HIPAA Journal

NOVEMBER 17, 2022

My first professional experience in healthcare was as a licensed social worker in an acute care hospital. I’m currently on contract to a State Medicaid Agency’s Privacy Office. Medicaid modularity, health information exchange, patient access APIs and apps. I definitely learned on the job.

Governance 92

Governance HIPAA Compliance Nursing Homes 92

Healthcare Law Blog

MAY 16, 2022

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). Refining Definition for Fully Integrated and Highly Integrated D-SNPs (§§ 422.2 and 422.107).

Medicare 52

Medicare Medicare Medicaid Medicaid 52

MedTrainer

OCTOBER 29, 2023

Before looking specifically at provider credentialing in California, let’s start with a definition. Physical License Only California currently provides physical licenses for practitioners. This wallet-size license requires holders to scan, photocopy, or take a picture for recredenialing or verification.

Licensing 52

Licensing Malpractice Medicaid Medicaid 52

Medisys Compliance

JULY 10, 2023

This article aims to provide a comprehensive guide to modifiers for mental health billing, exploring their definitions, purposes, and relevant keywords. AJ Modifier – Licensed Clinical Social Worker (LCSW) The AJ modifier is used to identify services provided by a Licensed Clinical Social Worker (LCSW). What are Modifiers?

Medical Billing Outsourcing 52

Medical Billing Outsourcing Licensing Doctors Medicare 52

Verisys

JANUARY 19, 2022

As the number of satellite facilities per provider increases and the definition of healthcare expands, it adds to healthcare organizations’ burdens–not just in providing care, but also in terms of the administrative burden and costs necessary to maintain a practice. Ensures proper credentialing and privileging of the licensed medical staff.

US Department of Health and Human Services 52

US Department of Health and Human Services Hospitals Malpractice Compliance Officers 52

New Jersey Healthcare Blog

JANUARY 12, 2022

This notice extends the waiver of the continuing education requirements for current active health officers and REHSs who are renewing their license for the 2022 licensing period. The Manual extends Medicaid eligibility to certain persons not eligible under the provisions at N.J.A.C. Definitions and 4.1, See N.J.A.C.

Licensing 40

Licensing Medicaid Medicaid Nurses 40

YouCompli

DECEMBER 19, 2023

Users are encouraged to use the electronic version, to allow access to hyperlinked definitions and resource documents. Exclusions (page 26) : OIG recommends that any entity participating in the federal Medicaid program should check the state Medicaid program exclusion list for each applicable state.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52

Healthcare Law Blog

FEBRUARY 28, 2023

On February 13, 2023, the Centers for Medicare and Medicaid Services (CMS) published the revised List of Telehealth Services for Calendar Year (CY) 2023 (List). The List includes the services that are payable under the Medicare Physician Fee Schedule when furnished via telehealth.

Medicare 52

Medicare Medicare Nurses Licensing 52

MedTrainer

MARCH 28, 2024

The answer has as many layers as the definition of compliance itself. Licensing and credentialing were introduced to regulate healthcare professionals and ensure minimum standards of care. But that’s only one aspect of this complex – and sometimes confusing – process.

Compliance 52

Compliance Compliance Officers Licensing Regulatory Compliance 52

Healthcare Law Blog

JANUARY 26, 2023

Medicaid and Medicare The Balanced Budget Act of 1997, Public Law 105–33, 111 Stat. The Medicaid and Medicare statutes also contain conscience provisions related to the performance of advanced directives, religious nonmedical healthcare providers and their patients.

ACA 105

ACA Medicaid Medicaid Compliance 105

YouCompli

NOVEMBER 29, 2023

Users are encouraged to use the electronic version, to allow access to hyperlinked definitions and resource documents. Exclusions (page 26) : OIG recommends that any entity participating in Medicaid should check the state Medicaid program exclusion list for each applicable state.

Compliance 52

Compliance Compliance Officers Medicaid Medicaid 52

AIHC

SEPTEMBER 5, 2023

Most private insurers and Medicaid cover telebehavioral health care, but check for reimbursement restrictions and obtain professional coding and billing guidance to avoid overpayment situations. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs. This is also called “store-and-forward telemedicine.”

COVID-19 59

COVID-19 Telemedicine Informed Consent Compliance 59

HIT Consultant

OCTOBER 6, 2021

It doesn’t even take you to the Centers for Medicare & Medicaid Services (CMS) website. It is true that licensed nursing agencies are available to take much of the burden off family caregivers, but the cost of such services is beyond the reach of many of those who need it most. Try Googling the word “caregiving.”

COVID-19 98

COVID-19 Doctors Health Outcomes Licensing 98

Innovaare Compliance

OCTOBER 6, 2022

According to the Centers for Medicare & Medicaid Services (CMS), enrollment in MAPD keeps rising. MAOs have to ensure that TPMOs use a standardized disclaimer in their marketing materials that meet the definition of marketing whether they are in print, on the website, or in television advertising.

Medicare 52

Medicare Medicare Compliance Public Health 52

Hall Render

NOVEMBER 15, 2023

Billing for Advanced Practice Professionals (“APPs”) has been a challenging area for providers and practitioners because of different and changing Medicare, Medicaid and state law requirements. APPs should be enrolled in the Medicare and Medicaid programs and credentialed with commercial payors.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

New Jersey Healthcare Blog

SEPTEMBER 7, 2021

Additionally, technical changes were made to reflect the current name for the “Department of Health” and “Medicaid/NJ FamilyCare.” The proposed amendments include definition changes, as well as new rules. On August 2, 2021, at 53 N.J.R. See adopted N.J.A.C. On August 2, 2021, at 53 N.J.R. On August 16, 2021, at 53 N.J.R.

Telemedicine 40

Telemedicine Licensing Medicaid Medicaid 40

Provider Trust

MAY 18, 2022

As referenced in our recent post on definitions and regulations for healthcare vendors, the HHS Office of Inspector General Exclusions Program mandates that healthcare organizations refrain from doing business with “excluded or sanctioned” individuals or entities, which includes your organization’s network of vendors.

Compliance 52

Compliance Due Diligence Medicaid Medicaid 52

Hall Render

AUGUST 1, 2022

CMS is also proposing that REHs may provide outpatient services that are not otherwise paid under the OPPS (such as services paid under the Clinical Lab Fee Schedule) as well as post-hospital extended care services furnished in a unit of the facility that is a distinct part of the facility and licensed as a skilled nursing facility.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

Healthcare IT News - Telehealth

SEPTEMBER 9, 2024

Meanwhile, the American Telemedicine Association is pleading with the Centers for Medicare and Medicaid Services for expanded flexibilities and further guidance on payment and coverage. Licenses that allowed physicians to practice across state lines and provided reimbursement parity due to the pandemic have now expired. with broadband.

Telemedicine 154

Telemedicine Licensing Health Outcomes Governance 154

Healthcare Law Blog

JANUARY 10, 2022

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”). Refining Definitions for Fully Integrated and Highly Integrated D-SNPs (§§ 422.2

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

Hall Render

SEPTEMBER 1, 2023

ALABAMA American Family Care opens new health care center in Northeast Birmingham doctors secure $13.9M operating margin, $1B net gain halfway through its first year Illinois public health officials warn of “rising COVID-19 activity” St. million to Resolve False Claims Act Allegations Michigan Pain Center Owner Pays $6.5M

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

New Jersey Healthcare Blog

JULY 22, 2022

The chapter describes the policies and procedures of the New Jersey Medicaid/NJ FamilyCare program regarding transportation services. to require that supervisors of licensed associate counselors be professional counselors licensed in New Jersey for at least three years and have an approved clinical supervisor certification.

COVID-19 Vaccine 40

COVID-19 Vaccine Licensing COVID-19 Public Health 40

Healthcare IT News - Telehealth

JULY 11, 2023

Ophelia is licensed to provide care in 36 states and contracted with Medicaid, Medicare and commercial insurers covering 85 million American lives. PROPOSAL Ophelia is a digital provider of medication-assisted treatment (MAT) for OUD, committed to making evidence-based treatment universally accessible.

Licensing 90

Licensing Medicaid Medicaid Telemedicine 90

Health Law Advisor

APRIL 4, 2023

On March 15, the Centers for Medicare and Medicaid Services (CMS) released guidance on the drug price negotiations provisions of the Inflation Reduction Act (IRA). Joint ventures, in-licensing and other forms of acquisition of capabilities allow complementary technologies in therapies, reduce risk and accelerate access.

FDA 52

FDA Medicaid Medicaid Medicare 52

Verisys

FEBRUARY 1, 2022

All individuals and organizations that meet the definition of healthcare provider as described in 45 CFR 160.103 that conduct transactions or use health records that fall under HIPAA regulations are required to obtain an NPI. Who Needs an NPI? . When Did NPI Numbers Begin? The NPI Final Rule, published on Jan.

Fraud 52

Fraud Medicare Medicare HIPAA 52

Healthcare IT News - Telehealth

AUGUST 30, 2021

In doing so, Trinity also hoped to receive readmission incentives from the Centers for Medicare and Medicaid Services, avoid penalties, and reduce costs as it transitioned to value-based care reimbursement. There is definite value with continuing to monitor patients after a home care episode, Joyce noted.

Patient Satisfaction 169

Patient Satisfaction Nurses Medicare Medicare 169

AIHC

JUNE 22, 2022

Many facilities and groups who are accredited by an entity, such as JCAHO, AAAHC, AAAASF (just to name a few), are REQUIRED to complete this process for every provider who is rendering services within the group or facility, especially active, licensed, independent practitioners, or LIPs.

Medicaid 52

Medicaid Medicaid Due Diligence Medicare 52

Hall Render

JANUARY 6, 2022

Nursing homes face possible citations, civil monetary penalties, denial of payments and—as a final measure—termination of participation from the Medicare and Medicaid programs by the Centers for Medicare & Medicaid Services (“CMS”) as they embark on complying with the new CMS COVID-19 vaccine requirements for their staff.

COVID-19 Vaccine 40

COVID-19 Vaccine COVID-19 Nurses Compliance 40

MedTrainer

OCTOBER 26, 2023

Before looking specifically at provider credentialing in Washington state, let’s start with a definition. ProviderOne: ProviderOne system is the system used by the Washington State Health Care Authority to enroll providers and pay claims for Apple Health (Washington’s Medicaid). Primary Source Verification.

Malpractice 52

Malpractice Licensing Medicaid Medicaid 52

Hall Render

DECEMBER 22, 2023

health care spending hits $4.5 Million in Retaliation Suit John Muir, Tenet scrap hospital deal after FTC challenge Kaiser to lay off 79 administrative employees Leaning toward big wins in schizophrenia and vaccines, venture group raises new fund of $389 million Madera hospital creditors want to be paid, including CEO. health care spending hits $4.5

Nursing Homes 40

Nursing Homes Nurses COVID-19 Hospitals 40

Hall Render

AUGUST 4, 2023

Will Nemours’ Medicaid move leave 10,000 special-needs kids behind? News ranking as the ‘Best Hospitals’ in the country Nearly a Third of KS Rural Hospitals At Risk Of Closure, New Data Shows Report: Kansas hospitals fall short in making billing information transparent.

COVID-19 40

COVID-19 Hospitals Nursing Homes Nurses 40

Hall Render

JANUARY 19, 2024

Francis emergency room KENTUCKY Apollo’s 220-hospital ‘stranglehold’ harms patients and workers, report alleges Humana cuts ‘small’ number of jobs in multiple locations LMU School of Nursing will open Lexington site at CHI Saint Joseph Health Mercy Health announces acquisition of orthopedic center in Paducah, Ky.

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

OCTOBER 27, 2023

Ransomware attacks against hospitals put patients’ lives at risk, researchers say States, FTC continue to target noncompetes: 3 updates The best hospital in each state, per Newsweek What to know about Stark law’s $9.2M Here’s why Grady Health System recognized as health care I.T. RHODE ISLAND Lifespan, largest hospital owner in R.I.,

US Department of Health and Human Services 40

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

Health Law Advisor

AUGUST 10, 2023

4] This definition has been remarkably durable, because instead of focusing on a particular technology, it focuses on how products are intended to be used. 4] This definition has been remarkably durable, because instead of focusing on a particular technology, it focuses on how products are intended to be used. Very brief.

FDA 98

FDA Licensing Hospitals Medicaid 98

Hall Render

SEPTEMBER 8, 2023

million deal to sell skilled nursing facilities California health system pays $5 million for alleged Medicaid false claims California’s ASC activity heats up California hospital issues layoffs CommuniCare Health Centers gets $1.5 for Chemotherapy Study US Awards $1.3M

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

APRIL 28, 2023

on EHR upgrade New SSM Health children’s developmental center opening today Illinois Capitol bills would give more money to community health centers Illinois physician selected for year-long NASA Mars simulation HSHS St.

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

MAY 31, 2024

Vincent Named President of the Association of Black Cardiologists Arkansas Children’s Hires Morse as Chief Administrator for ACNW Children’s Miracle Network Hospitals partners raise $5.4 healthcare workforce finds lack of diversity St. operating income, 4.1%

Nursing Homes 40

Nursing Homes Nurses Hospitals Medicaid 40