Healthcare Dive

DECEMBER 14, 2022

The Center for Medicare and Medicaid Innovation is currently operating 33 models studying potential improvements in healthcare payment and delivery.

Medicaid 182

Medicaid Medicaid Medicare Medicare 182

Healthcare IT News - Telehealth

JULY 9, 2020

The Centers for Medicare and Medicaid Services has put together further detailed guidance for how healthcare providers should be documenting and reporting electronic clinical quality measures for telehealth encounters.

Payment Systems 195

Payment Systems Medicaid Medicaid Medicare 195

Healthcare IT News - Telehealth

NOVEMBER 2, 2020

Centers for Disease Control and Prevention released Friday found a 154% increase in telehealth visits during the last week of March 2020, compared with the same time period in 2019. million telehealth encounters occurred from January through March 2020 – what the agency calls the "early pandemic period.

COVID-19 184

COVID-19 Medicaid Medicaid Public Health 184

HIT Consultant

SEPTEMBER 12, 2023

The company plans to utilize the capital to support Bold’s continued expansion with national and regional Medicare plans and provider groups, and accelerate the growth of its clinical exercise offerings to support the diverse physical and mental health needs of older adults. With less than 15 percent of older adults in the U.S.

Medicare 116

Medicare Medicare 116

Mobi Health News

AUGUST 11, 2022

Researchers found remote patient monitoring use among Medicare beneficiaries increased from 91 claims per 100,000 enrollees in February 2020 to 594 claims per 100,000 enrollees in September 2021.

Medicare 95

Medicare Medicare 95

HIT Consultant

NOVEMBER 18, 2021

What You Should Know: – Easyhealth raises $135M to redesign Medicare with its end-to-end Medicare experience to help 50 million Medicare members find the best plan and support them through their healthcare journey. Redesigning The Medicare Experience. Improved Medicare Plan Performance.

Medicare 98

Medicare Medicare Health Outcomes 98

Kaiser Health News

JANUARY 28, 2022

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.

Nursing Homes 145

Nursing Homes Medicare Medicare Nurses 145

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

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

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

HIT Consultant

JANUARY 24, 2022

The relationship also includes an investment by Cigna Ventures in January 2020. We are proud to expand our partnership with Cigna to improve the overall quality of life, including pain reduction and a return to previous functionality for the Medicare Advantage population,” said Dustin Eggers, EVP and chief commercial officer of RecoveryOne.

Medicare 98

Medicare Medicare Health Outcomes 98

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

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

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 76

Medicare Medicare COVID-19 HIPAA 76

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 150

Public Health Medicare Medicare COVID-19 150

Medisys Compliance

MAY 19, 2022

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. In this article, we shared revised Medicare billing and coding guidelines which will help in billing Medicare telehealth during COVID-19 PHE.

COVID-19 52

COVID-19 Medicare Medicare Medical Billing 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

Hall Render

JUNE 8, 2023

On June 7, CMS issued a much-anticipated Final Rule addressing the placement of Medicare Advantage patient days within the Medicare DSH calculation. The Final Rule adopts a retroactive policy that will place Medicare Advantage days in the Medicare Fraction of the DSH calculation for discharges before October 1, 2013.

Medicare 40

Medicare Medicare Hospitals Governance 40

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

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

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

HIT Consultant

OCTOBER 12, 2021

– Bamboo Health’s ACO partners succeed under value-based care programs like the MSSP by utilizing their Pings solution, which provides real-time visibility into patient admission, discharge, and transfer (ADT) care events.

Medicare 52

Medicare Medicare 52

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

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 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

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

Health Populi

JANUARY 9, 2020

Health care is the top issue driving voters’ choices in the 2020 elections for most Americans. For overall healthcare reform, the plurality of Americans prefer improving the current system (that is, building on the Affordable Care Act) versus repealing and replacing the ACA or adopting a Medicare for All plan.

ACA 77

ACA FDA Public Health Medicare 77

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 59

Medicare Medicare Fraud ADA 59

Healthcare IT Today

MARCH 17, 2020

CMS has announced the expansion of Medicare coverage and payment for telehealth and telemedicine visits.

COVID-19 71

COVID-19 Medicare Medicare Telemedicine 71

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

Fierce Healthcare

SEPTEMBER 17, 2023

Some 17% of people living in the United States, or more than 1 in 6, were 65 or older in 2020. By 2040, there will be about 80.8

Medicare 117

Medicare Medicare 117

Bill of Health

JULY 1, 2022

Patents And Regulatory Exclusivities On Inhalers For Asthma And COPD, 1986-2020. Analysis of Supportive Evidence for US Food and Drug Administration Approvals of Novel Drugs in 2020. Coverage of New Drugs in Medicare Part D. A full posting of abstracts/summaries of these articles may be found on our? Health Aff (Millwood).

FDA 205

FDA COVID-19 Medicare Medicare 205

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

Healthcare Compliance Blog

MARCH 2, 2022

The money laundering scheme involved the submission of false and fraudulent claims to Medicare for medically unnecessary genetic tests and durable medical equipment. Allegedly, between January 2020 and July 2021, the ten Florida defendants referred Medicare beneficiaries for medically unnecessary genetic tests and durable medical equipment.

Medicare 45

Medicare Medicare Fraud Compliance 45

Mobi Health News

AUGUST 10, 2020

More than 60% of Medicare-eligible seniors say they’ve embraced technology more during the pandemic, according to a new survey from healthinsurance.com.

Medicare 145

Medicare Medicare 145

The Health Law Firm

FEBRUARY 17, 2021

Board Certified by The Florida Bar in Health Law In October 2020, Massachusetts federal prosecutors charged three individuals for their alleged roles in a multi-million dollar plot to defraud Medicare. Indest III, J.D., Both individuals obtaining the personal health information were located in Florida, wouldn't you know it.

Medicare 40

Medicare Medicare Fraud HIPAA 40