Healthcare IT News - Telehealth

JANUARY 31, 2022

senators and representatives urged congressional leadership to safeguard Medicare telehealth services this past Friday. "Without more definitive knowledge about the duration of the pandemic and Medicare’s long-term coverage of telehealth, many organizations have been hesitant to fully invest in telehealth," the letter read.

COVID-19 155

COVID-19 Medicare Medicare Public Health 155

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., But the details of telehealth reimbursement are still unknown.

Licensing 198

Licensing Medicare Medicare Governance 198

Healthcare IT Today

JUNE 7, 2021

We are delighted to […].

Medicare 111

Medicare Medicare 111

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-19 202

COVID-19 Governance Medicare Medicare 202

American Medical Compliance

APRIL 17, 2024

The following Understanding Medicare Training educates healthcare providers and patients on the purpose of the Medicare program in the United States. Medicare is the federal health insurance program for people aged 65 or older, certain younger people with disabilities, and also people with End-Stage Renal disease.

Medicare 52

Medicare Medicare Compliance Health Insurance 52

American Medical Compliance

JULY 9, 2024

The Medicare FWA Compliance Training aims to educate healthcare providers (HCP) on the definitions of fraud, waste, and abuse in the context of Medicare. Additionally, education regarding Medicare FWA is crucial to providing proper care and the prevention of FWA. What Is Medicare?

Medicare 52

Medicare Medicare Compliance Fraud 52

Healthcare IT News - Telehealth

JUNE 8, 2020

It has broadened the definition of "vulnerable population" to include elderly people, those with chronic illnesses, people experiencing domestic violence, healthcare frontline workers and others. Since the pandemic began its spread across the U.S. this spring, Smith said, MTP has expanded its focus.

COVID-19 218

COVID-19 Medicaid Medicaid Telemedicine 218

Healthcare IT News - Telehealth

AUGUST 30, 2021

In 2017, the health system – which has 100 continuing care locations, including home care, hospice, PACE programs and senior living facilities – was in a bind, facing double-digit hospital readmissions of 16% across its high-risk Medicare population. THE PROBLEM. Trinity needed to reduce readmissions to single digits.

Patient Satisfaction 197

Patient Satisfaction Nurses Medicare Medicare 197

Hall Render

MAY 16, 2023

Could it be that CMS is implementing changes in the Medicare Communications and Marketing standards that will change the content and tone of the omnipresent television and radio advertisements targeted at potential enrollees? The post CMS Updates Definition of Marketing for Medicare Advantage and Part D Plans: What Does this Mean for Plans?

Medicare 40

Medicare Medicare 40

Med Law Blog

JULY 17, 2023

The 2024 Medicare Physician Fee Schedule proposes a 3.34% decrease in the 2024 PFS conversion factor. It’s currently $33.89 and is proposed to be reduced to $32.75.

Medicare 52

Medicare Medicare 52

Medisys Compliance

APRIL 8, 2022

In this article, we briefly discussed these Medicare telehealth billing guidelines. Due to the provisions of the Consolidated Appropriations Act of 2021, the CMS continues to evaluate the inclusion of telehealth services that were temporarily added to the Medicare telehealth services list during the COVID-19 PHE (Public Health Emergency).

Medicare 59

Medicare Medicare Medical Billing Outsourcing COVID-19 59

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-19 202

COVID-19 Telemedicine Medicaid Medicaid 202

MRO Compliance

AUGUST 8, 2024

The Role of Clinical Data Registries According to the latest information from the Centers for Medicare and Medicaid Services (CMS), 90% of payments are now linked to value, with 40% flowing through alternative payment models (APMs), showing the shift towards more cost-effective care driven by data from registries.

Patient Satisfaction 147

Patient Satisfaction Medicare Medicare Medicaid 147

Medisys Compliance

APRIL 29, 2025

The Role of Modifiers in Cardiology Coding CPT modifiers are two-character (numeric or alphanumeric) codes appended to a CPT code to provide additional information about the service rendered without changing the fundamental definition of the code. CMS (Centers for Medicare and Medicaid Services): For NCCI edits and Medicare coding policies.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicare 59

Innovaare Compliance

JUNE 30, 2024

The Centers for Medicare & Medicaid Services (CMS) provides standardized model materials to facilitate the process. Chapter 5 and under Definitions in Chapter 12, EOC) Lengthy explanation for requesting exceptions to the formulary (Sections 6.2, However, MAOs must certify that the material complies with all applicable standards.

Medicare 52

Medicare Medicare Compliance Medicaid 52

Healthcare IT News - Telehealth

JUNE 14, 2024

RPM was initially recognized in 2019 by the Centers for Medicare and Medicaid Services through a small set of codes for remote physiologic monitoring services, enabling clinicians to seek reimbursement for gathering data from patients through certain medical devices outside the hospital setting.

Medicare 178

Medicare Medicare Nursing Homes Hospitals 178

Bill of Health

SEPTEMBER 25, 2024

In short, the conflict hinges on the definition of what it means to be “entitled to supplemental security income (SSI) benefits.” DSH payments are administered as part of the Medicare program.

Medicare 100

Medicare Medicare Medicaid Medicaid 100

AIHC

DECEMBER 27, 2024

This provides a straightforward definition of consent as it applies specifically to intimate areas of the body defined by the policy as breasts, buttock, groin, or genitals. [14] In order to address concerns about these unauthorized practices, an increasing number of states have passed laws protecting the bodily autonomy of patients.

Informed Consent 98

Informed Consent Bioethics ADA Medical Personnel 98

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

HIT Consultant

APRIL 19, 2024

Medicare providers in hospitals and skilled nursing facilities (SNFs) are adjusting to new split/shared services documentation and billing regulations rolled out by the Centers for Medicare and Medicaid Services (CMS) as part of the 2024 Medicare Physician Fee Schedule (MPFS) final rule.

Nurses 102

Nurses Medicare Medicare Medicaid 102

Innovaare Compliance

FEBRUARY 5, 2024

Health Care Service Corporation (HCSC) has entered into a definitive agreement to purchase Cigna’s Medicare Advantage, Medicare Supplemental Benefits, Medicare Part D, and CareAllies businesses for $3.3 With Cigna’s Medicare plans serving 3.6 million members, HCSC will substantially increase its Medicare footprint.

Medicare 52

Medicare Medicare Due Diligence Health Insurance 52

HIT Consultant

JULY 15, 2024

– The Centers for Medicare & Medicaid Services (CMS) released a proposed rule outlining changes to Medicare payments under the Physician Fee Schedule (PFS) for services furnished and other Medicare Part B issues on or after January 1, 2025. Continued suspension of frequency limitations for certain telehealth services.

Medicare 52

Medicare Medicare Payment Systems Medicaid 52

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 184

Hospitals Public Health COVID-19 Patient Satisfaction 184

Medisys Compliance

FEBRUARY 20, 2023

Healthcare providers often get confused about the appropriate use of modifiers GA, GX, GY, and GZ while billing Medicare. GA modifier indicates that an Advance Beneficiary Notice (ABN) is on file and allows the provider to bill the patient if not covered by Medicare. Medicare does not pay for all health care costs.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

Healthcare IT Today

JANUARY 20, 2025

My career spans over three decades in health information technology, health policy and public health, including roles at the Centers for Medicare and Medicaid Innovation and in state government. Definitely. My name is Vatsala Kapur, and I’m the Vice President of External Affairs at Bamboo Health.

Governance 67

Governance Medicaid Medicaid Health Outcomes 67

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 167

Telemedicine COVID-19 Health Insurance Medicaid 167

Med Law Blog

JULY 15, 2024

CMS proposed several telehealth changes in the 2025 Medicare Physician Fee Schedule Proposed Rule, issued July 10, 2024.

Medicare 40

Medicare Medicare Telemedicine 40

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

Medicare 52

Medicare Medicare Medicaid Medicaid 52

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. MLR measures the percentage of premium income and Medicare payments a Sponsor pays for medical claims.

Medicare 52

Medicare Medicare Fraud Medicaid 52

Innovaare Compliance

JUNE 17, 2024

The Centers for Medicare & Medicaid Services (CMS) provides standardized model materials to facilitate the process. Chapter 5 and under Definitions in Chapter 12, EOC) Lengthy explanation for requesting exceptions to the formulary (Sections 6.2, However, MAOs must certify that the material complies with all applicable standards.

Medicare 40

Medicare Medicare Compliance Medicaid 40

Innovaare Compliance

JANUARY 15, 2024

The Prescription Drug Program, commonly known as Medicare Part D, is undergoing significant transformations in 2025 due to the Inflation Reduction Act (IRA) of 2022. Medicare Part D will have three (3) phases instead of four (4) – Deductible, Initial Coverage Phase and Catastrophic Phase. generics) in the catastrophic phase.

Medicare 52

Medicare Medicare Compliance FDA 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 challenged the current Overpayment Rule in litigation. [1]

Overpayments 98

Overpayments Overpayment Medicare Medicare 98

Hall Render

MARCH 20, 2025

In December 2024, the Centers for Medicare & Medicaid Services (CMS) made many revisions to its Guidance for SNF Attachment on Form CMS-855A (Guidance). Note that there is no formal definition of the term maximum feasible efforts beyond its plain meaning because every factual situation will be different.

Nurses 52

Nurses Medicaid Medicaid Medicare 52

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. Standards for benchmarking and data completeness for the Medicare CQM collection type will mirror the MIPS benchmarking and scoring policies.

Medicare 40

Medicare Medicare Nurses Payment Systems 40

Hall Render

SEPTEMBER 10, 2024

On July 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) issued its calendar year 2025 Medicare Physician Fee Schedule (“MPFS”) proposed rule (“Proposed Rule”), to implement certain payment updates effective January 1, 2025.

Medicare 40

Medicare Medicare Medicaid Medicaid 40

Hall Render

DECEMBER 20, 2023

Finalized Revisions to Form CMS-855A For SNFs, the aforementioned data would be reported by completing the Form CMS-855A Medicare enrollment application (“CMS-855A” or “Form”). For NFs, the data would be reported via means prescribed by the applicable state Medicaid agency.

Nurses 40

Nurses Medicaid Medicaid Medicare 40

Innovaare Compliance

FEBRUARY 5, 2024

Health Care Service Corporation (HCSC) has entered into a definitive agreement to purchase Cigna’s Medicare Advantage, Medicare Supplemental Benefits, Medicare Part D, and CareAllies businesses for $3.3 With Cigna’s Medicare plans serving 3.6 million members, HCSC will substantially increase its Medicare footprint.

Medicare 40

Medicare Medicare Due Diligence Health Insurance 40