS claim payment reductions until December 31, 2021. In response to the COVID-19 pandemic, Congress passed the Coronavirus Aid, Relief, and Economic Security (“ CARES ”) Act in March 2020. Continue Reading ?.

Medicare 40

Medicare Medicare COVID-19 Medicaid 40

HIT Consultant

AUGUST 6, 2023

They are no longer simply a place for aging Medicare and Medicaid patients to live out their final years. Both traditional Medicare and Medicare Advantage, along with Medicaid, are leading the way in value-based reimbursement models, according to the report. Nursing homes are evolving. percent of U.S.

Nursing Homes 98

Nursing Homes Nurses Medicare Medicare 98

Health Law Advisor

AUGUST 14, 2023

2] This means, in most cases, that Medicare beneficiaries must now come to a physician practice’s office location to pick up their DME – including IUCs – when the DME items are furnished and billed by physicians or their practices. The IOAS exception does NOT apply.

COVID-19 52

COVID-19 Medicare Medicare Public Health 52

Kaiser Health News

NOVEMBER 11, 2021

Encontrar el mejor plan médico privado, o de medicamentos, de Medicare entre docenas de opciones es lo suficientemente difícil sin incluir estrategias de venta engañosas. “No eres de Medicare”, le dijo Heimer. Cuando respondió, reconoció la voz de la misma mujer. Heimer colgó de nuevo.

Medicare 58

Medicare Medicare Fraud ADA 58

Healthcare IT Today

JANUARY 14, 2024

News and Studies Follow-up rates for telehealth and in-office visits have remained consistent since 2020 , according to analysis from Epic Research. That said, telehealth visits are more likely to result in follow-ups at the 7-, 30- and 9-day mark, especially in OB/GYN, podiatry, and internal medicine.

Medicaid 100

Medicaid Medicaid FDA Medicare 100

Healthcare IT News - Telehealth

JANUARY 25, 2021

The bill, which was first introduced in July 2020, would help safeguard access to virtual care after COVID-19 via four main provisions. Authorize the Centers for Medicare and Medicaid Service to continue reimbursement for telehealth for 90 days beyond the end of the public health emergency. WHY IT MATTERS.

COVID-19 211

COVID-19 Medicare Medicare Telemedicine 211

HIT Consultant

FEBRUARY 3, 2022

What You Should Know: – Hackensack Meridian Health , New Jersey’s largest and most integrated health network launches of Hospital At Home at JFK University Medical Center in Edison, a program that delivers high-quality acute care in the home of a Medicare patient and may ultimately be scalable to the larger patient population.

Hospitals 98

Hospitals COVID-19 Medicare Medicare 98

Healthcare IT News - Telehealth

SEPTEMBER 27, 2021

The brief, which examined oversight efforts as of January and February 2020, stemmed from a survey of Medicaid directors from 37 states, as well as structured interviews with relevant stakeholders. Even so, only 11 conduct telehealth-specific monitoring and oversight. OIG issued three recommendations for the U.S. Twitter: @kjercich.

Fraud 182

Fraud COVID-19 Medicaid Medicaid 182

HIT Consultant

OCTOBER 31, 2023

What You Shoud Know: – Medicaid prospective payment rate for Michigan’s federally qualified health centers (FQHCs) has not kept pace with the actual costs incurred to provide healthcare, resulting in a substantial reimbursement gap of $97.95

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIPAA Journal

MAY 12, 2023

A settlement has been proposed by Maxim HealthCare Services to resolve all claims related to a 2020 cyberattack and data breach involving unauthorized access to multiple employee email accounts. The breach was reported to the HHS’ Office for Civil Rights as affecting 65,267 patients. A lawsuit – Wilson, et al.

HIPAA 86

HIPAA Medicaid Medicaid Medicare 86

Healthcare IT News - Telehealth

MARCH 25, 2021

Using data from Blue Health Intelligence data repository – an independent data and analytics company that is a licensee of the Blue Cross and Blue Shield Association – researchers from the Johns Hopkins Bloomberg School of Public Health compared claims data from March through June 2019 with March through June 2020.

COVID-19 207

COVID-19 Public Health Medicare Medicare 207

NY Health Law

FEBRUARY 13, 2024

On January 9, 2024, the federal Centers for Medicare and Medicaid Services (CMS) finally approved New York State’s 1115 waiver amendment to establish the New York Health Equity Reform (NYHER) Program. Workforce: Workforce investments with a goal of equitable and sustainable access to care in Medicaid.

Medicaid 52

Medicaid Medicaid Nurses Medicare 52

HIT Consultant

FEBRUARY 9, 2023

Czekai, MPH, VP of Strategic Partnerships at Cohere Health The Centers for Medicare & Medicaid Services (CMS) recently proposed a new rule to advance interoperability and improve the prior authorization (PA) process for Medicare and Medicaid patients. LinkedIn – [link].

Medicaid 98

Medicaid Medicaid Medicare Medicare 98

Healthcare IT News - Telehealth

OCTOBER 2, 2020

The Telehealth Improvement for Kids’ Essential Services, or TIKES, Act of 2020 would require the Secretary of the U.S. Department of Health and Human Services to issue guidance to states about how to increase access to telehealth under Medicaid and the Children’s Health Insurance Program. Blunt Rochester in a statement.

US Department of Health and Human Services 154

US Department of Health and Human Services COVID-19 Medicaid Medicaid 154