Bill of Health

FEBRUARY 10, 2023

That is why the ACA’s Medicaid expansion doesn’t exist in 11 states , why the penalties for failing to have insurance under the “individual mandate” has been set to $0.00. The traditional definition of the Police Power is the responsibility of the state to protect “health, safety, morals and general welfare.” Emphasis added.)

Public Health 261

Public Health Health Care Reform ACA COVID-19 261

Bill of Health

FEBRUARY 6, 2024

Congress can enhance the federal Earned Income Tax Credit (EITC) (26 U.S. Code § 32) by making the tax credit monthly. State Government Opportunities: States can increase expungement rates by amending laws to apply automatic expungement to minor drug possession convictions and seal the records.

Governance 300

Governance Public Health Local Policy Medicaid 300

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

Healthcare IT News - Telehealth

JUNE 8, 2020

"Regrettably, minority groups are being left behind by the telehealth revolution," said David Smith, executive director for the Medicaid Transformation Project, in an interview with Healthcare IT News. " David Smith, Medicaid Transformation Project Executive Director. Since the pandemic began its spread across the U.S.

COVID-19 181

COVID-19 Medicaid Medicaid Telemedicine 181

AIHC

FEBRUARY 7, 2024

Medicaid policies on this issue vary from state to state. Centers for Medicare & Medicaid Services (CMS) offers a 17-page PDF: “ Telehealth for Providers: What You Need to Know ”. Centers for Medicare & Medicaid Services (CMS) offers a 17-page PDF: “ Telehealth for Providers: What You Need to Know ”.

HIPAA 59

HIPAA Medicaid Medicaid Telemedicine 59

AIHC

FEBRUARY 7, 2024

Medicaid policies on this issue vary from state to state. Centers for Medicare & Medicaid Services (CMS) offers a 17-page PDF: “ Telehealth for Providers: What You Need to Know ”. Centers for Medicare & Medicaid Services (CMS) offers a 17-page PDF: “ Telehealth for Providers: What You Need to Know ”.

HIPAA 52

HIPAA Medicaid Medicaid Telemedicine 52

Healthcare It News

JUNE 3, 2022

Since California expanded health coverage under the Affordable Care Act, a large number of people have been mistakenly bounced between Covered California, the state’s marketplace for those who buy their own insurance, and Medi-Cal, the state’s Medicaid program for low-income residents. “This shouldn’t be happening.

Public Health 235

Public Health Health Insurance Professionals ACA Medicaid 235

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

Verisys

JULY 12, 2023

Updates include requirements for credentialing providers in state Medicaid services, state employee medical programs, health maintenance organization contracts, hospital quality assessments, and health plan and insurer requirements. Major changes to Medicaid credentialing are effective July 1, 2024.

Licensing 52

Licensing COVID-19 Medicaid Medicaid 52

HIT Consultant

NOVEMBER 22, 2021

What You Should Know: – Today, global health IT company, Edifecs announced it has entered a definitive agreement to acquire Health Fidelity, a San Francisco-based tech provider. Together, the companies will offer health plans and provider customers with the most complete risk adjustment solution in healthcare. Edifecs , Inc.,

ACA 52

ACA Medicaid Medicaid Medicare 52

HIPAA Journal

NOVEMBER 17, 2022

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. HIPAA, specifically the Privacy Rule, has very little definitive provisions. What is your current position?

Governance 87

Governance HIPAA Compliance Nursing Homes 87

Innovaare Compliance

FEBRUARY 14, 2022

This includes CMS regulations for Medicare Plans, regulations for Commercial Plans and Medicaid regulations for state plans. With this in mind, much as possible, find a way to standardize grievance categories so that they can equally apply to CMS reporting, Medicaid reporting and Commercial reporting.

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52

Healthcare Law Blog

DECEMBER 27, 2022

The Centers for Medicare and Medicaid Services (“CMS”) has issued a proposed rule which would amend the existing regulations for reporting and returning identified overpayments (the “Proposed Rule”). UnitedHealthcare Litigation. UnitedHealthcare challenged the current Overpayment Rule in litigation. [1]

Overpayments 98

Overpayments Overpayment Medicare Medicare 98

HIT Consultant

OCTOBER 7, 2021

The Welltok acquisition will accelerate Virgin Pulse’s ability to serve substantially more clients, consumers, patients and members across the full healthcare continuum – employer, health plans (commercial, Medicare Advantage, Managed Medicaid), pharmacies/pharmacy benefits managers (PBMs) and health systems.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Jane Sarashon

MARCH 29, 2023

” Start with the definition set forth in the report: that techquity is the “intentional design and deployment of technology both to advance health equity and to avoid depending existing systemic inequities and health disparities.”

Health Outcomes 101

Health Outcomes Medicaid Medicaid Medicare 101

Healthcare Law Blog

NOVEMBER 2, 2023

According to the Congressional Research Service, which analyzed data from the Centers for Medicare & Medicaid Services (“CMS”) National Health Expenditure Accounts (“NHEA”) on the personal health expenditures for LTSS by payer, in 2021, an estimated $467.4 billion was spent on LTSS. This represents 13.2% of LTSS spending. [5]

Nursing Homes 52

Nursing Homes Medicaid Medicaid Medicare 52

C&M Health Law

OCTOBER 18, 2023

Section 504 covers all health care and human services programs and activities funded by HHS, from providers, like hospitals and doctors that accept Medicare or Medicare, to state child welfare programs, as well as Medicare Advantage Plans, and Medicaid Managed Care Plans.

ADA 98

ADA COVID-19 Medicare Medicare 98

Verisys

NOVEMBER 8, 2023

The NPI improves the Medicare and Medicaid programs, other federal and private health programs, and the overall effectiveness and efficiency of the healthcare industry by simplifying administration and enabling the efficient electronic transmission of health information. Who Needs an NPI? Learn More About NPIs When Did NPI Numbers Begin?

Fraud 97

Fraud HIPAA Medicare Medicare 97

Healthcare IT Today

OCTOBER 20, 2023

Previous articles covered the definition, collection, sharing, and use of SDoH. Another source of fresh foods for low-income people is FarmboxRx , often available through Medicaid and Medicare Advantage programs as part of SNAP or Healthy Food Card benefits. I’ll finish with a look at some specific areas of intervention.

Medicaid 115

Medicaid Medicaid COVID-19 Doctors 115

CMS.gov

SEPTEMBER 13, 2021

The Centers for Medicare & Medicaid Services (CMS) is committed to ensuring people on Medicare have quicker access to innovative medical technologies for life-threatening or irreversibly debilitating diseases – like cancer and heart disease.

Medicare 37

Medicare Medicare FDA Medicaid 37

HIT Consultant

SEPTEMBER 18, 2023

Michael Pattwell, Principal Business Advisor, Value-Based Care, Edifecs While the need to address social determinants of health (SDOH) is definitely not new, 2023 marks the first year SDOH is codified into national and statewide value-based payment program mandates.

Health Outcomes 114

Health Outcomes Electronic Medical Records Medicaid Medicaid 114

Healthcare Compliance Blog

JUNE 9, 2022

Those claims were for presumptive and definitive Urine Drug Tests (UDTs) that were not medically reasonable or necessary and were not used to aid in the diagnosis and treatment of patients. Providers must ensure that the claims they submit to Medicare and Medicaid are true and accurate.

US Department of Health and Human Services 59

US Department of Health and Human Services Medicare Medicare Overpayments 59

Medisys Compliance

JANUARY 4, 2024

However, specific definitions might differ depending on payers and specialties. Consult payer policies and the Current Procedural Terminology (CPT ® ) manual for definitive guidance. Choosing the Right CPT ® Code CPT ® codes paint a precise picture of the services rendered during a new patient visit.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medical Billing Services 59

HIT Consultant

AUGUST 25, 2021

What You Should Know: – Headspace , a global leader in mindfulness and meditation, and Ginger , a leader in on-demand mental healthcare, today announced they have entered into a definitive agreement to merge. states and in 190+ countries worldwide.

World Health 98

World Health Medicaid Medicaid 98

Compliancy Group

JANUARY 3, 2024

This is why a regular review of these contracts is essential so that providers and administrators can clear up uncertainties in the terms or conditions, remain compliant, and ensure the payer is engaging in fair practices.

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 52

Healthcare IT News - Telehealth

MARCH 18, 2022

Norden is particularly passionate about funding companies focused on the Medicaid population – a traditionally tricky and often ignored area. By some definitions the digital health field lost almost 70% of its market cap, or $180 billion. What's happening in this area of digital health?

Medicaid 199

Medicaid Medicaid COVID-19 Telemedicine 199

Healthcare IT News - Telehealth

SEPTEMBER 3, 2020

Centers for Medicare and Medicaid Services to extend administrative flexibility around greater portability of licensure for telehealth service providers. "States and the federal government should work to harmonize definitions and regulations (e.g.,

Licensing 158

Licensing Medicare Medicare Governance 158

Hall Render

JULY 7, 2022

On June 30, 2022, the Centers for Medicare & Medicaid Services (“CMS”) released proposed regulations (“Proposed Rule”) addressing the Conditions of Participation (“CoPs”) that a provider will need to meet to qualify as an REH. The Proposed Rule does not include any details on the payment policies for REHs. Proposed REH CoPs.

Hospitals 70

Hospitals Payment Systems Medicare Medicare 70

Healthcare IT Today

JUNE 7, 2023

In the comments that we will submit to ONC on HTI-1, we’ll also be encouraging ONC and the Centers for Medicare and Medicaid Services (CMS) to work more closely together to address the misalignments that frequently occur between when ONC tells software developers to deploy new certified versions and when CMS requires providers to be using them.

FDA 75

FDA Compliance Regulatory Compliance Medicaid 75

Healthcare IT News - Telehealth

JUNE 26, 2020

"It is definitely helpful to have someone there who understands technology who can troubleshoot with you," said A. " McBride and other panelists noted that before the COVID-prompted changes from the Centers for Medicare and Medicaid Services, Northwell was not seeking reimbursement for MTT services.

COVID-19 176

COVID-19 Telemedicine Medicaid Medicaid 176

Healthcare IT News - Telehealth

OCTOBER 27, 2020

The Centers for Medicare and Medicaid Services announced earlier this month , for example, that it would add 11 virtual services to its reimbursement list during the COVID-19 public health emergency – following in the footsteps of its earlier flexibilities for virtual care. " Kat Jercich is senior editor of Healthcare IT News.

COVID-19 185

COVID-19 Governance Medicare Medicare 185

Healthcare IT Today

AUGUST 28, 2022

The latest survey from Definitive Healthcare found that about 40% of healthcare professionals plan to incorporate AI and machine learning into their daily operations in the next two years , while 73% of organizations already using AI plan to expand their use.

Nurses 81

Nurses Hospitals Health Insurance Medicaid 81

Healthcare Compliance Blog

APRIL 14, 2022

The Office of Inspector General (OIG) released their findings of an audit they conducted to determine if hospital admissions of Indiana skilled nursing facility (SNF) residents who are enrolled in both Medicare and Medicaid (dually eligible beneficiaries) were potentially avoidable, and if level-of-care requirements for Medicare were met.

Medicare 59

Medicare Medicare Overpayments Overpayment 59

Healthcare IT News - Telehealth

OCTOBER 14, 2021

" Key to moving forward will be a delivery model through the Centers for Medicare and Medicaid Services Innovation Center that will enable testing and implementation of a long-term advanced care at home framework. "We're going to need to have a few different ways of measuring this." "There's no vanity here.

Hospitals 141

Hospitals Public Health Patient Satisfaction COVID-19 141

Healthcare IT Today

NOVEMBER 12, 2023

News The 2024 Medicare Physician Fee Schedule continues many telehealth flexibilities first adopted during the public health emergency, such as an expanded scope of originating sites an expanded definition of qualified practitioners. As a result, these flexibilities will be in place until at least Dec.

Payment Systems 107

Payment Systems Public Health Medicare Medicare 107

Healthcare IT News - Telehealth

FEBRUARY 3, 2022

The highest rates of telehealth visits were among Medicaid and Medicare users, along with Black patients and those earning less than $25,000 a year. For instance, lawmakers in New Hampshire this past year sought to exclude audio-only care from the definition of telemedicine.

Telemedicine 126

Telemedicine COVID-19 Health Insurance Medicaid 126

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