Medisys Compliance

APRIL 18, 2022

In October 2021, the Center for Medicare and Medicaid Innovation (CMMI) announced a goal of having every Medicare beneficiary and the majority of Medicaid beneficiaries covered by some type of alternative payment model (APM) by 2030. Incentives for Medicaid clinicians who also treat Medicare patients. APMs Overview.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medicaid Medicaid 52

Healthcare IT Today

JUNE 7, 2023

Many of our concerns center on the proposed implementation timeframes associated with various concepts included in HTI-1, as well as ONC’s failure to sufficiently consider the burden compliance will place on provider organizations and health IT developers. 31, 2024, compliance timeline is unrealistic.

FDA 87

FDA Compliance Regulatory Compliance Medicaid 87

Healthcare Law Blog

DECEMBER 15, 2022

The Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule , “Advancing Interoperability and Improving Prior Authorization Processes” (the “Proposed Rule”), that is intended to improve patient and provider access to health information and streamline processes related to prior authorization for medical items and services.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Medisys Compliance

JULY 27, 2022

In the CY 2017 PFS Final Rule, the Centers for Medicare & Medicaid Services (CMS) modified coding and reporting of procedural services that include moderate sedation as an inherent part of the service, including for screening colonoscopies. For dates of service calendar years 2027-2029, the reduced coinsurance is 10%.

Medical Billing 52

Medical Billing Medical Billing Outsourcing ACA Medicare 52

Hall Render

MARCH 3, 2023

million for youth mental health care KENTUCKY Pike County nursing home officials release statement following loss of Medicare agreement Three Humana executives drop $11.2M

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

NOVEMBER 28, 2023

On November 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update Final Rule (“2024 Final Rule”), which has since been filed in the Federal Register. Hospices need to be much more vigilant about compliance.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

Healthcare Law Blog

NOVEMBER 13, 2023

On November 6, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released the contract year 2025 proposed rule for Medicare Advantage (“MA”) organizations and Part D sponsors (the “Proposed Rule”). This proposal would shift the burden from CMS to the MA organization to demonstrate compliance with this standard.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Healthcare Law Blog

AUGUST 25, 2022

The first list of up to 10 Part D negotiation-eligible drugs will be published in 2026, the earliest “price applicability date” at which the Program takes effect. The drug publication date for 2026 will be chosen by September 1, 2023. Program Compliance. Improvement of Access to Adult Vaccines under Medicaid and CHIP.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Health Care Law Brief

MARCH 8, 2022

On February 24, 2022, the Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), announced the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, which will begin January 1, 2023, and replace the Global and Professional Direct Contracting (GPDC) Model.

Medicare 52

Medicare Medicare Fraud Compliance 52

Hall Render

JANUARY 27, 2023

West Springs Hospital found in ‘full compliance’ after state audit Parkview Health System finalizes merger agreement with UCHealth COVID, flu and RSV hospitalizations keep falling in Colorado Post-pandemic telehealth visits remain high in Colorado ‘This is a great community,’ Centura-St. But will consumers actually benefit?

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes COVID-19 Nurses 40

Healthcare Law Blog

JANUARY 5, 2023

Just in time for the holidays, the Centers for Medicare and Medicaid Services (“CMS”) issued the Contract Year 2024 Proposed Rule for Medicare Advantage organizations (“MAOs”) and Part D sponsors (the “Proposed Rule”). That is, the HEI is specifically designed to create an incentive to reduce disparities in care.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

C&M Health Law

MARCH 15, 2022

CMS will apply more stringent screening protocols of applicants and will more closely monitor model participants to ensure compliance with beneficiary protections. The GPDC model will transition to the ACO REACH model at the end of this calendar year and will run through 2026.

Medicare 52

Medicare Medicare Governance Compliance 52

C&M Health Law

JANUARY 25, 2023

HHS is directed to submit to Congressional committees the result of findings in an interim report in October 2024 and a final report in August 2026. In addition, Section 1331 of the Act authorizes grants to states to enforce and ensure compliance with mental health and substance use disorder parity requirements.

Medicaid 104

Medicaid Medicaid Medicare Medicare 104