Hall Render

MARCH 20, 2024

The Final Rule also imposes additional reporting requirements under the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals and for eligible clinicians reporting under the Promoting Interoperability performance category of the Merit-Based Incentive Payment System.

Medicare 40

Medicare Medicare Health Insurance Medicaid 40

Innovaare Compliance

APRIL 7, 2024

The Centers for Medicare & Medicaid Services (CMS) officially announced capitation rates for Medicare Advantage (MA) plans for CY 2025 – average increase of 3.7% In total, gross spending under Medicare Part D was $240 billion in 2022; Ozempic accounted for 2% of this amount, before rebates [5]. billion [4].

Medicare 59

Medicare Medicare COVID-19 Medicaid 59

Hall Render

OCTOBER 27, 2023

According to a recent study , physician-owned hospitals treated some of the most expensive Medicare beneficiaries at significantly lower costs compared to traditional hospitals, despite serving similar patient populations. trillion in loan maturities through 2027.

Hospitals 40

Hospitals Medicare Medicare Nursing Homes 40

Healthcare Law Blog

JANUARY 26, 2024

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Medicaid 52

Innovaare Compliance

APRIL 7, 2024

The Centers for Medicare & Medicaid Services (CMS) officially announced capitation rates for Medicare Advantage (MA) plans for CY 2025 – average increase of 3.7% In total, gross spending under Medicare Part D was $240 billion in 2022; Ozempic accounted for 2% of this amount, before rebates [5]. billion [4].

Medicare 52

Medicare Medicare COVID-19 Medicaid 52

Health Care Law Brief

FEBRUARY 2, 2024

The Waiver Amendment was approved on January 9, 2024, by the Centers for Medicare & Medicaid Services (“CMS”) under Section 1115(a) of the Social Security Act and will expire on March 31, 2027. The rates must be at least 80% of Medicare rates. billion in Medicaid investments over the next three years.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Matt Kinley

OCTOBER 22, 2024

Other health facilities will start at $21 per hour in 2024, reaching $25 per hour by 2027 for community clinics and by 2028 for other facilities. Facilities with a large percentage of Medicare and Medicaid patients, rural independent hospitals, and small county facilities will start at $18 per hour in 2024, with a 3.5%

Compliance 40

Compliance Hospitals Medicaid Medicaid 40

Hall Render

AUGUST 27, 2024

The Centers for Medicare & Medicaid Services (“CMS”) will publish the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) in the Federal Register on August 28 with an effective date of October 1, 2024. By FY 2027, these changes will increase IPPS spending by $459 million.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

Medisys Compliance

JULY 27, 2022

For dates of service calendar years 2027-2029, the reduced coinsurance is 10%. For dates of service on or after calendar year 2030, Medicare waives the coinsurance. Background for Reduced Co-Insurance. These provisions are effective for services furnished on or after January 1, 2011.

Medical Billing 52

Medical Billing Medical Billing Outsourcing ACA Medicare 52

Health Care Law Brief

FEBRUARY 16, 2024

Existing contract terms that conflict with newly proposed network pharmacy contract restrictions would be voided and superseded by the draft regulations after January 1, 2027. ERISA/self-insured plans are not expressly excluded from the scope of the draft rules, unlike the Medicare Advantage and Worker’s Compensation plans that are excluded.

Licensing 52

Licensing Medicare Medicare Regulatory Compliance 52

Healthcare IT Today

JANUARY 5, 2023

Despite this, an organization’s flexibility and compliance with new regulations will help ensure success. The 2023 final Medicare Physician Fee Schedule (PFS) eased supervisory requirements for care delivered by a licensed professional counselor or licensed marriage and family therapist.

Nurses 82

Nurses Hospitals Licensing Health Outcomes 82

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”). Health Equity in Medicare Advantage. We’ve summarized some of the key changes in the Proposed Rule.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

HIT Consultant

JANUARY 17, 2024

– Public reporting: Similar to Medicare FFS, impacted payers must report prior authorization metrics, increasing transparency and accountability. – Clearer communication: All payers must provide specific reasons for denial, allowing for easier resubmissions or appeals.

Compliance 97

Compliance Health Outcomes Doctors Nurses 97

Healthcare Law Blog

AUGUST 25, 2022

The expansive legislation includes key health care provisions, including drug pricing reforms, inflationary rebates, Medicare Part D benefit redesign, as well as myriad other updates. Medicare Drug Price Negotiation Program. The Inflation Reduction Act (“IRA”) was signed into law by President Biden on August 16, 2022.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare IT Today

DECEMBER 9, 2024

Earlier in 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Interoperability and Patient Access Final Rule (CMS-0057-F)requiring impacted payers to implement and maintain an ePA-specific API to automate the process for providers. There is hard work to be done.

Compliance 78

Compliance Medicaid Medicaid Public Health 78

Hall Render

AUGUST 23, 2024

Vincent Heart Center ranked No. 1 in Indiana, No. million impact on local economy Proposal: Nursing home would have 10-plus years to pay $1 million owed to the state of Iowa This Des Moines hospital was rated 5 stars by CMS. hospitals Gov. hospitals Gov.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

AUGUST 26, 2024

Vincent Heart Center ranked No. 1 in Indiana, No. million impact on local economy Proposal: Nursing home would have 10-plus years to pay $1 million owed to the state of Iowa This Des Moines hospital was rated 5 stars by CMS. hospitals Gov. hospitals Gov.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

AUGUST 16, 2024

Check list of latest federal quality ratings Obesity rates are skyrocketing in NJ post-COVID. What’s causing it? Davis Medical Center, a state-run hospital in Dinwiddie County, is closing WASHINGTON 1,100 workers at Providence hospital plan 8-day strike How Providence, Northwell are handling a blood culture bottle shortage Introducing St.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Hospitals Nurses 40

Hall Render

AUGUST 16, 2024

Check list of latest federal quality ratings Obesity rates are skyrocketing in NJ post-COVID. What’s causing it? Davis Medical Center, a state-run hospital in Dinwiddie County, is closing WASHINGTON 1,100 workers at Providence hospital plan 8-day strike How Providence, Northwell are handling a blood culture bottle shortage Introducing St.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Hospitals Nurses 40

Hall Render

DECEMBER 6, 2024

Medicare fraud scheme California system CEO to retire California system posts $165M annual operating loss, -18.5% Medicare fraud scheme HCA to acquire Prime Florida hospital HHS Office for Civil Rights Imposes a $1.19 A lawmaker has a new plan to help them California city approves $1.2B million for violating False Claims Act Ga.

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Hospitals Nurses 40