Hall Render

NOVEMBER 29, 2023

On November 2, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule Final Rule (“Final Rule”) for calendar year (“CY”) 2024. These changes become effective on January 1, 2024. CMS anticipates the changes will increase MSSP participation by 10% to 20%.

Medicare 40

Medicare Medicare Nurses Payment Systems 40

Innovaare Compliance

AUGUST 24, 2023

Medicare Advantage plans (MAO) have been increasingly popular with Medicare eligible beneficiaries enrolling 51% of the eligible population in 2023 taking in $454 billion (or 54%) in Medicare spending.

Medicare 52

Medicare Medicare Fraud Medicaid 52

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 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

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”). and 422.107).

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare IT News - Telehealth

OCTOBER 14, 2021

A group of healthcare organizations announced this week the launch of the Advanced Care at Home Coalition, an advocacy effort aimed at creating a pathway toward safeguarding access to hospital-level services. The coalition's perspective, he said, is that regulators should "put guardrails on, but let us continue the good work."

Hospitals 152

Hospitals Public Health Patient Satisfaction COVID-19 152

Health Law Advisor

AUGUST 14, 2023

During the COVID-19 PHE, CMS issued temporary waivers, including a waiver of the “location requirement” of the In-Office Ancillary Services (“IOAS”) exception. 1] With the end of the PHE having occurred over three months ago, that temporary waiver of sanctions ended and can no longer be relied upon for legal compliance with the Stark Law. [2]

COVID-19 52

COVID-19 Medicare Medicare Public Health 52

MedTrainer

OCTOBER 29, 2023

California is known for being “extra,” and that’s what you can expect when it comes to medical credentialing services in California. Before looking specifically at provider credentialing in California, let’s start with a definition. The post Medical Credentialing Services in California appeared first on MedTrainer.

Licensing 52

Licensing Malpractice Medicaid Medicaid 52

Healthcare IT News - Telehealth

APRIL 30, 2021

The act would expand coverage of Medicare telehealth services and make some COVID-19 telehealth flexibilities permanent, among other provisions. Access for Medicare beneficiaries. The CONNECT Act would aim to answer at least some of those questions, at least where Medicare is concerned.

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COVID-19 Medicare Medicare Public Health 216

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

Health Care Law Brief

APRIL 12, 2023

On April 5, the Centers for Medicare & Medicaid Services (“CMS”) released the 2024 Medicare Advantage and Prescription Drug Benefit Programs Final Rule (“Final Rule”), which will be codified at 42 C.F.R. The SRFs include low-income subsidy, dual eligibility (meaning eligible for Medicare and Medicaid) and disability.

Medicare 52

Medicare Medicare Overpayments Overpayment 52

Innovaare Compliance

OCTOBER 6, 2022

Annual Election Period (AEP) is about two weeks away when Medicare Advantage Prescription Drug Plans (MAPD) will be signing up new enrollees by the thousands. According to the Centers for Medicare & Medicaid Services (CMS), enrollment in MAPD keeps rising.

Medicare 52

Medicare Medicare Compliance Public Health 52

AIHC

FEBRUARY 7, 2024

This article provides a basic overview of Artificial Intelligence, Telehealth, Asynchronous Services and HIPAA privacy concerns. Telehealth refers to a collection of methods to enhance health care delivery and education — it’s not a specific service. It is a service rendered outside of a real-time or live interaction with a patient.

HIPAA 59

HIPAA Medicaid Medicaid Telemedicine 59

AIHC

FEBRUARY 7, 2024

This article provides a basic overview of Artificial Intelligence, Telehealth, Asynchronous Services and HIPAA privacy concerns. Telehealth refers to a collection of methods to enhance health care delivery and education — it’s not a specific service. It is a service rendered outside of a real-time or live interaction with a patient.

HIPAA 52

HIPAA Medicaid Medicaid Telemedicine 52

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. Providers also need an NPI to enroll in Medicare.

Fraud 97

Fraud HIPAA Medicare Medicare 97

C&M Health Law

OCTOBER 18, 2023

Department of Health and Human Services (“HHS”) published a proposed rule updating Section 504 of the Rehabilitation Act of 1973 (“Section 504”). The Proposed Rule clarifies obligations to provide services in the most integrated setting appropriate to a person’s needs. On September 14, 2023, the U.S. Web and mobile accessibility.

ADA 98

ADA COVID-19 Medicare Medicare 98

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-19 188

COVID-19 Medicaid Medicaid Telemedicine 188

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 challenged the current Overpayment Rule in litigation. [1]

Overpayments 98

Overpayments Overpayment Medicare Medicare 98

Healthcare IT News - Telehealth

SEPTEMBER 3, 2020

"Each of the four elements of distributed health services has progressed rapidly over the past decade, more or less independently of the others," Auerswald wrote. Centers for Medicare and Medicaid Services to extend administrative flexibility around greater portability of licensure for telehealth service providers.

Licensing 161

Licensing Medicare Medicare Governance 161

Healthcare IT News - Telehealth

OCTOBER 27, 2020

Virtual care may be popular among patients, but if providers can't get paid for their services, it's unlikely they'll be able to continue to provide them. The government has signaled its support for reimbursing some telehealth services, at least in the short term. " Kat Jercich is senior editor of Healthcare IT News.

COVID-19 191

COVID-19 Governance Medicare Medicare 191

Healthcare Compliance Blog

JUNE 9, 2022

His exclusion means that no federal healthcare program payment may be made, either directly or indirectly, for any items or services furnished by him or at his direction or prescription. Between 2017 and 2019, the man, through a group of pain clinics he controlled, caused the submission of false claims for payment to Medicare.

US Department of Health and Human Services 59

US Department of Health and Human Services Medicare Medicare Overpayments 59

Healthcare IT Today

OCTOBER 20, 2023

Previous articles covered the definition, collection, sharing, and use of SDoH. A company survey showed it to be the service most desired by health plan clients. Recently, though, Medicaid has imposed tight restrictions on its food programs , leaving more people food-insecure. They buy from local growers when possible.

Medicaid 120

Medicaid Medicaid COVID-19 Doctors 120

Medisys Compliance

JUNE 28, 2022

Medicare Coverage for Continuous Glucose Monitors (CGMs). On December 28, 2021, the Centers for Medicare & Medicaid Services (CMS) published a final rule in the Federal Register that addressed the classification and payment of continuous glucose monitors (CGMs) under the Medicare Part B benefit for durable medical equipment (DME).

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Medicare Medicare 52

Innovaare Compliance

MARCH 4, 2024

Until the enactment of the Medicare Modernization Act (MMA) in 2006 [1] , the Centers for Medicare & Medicaid Services does not cover most outpatient prescription drugs under Part B (“Part B drugs”). However, some drugs self-administered by Medicare beneficiaries at home are Part B eligible.

Medicare 52

Medicare Medicare Nurses Medicaid 52

Hall Render

JULY 7, 2022

The Consolidated Appropriations Act, 2021 (the “Act”) signed into law on December 27, 2020, created a new Medicare provider type called a Rural Emergency Hospital (“REH”). The Act created the new REH Medicare provider type. An REH must provide 24/7 emergency services and certain other outpatient health services.

Hospitals 70

Hospitals Payment Systems Medicare Medicare 70

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

Healthcare Law Blog

JANUARY 26, 2023

Department of Health and Human Services (“HHS”) published a notice of proposed rulemaking entitled “Safeguarding the Rights of Conscience as Protected by Federal Statutes” (the “ Proposed Rule “). Medicaid and Medicare The Balanced Budget Act of 1997, Public Law 105–33, 111 Stat. On January 5, 2023, the U.S.

ACA 105

ACA Medicaid Medicaid Compliance 105

HIT Consultant

JULY 24, 2022

Elizabeth Hogan Hamacher, MHL, BSN, RN, VP of Clinical Services and Support, Podimetrics. These screening services are often available solely from specialist providers, many of whom only accept commercial insurance. Department of Health and Human Services (HHS), so that healthcare providers become more aware of PAD symptoms.

Medicaid 98

Medicaid Medicaid Medicare Medicare 98

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

Healthcare IT News - Telehealth

FEBRUARY 3, 2022

Department of Health and Human Services' Office of the Assistant Secretary for Planning and Evaluation found that although telehealth use increased dramatically during the pandemic, not all patients appeared to have equal access to virtual services. An issue brief released this week from the U.S. THE LARGER TREND. ON THE RECORD.

Telemedicine 136

Telemedicine COVID-19 Health Insurance Medicaid 136

Health Care Law Brief

AUGUST 26, 2022

The Centers for Medicare & Medicaid Services (“ CMS ”) recently published the proposed 2023 Physician Fee Schedule (“ PFS ”), which contains several important changes affecting Accountable Care Organizations (“ ACOs ”) that participate in the Medicare Shared Savings Program (“ MSSP ”), including a new Advanced Incentive Program.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Medisys Compliance

MAY 30, 2024

Accurate ICD-10 coding is crucial for: Accurate Billing: Proper codes ensure you receive appropriate reimbursement for services provided in managing prediabetes patients. when diagnostic criteria for prediabetes are definitively met based on blood sugar levels.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Public Health ADA Medical Billing 59

Healthcare IT News - Telehealth

JUNE 26, 2020

As the COVID-19 crisis has made evident, telehealth can be a useful tool to help connect patients with services remotely. Throughout 2018 and 2019, Northwell Health piloted small-scale programs in partnership with the Gary and Mary West Health Institute Collaboration to bring medical services virtually to the homes of their patients.

COVID-19 186

COVID-19 Telemedicine Medicaid Medicaid 186

Health Law Advisor

APRIL 10, 2023

The OIG stated that gift cards that can be redeemed for a limited category of items or services, such as a gas card or food delivery service gift card or voucher would be considered in-kind remuneration. OIG Advisory Opinion (AO) 23-03 On March 29, 2023, the OIG posted AO 23-03 to its website.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Compliancy Group

JANUARY 3, 2024

One of the most common ways for providers and healthcare organizations to run afoul is to incorrectly or illegally bill and code for services or supplies. Still, administrators and providers must stay abreast of all applicable laws concerning the coding and billing of supplies and services. Are the claims accurate and complete?

Medical Billing 52

Medical Billing Compliance ACA Health Insurance 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. Medical record documentation and employment relationships are key to supporting how services are provided and billed.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Medisys Compliance

JULY 10, 2023

As mental health services continue to evolve, it is crucial for mental health professionals and billing specialists to have a thorough understanding of the modifiers used in mental health billing. Modifiers are codes or symbols used to provide additional information about a service or procedure performed by healthcare providers.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Licensing Doctors Medicare 52