Healthcare IT News - Telehealth

OCTOBER 26, 2020

Furthermore, questions of post-discharge patient activity are likely to loom large in the coming weeks, as the Centers for Medicare and Medicaid Services require hospitals to send electronic notifications to other healthcare facilities when a patient is admitted, discharged or transferred.

Telemedicine 207

Telemedicine Hospitals Medicaid Medicaid 207

Healthcare Law Blog

FEBRUARY 1, 2023

On January 30, 2023 , the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”). One thing that is certain, CMS can expect further challenges to its RADV audit methodology.

Medicare 105

Medicare Medicare Overpayment Overpayments 105

Compliance Now

AUGUST 10, 2023

As background, according to federal Health Insurance Portability and Accountability Act (HIPAA) rules, individuals have 60 days from losing CHIP and Medicaid eligibility to elect coverage under their group plan. A flyer employers can share with employees who are enrolled in Medicaid or CHIP and may lose their coverage.

Medicaid 100

Medicaid Medicaid COVID-19 Compliance 100

Compliance Now

AUGUST 10, 2023

As background, according to federal Health Insurance Portability and Accountability Act (HIPAA) rules, individuals have 60 days from losing CHIP and Medicaid eligibility to elect coverage under their group plan. A flyer employers can share with employees who are enrolled in Medicaid or CHIP and may lose their coverage.

Medicaid 100

Medicaid Medicaid COVID-19 Compliance 100

Healthcare It News

JANUARY 4, 2022

"The adoption of hospital-at-home programs across the country has been rapid, with nearly 200 hospitals participating in the Centers for Medicare and Medicaid Services’ Acute Hospital Care at Home program in only a year since its launch," said Majmudar.

COVID-19 362

COVID-19 Hospitals Nurses Medicaid 362

Bill of Health

NOVEMBER 17, 2022

Characterization and corroboration of safety signals identified from the US Food and Drug Administration Adverse Event Reporting System, 2008-19: cross sectional study. Medicare’s National Coverage Determination for Aducanumab – A One-Off or a Pragmatic Path Forward? Medicaid Spending on Antiretrovirals from 2007-2019.

FDA 189

FDA World Health Medicaid Medicaid 189

Innovaare Compliance

JUNE 28, 2024

The upcoming Medicare Prescription Payment Plan (M3P), set to launch in January 2025, marks a significant shift in Medicare’s approach to prescription drug coverage. Understanding the Medicare Prescription Payment Plan M3P introduces a novel approach to managing prescription drug costs for Medicare beneficiaries.

Medicare 94

Medicare Medicare Prescription Drug Pricing Compliance 94

Health Populi

JUNE 18, 2021

with employer-sponsored health insurance worry that a major health event in their household could lead to bankruptcy, according to research gathered by West Health and Gallup in Business Speaks: The Future of Employer-Sponsored Insurance. One in two people in the U.S. Health Populi’s Hot Points: U.S. households.

ACA 139

ACA Health Insurance Medicaid Medicaid 139

HIT Consultant

MARCH 28, 2022

The COVID-19 pandemic feels like a once-in-a-lifetime event for those of us involved in healthcare, but the patterns of how the crisis affected our industry feel familiar. The Dow Jones Industrial Average dropped precipitously and this event served as the turning point for improving how the financial world shared information.

COVID-19 138

COVID-19 Medicaid Medicaid Medicare 138

Healthcare IT News - Telehealth

AUGUST 11, 2021

Andrew Vanlandingham, senior counselor for Medicaid Policy and acting health IT lead at OIG, called attention to recent revisions to safe harbors under the Anti-Kickback Statute and Civil Monetary Penalty Rules around coordinated care. They're not submitting a telehealth claim to Medicare. Healthcare IT News is a HIMSS publication.

US Department of Health and Human Services 167

US Department of Health and Human Services Fraud Medicare Medicare 167

Healthcare IT News - Telehealth

JANUARY 11, 2021

In November, the Centers for Medicare and Medicaid Services took several new steps to help U.S. Previously with Medicare, programs like mine had no way to bill for care. Now this is the opportunity to bill Medicare for home hospital-level care, and this is going to be offered all across the country."

Hospitals 187

Hospitals Medicare Medicare COVID-19 187

Total Medical Compliance Resources

APRIL 16, 2025

Several regulatory agencies, including the Joint Commission and Centers for Medicare and Medicaid mandate documentation. The Center for Disease Control (CDC) and the Association of Perioperative Registered Nurses (AORN) have steps to follow in the event a spore testing is positive.

Medicaid 52

Medicaid Medicaid Nurses Medicare 52

Healthcare IT News - Telehealth

APRIL 24, 2020

The Alliance for Integrated Care of New York (AICNY) oversees the healthcare needs of roughly 6,200 dually eligible Medicare and Medicaid beneficiaries with intellectual and developmental disabilities (IDD). Many AICNY beneficiaries reside in group homes and use Federally Qualified Community Health Centers. THE PROBLEM. MARKETPLACE.

Telemedicine 202

Telemedicine COVID-19 Medicaid Medicaid 202

HIT Consultant

OCTOBER 18, 2021

– Papa and Uber are working together to mitigate social isolation and negative health outcomes among Medicare and Medicaid recipients as well as those with employer health plans. The partnership advances Papa’s and Uber Health’s shared missions to support population health among vulnerable communities.

Medicaid 95

Medicaid Medicaid Health Outcomes HIPAA 95

MedTrainer

FEBRUARY 29, 2024

Healthcare has its own near-miss events where a complication or medical error causes injury but the patient survives. What are near-miss events in healthcare? In this blog, we’ll describe near-miss events and how incident reporting software helps healthcare organizations better understand causes and ways to prevent future problems.

US Department of Health and Human Services 52

US Department of Health and Human Services Compliance Nurses World Health 52

Healthcare IT Today

DECEMBER 30, 2024

Additionally, AI can be a game-changer for risk and design; predictive analytics can reshape trials by identifying high-impact patient populations and preventing adverse events, thus, offering practical strategies to reduce inefficiencies and align trials with real-world patient needs.

US Department of Health and Human Services 88

US Department of Health and Human Services Nurses Medicare Medicare 88

Healthcare IT News - Telehealth

NOVEMBER 8, 2022

Orlando Health's program is the first in Central Florida to be approved by Centers for Medicare and Medicaid Services, and represents an expansion of a federal enhanced care model created during the pandemic to extend the scop of hospital resources. 15 and 16 from noon-4 p.m. THE LARGER TREND.

Hospitals 148

Hospitals Nurses COVID-19 Medicaid 148

Healthcare IT News - Telehealth

NOVEMBER 8, 2021

We are appalled by the idea that our patients could be stranded at home in case of an emergency or adverse event, with no way to get immediate help or medical intervention and treatment," said the statement. "Nurses know that our patients can be fragile and their condition can deteriorate quickly and unexpectedly. ON THE RECORD.

Nurses 192

Nurses COVID-19 Patient Satisfaction Hospitals 192

Healthcare IT News - Telehealth

JUNE 12, 2020

The good news for telehealth is that the reimbursement environment has improved, with the Center for Medicare and Medicaid Services bringing telehealth and eVisits on par with in-person visits for the duration of the pandemic, along with a relaxing of rules for virtual consults across state lines.

COVID-19 218

COVID-19 Hospitals Medicaid Medicaid 218

HIT Consultant

DECEMBER 15, 2021

What You Should Know: – Bamboo Health announced that it has expanded its care coordination partnership with Oak Street Health intended to arm the network of value-based primary care centers (for Medicare) with an additional level of resources for managing real-time patient event notifications.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

HIT Consultant

MARCH 8, 2022

Under the PHE, states must keep Medicaid enrollees continuously covered, irrespective of their circumstances. . By December 2021, enrollment in Medicaid and CHIP (Children’s Health Insurance Program) grew to a record high of more than 83 million individuals, primarily due to the continuous coverage requirements of the PHE.

Public Health 98

Public Health Medicaid Medicaid COVID-19 98

Health Populi

MAY 21, 2020

Among those covered with insurance, one-half had employer-sponsored insurance, 1 in 4 Medicare, and 13%, individual cover. Another 8% had Medicaid or a state health insurance program. Nearly every respondent in the study reported having health insurance coverage.

COVID-19 161

COVID-19 Doctors Health Insurance Medicare 161

Jane Sarashon

APRIL 14, 2025

As Weight Watchers prepares to initiate bankruptcy proceedings, I file the news event under “thinking the unthinkable.” ” “Thinking about the unthinkable” is what Herman Kahn, a father of scenario planning, asked us to do when he pioneered the process.

Medicaid 59

Medicaid Medicaid Medicare Medicare 59

Healthcare IT News - Telehealth

MARCH 25, 2024

The Centers for Medicare and Medicaid Services just released data on its Acute Hospital Care at Home initiative , which thus far has admitted 11,159 patients suffering from respiratory infections, heart failure and severe sepsis.

Hospitals 195

Hospitals Health Outcomes Medicaid Medicaid 195

Healthcare Law Blog

JANUARY 20, 2023

To add uniformity to this practice, CMS codified this flexibility in the 2016 Medicaid and Children’s Health Insurance Plan (CHIP) managed care final rule by authorizing coverage for “In Lieu of Service or Settings” (ILOS). [i] ILOSs must advance the objectives of the Medicaid program. ILOSs must be medically appropriate.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Medisys Compliance

MAY 5, 2022

On 22 nd April 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule to update Medicare enrollment and eligibility rules that would expand coverage for people with Medicare and advance health equity. Sections 120 and 402 of the CAA made two key changes to Medicare enrollment rules.

Medicare 52

Medicare Medicare Medical Billing Outsourcing Medical Billing 52

MedTrainer

JUNE 9, 2022

Over the past two years or so, Centers for Medicare and Medicaid Services (CMS) surveys have been much less frequent in response to the pandemic. The takeaway from this new information is to have your compliance in place BEFORE a surprise survey, or before an event happens that can trigger a survey.

Compliance 86

Compliance Medicaid Medicaid Medicare 86

Compliancy Group

MARCH 12, 2025

A healthcare organization that does not follow proper methods of obtaining reimbursement from federal payor programs such as Medicare may run afoul of federal fraud, waste, and abuse laws. To avoid running afoul of potential civil or criminal liability, organizations must ensure that Medicare claim reporting is accurate.

Fraud 52

Fraud Compliance Medicare Medicare 52

HIPAA Journal

JANUARY 30, 2023

The event provides a tremendous opportunity for learning through HIPAA workforce training sessions and keynote speeches from top government officials and leading industry professionals. Tennant, MA The full schedule for the event can be downloaded here – HIPAA Summit Schedule (PDF).

US Department of Health and Human Services 83

US Department of Health and Human Services HIPAA Compliance Medicaid 83

Healthcare IT Today

AUGUST 10, 2023

These datasets, which are critical to patient care, workflow processes, quality reporting, financial claims, and operational tasks, are encoded with granular medical event data and are represented using common data standards such as HL7, FHIR, EDI, and 837s, among others.

Health Insurance 97

Health Insurance Medicaid Medicaid Medicare 97

Healthcare Law Blog

OCTOBER 21, 2022

For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. It can be found here.

Licensing 97

Licensing Medicaid Medicaid Hospitals 97

Innovaare Compliance

JULY 19, 2024

On April 15, 2022, the Centers for Medicare & Medicaid Services (CMS) released potential fraud, waste and abuse (FWA) trending data collected from Medicare Advantage Prescription Drug Plans (plan sponsors) for fourth quarter 2021. The most prominent suspect was misrepresentation of services/products (48.87%).

Fraud 52

Fraud Medicare Medicare Compliance 52

HIT Consultant

APRIL 3, 2023

These risk-based care models are designed to encourage proactive care, better population health and reduced spending across the healthcare spectrum.

Medicaid 98

Medicaid Medicaid Medicare Medicare 98

Healthcare IT News - Telehealth

DECEMBER 28, 2020

"Our legacy telemedicine program also was limited to a certain degree because of restrictions on reimbursement for services, particularly reduced rates for off-site telemedicine paid by New York State Medicaid funding," he explained.

COVID-19 217

COVID-19 Telemedicine Public Health Patient Satisfaction 217

Health Care Law Brief

FEBRUARY 2, 2024

While still subject to legislative approval, the Executive Budget incorporates the recently approved amendment (“Waiver Amendment”) to New York’s Medicaid Section 1115 Demonstration that includes $7.5 billion in Medicaid investments over the next three years. Services will be delivered via a two-tiered system.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIT Consultant

JULY 14, 2023

Anti-Kickback Statute Violation In addition, the government also alleges that NextGen violated the Anti-Kickback Statute, which prohibits anyone from offering or paying, directly or indirectly, any remuneration to induce referrals of items or services covered by Medicare, Medicaid, and other federally funded programs.

Governance 94

Governance Medicaid Medicaid Medicare 94

Hall Render

APRIL 28, 2025

Background For decades, LDTsin-house diagnostic tests developed, validated, and performed within a single laboratoryhave been regulated by states and the Centers for Medicare & Medicaid Services (“CMS”) under the Clinical Laboratory Improvement Amendments of 1988 (“CLIA”), while FDA exercised enforcement discretion.

FDA 52

FDA Medicaid Medicaid Medicare 52