Compliancy Group

APRIL 25, 2024

Maintaining Medicare compliance and avoiding legal and financial repercussions requires Medicare compliance training for employees at all organizational levels. Examples of Medicare fraud include billing for unrendered services and using a billing code or a service that’s more expensive than what a patient received.

Fraud 59

Fraud Medicare Medicare Compliance 59

Modern Healthcare

JULY 3, 2023

Nursing homes, rehab providers and psychiatric hospitals urged the Centers for Medicare and Medicaid Services to account for economic conditions in fiscal 2024 rates

Medicare 93

Medicare Medicare Nursing Homes Medicaid 93

Kaiser Health News

FEBRUARY 8, 2022

The federal government has penalized 764 hospitals — including more than three dozen it simultaneously rates as among the best in the country — for having the highest numbers of patient infections and potentially avoidable complications.

Medicare 123

Medicare Medicare Hospitals COVID-19 123

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. You contend CMS's Acute Hospital Care at Home program needs scalability to survive.

Hospitals 167

Hospitals Health Outcomes Medicaid Medicaid 167

Healthcare Law Blog

FEBRUARY 12, 2024

CMS approved $500 million in infrastructure spending for NYS to establish social care networks (“ SCNs ”) to provide HRSN screening and referral services to Medicaid beneficiaries that are targeted populations for HRSN services. Medicaid Hospital Global Budget Initiative CMS authorized up to $2.2

Medicaid 52

Medicaid Medicaid Hospitals Nurses 52

Fierce Healthcare

MARCH 21, 2024

More than 100 provider organizations want the Centers for Medicare & Medicaid Services (CMS) to take a tougher stance on Medicare Advantage (MA) plans’ practices following an industry survey es | Providers spent nearly $20 billion in 2022 pursuing delays and denials across all payer types, yet those efforts are substantially more costly on average (..)

Medicare 144

Medicare Medicare Medicaid Medicaid 144

Fierce Healthcare

JUNE 12, 2023

Industry hospital groups are pushing the Centers for Medicare & Medicaid Services to consider a higher annual pay bump and to shed some light on why it believes the number of uninsured patients | Public comments submitted to CMS by the hospital lobby were critical of a "woefully inadequate" 2.8%

Hospitals 119

Hospitals Payment Systems Medicaid Medicaid 119

Health Law RX

SEPTEMBER 14, 2021

Medicare and Medicaid certified facilities will be required to ensure that their employees are vaccinated for COVID-19, the Centers for Medicare & Medicaid Services (CMS) announced on September 9, 2021. The Interim Final Rule will apply to any healthcare facility receiving Medicare or Medicaid reimbursement.

Medicaid 75

Medicaid Medicaid Medicare Medicare 75

Compliancy Group

MAY 15, 2024

As we move deeper into 2024, hospitals must increasingly focus on compliance with regulations set forth by the Office of Inspector General (OIG). This guide outlines the OIG’s hospital compliance priorities and provides actionable advice on ensuring your hospital meets these rigorous standards.

Compliance 52

Compliance Hospitals Fraud Regulatory Compliance 52

Hall Render

FEBRUARY 22, 2024

In the FY 2024 IPPS Final Rule (the “Final Rule”), the Centers for Medicare & Medicaid Services (“CMS”) incorporated certain social risk factors into the Hospital Value-Based Purchasing (“VBP”) Program (“the Program”).

Hospitals 66

Hospitals Medicare Medicare Medicaid 66

Bill of Health

JUNE 15, 2023

By Laura Dolbow Merck recently filed a lawsuit that challenges the constitutionality of the Medicare price negotiation program created by the Inflation Reduction Act. Merck argues that this form of price regulation charts a “ radical new course ” for Medicare that violates the Takings Clause of the Fifth Amendment.

Medicare 190

Medicare Medicare Medicaid Medicaid 190

Compliancy Group

MARCH 22, 2024

depend on Medicare to get the healthcare they need. Remaining in good standing with Medicare has several advantages. Compliance Program A comprehensive way to avoid Medicare exclusion is to develop an organization-wide compliance program, one of the Centers for Medicare and Medicaid Services (CMS) requirements.

Medicare 52

Medicare Medicare Compliance Compliance Officers 52

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

Modern Healthcare

AUGUST 1, 2023

The Centers for Medicare and Medicaid Services also updated the hospital quality reporting program and outlined new health equity initiatives.

Hospitals 74

Hospitals Medicaid Medicaid Medicare 74

AIHC

JANUARY 5, 2023

Learn about the 7 steps to Medicare Compliance Medicare is federally regulated and requires healthcare providers to ensure that they comply with the many requirements before being eligible for reimbursement. Applying for Medicare compliance can be a daunting task for healthcare providers. What does this mean?

Medicare 59

Medicare Medicare Compliance Medicaid 59

Bill of Health

OCTOBER 19, 2023

The traditional model for post-graduate education for medical students, called residency, is regulated by the Accreditation Council for Graduate Medical Education ( ACGME ) and largely funded by the Center for Medicare Services (CMS). While this may have some merit, both students and hospitals also benefit.

Nurses 274

Nurses Medicare Medicare Medicaid 274

The Health Law Firm Blog

NOVEMBER 18, 2023

Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. This came in a ruling that limits regulators’ power to control what the program pays for certain [.]

Medicare 40

Medicare Medicare Hospitals Governance 40

Healthcare IT News - Telehealth

MARCH 4, 2021

Retain important “Hospital without Walls” site of care flexibility to support home-based hospital services. Encourage greater flexibility for home-based care services to meet commercial and Medicare Advantage network adequacy standards. Advocate for a bundled-payment model for extended care in the home.

Hospitals 212

Hospitals Medicare Medicare COVID-19 212

Health Law Advisor

NOVEMBER 2, 2022

Announced in the Consolidated Appropriations Act of 2021, Rural Emergency Hospitals (REHs) will be a new type of Medicare provider starting January 1, 2023. Existing CAHs and rural hospitals with fewer than 50 beds will be eligible to convert to an REH.

Medicare 52

Medicare Medicare Hospitals Malpractice 52

Modern Healthcare

APRIL 10, 2023

The fiscal 2024 Medicare inpatient prospective payment system proposed rule from the Centers for Medicare and Medicaid Services also includes new safety and health equity provisions.

Payment Systems 86

Payment Systems Hospitals Medicare Medicare 86

Wyatt Law Blog

FEBRUARY 22, 2024

On February 8, 2024, the Centers for Medicare and Medicaid Services (CMS) issued a memorandum entitled Texting of Patient Information and Orders for Hospitals and CAHs (the 2024 Memo), which provides updated guidance to State Survey Agency Directors.

Medicaid 98

Medicaid Medicaid Medicare Medicare 98

AIHC

JANUARY 28, 2022

For more information on filing compliance cost reports, attend the Medicare Cost Report Camp in March 2022 presented by KraftCPAs and sponsored by the American Institute of Healthcare Compliance. This is calculated based on the hospital’s relative share of uncompensated care nationally. In this rule, CMS will distribute roughly $8.3

Medicare 52

Medicare Medicare Hospitals Payment Systems 52

HIT Consultant

JUNE 22, 2022

Hospitals are increasingly turning to value-based care initiatives to transform care delivery, lower the total cost of care, and improve patient outcomes. Here are five ways hospitals can use technology to succeed under value-based care: 1. Reduce hospital admissions. Improve emergency department (ED) diversion.

Hospitals 98

Hospitals Medicare Medicare COVID-19 98

The Health Law Firm Blog

AUGUST 23, 2022

Supreme Court said the federal government improperly cut more than $1 billion a year in Medicare reimbursements to hospitals. Indest III, J.D., Board Certified by The Florida Bar in Health Law On June 15, 2022, the U.S. This came in a ruling that limits regulators’ power to control what the program pays for certain [.].

Medicare 52

Medicare Medicare Hospitals Governance 52

HIT Consultant

FEBRUARY 3, 2022

What You Should Know: – Hackensack Meridian Health , New Jersey’s largest and most integrated health network launches of Hospital At Home at JFK University Medical Center in Edison, a program that delivers high-quality acute care in the home of a Medicare patient and may ultimately be scalable to the larger patient population.

Hospitals 98

Hospitals COVID-19 Medicare Medicare 98

Medisys Compliance

MARCH 31, 2023

Ohio Medicaid is a government-sponsored healthcare program that provides medical benefits to eligible individuals in Ohio. To become a provider for Ohio Medicaid, you must first enroll in the Ohio Medicaid program. Here are the steps of provider enrollment for Ohio Medicaid: Provider Enrollment for Ohio Medicaid 1.

Medicaid 52

Medicaid Medicaid Licensing Medical Billing Outsourcing 52

Healthcare Law Blog

JANUARY 20, 2023

Research has indicated that healthcare systems that connect patients to basic resources have observed improvements in population health metrics, fostered trust with their patient base, and experienced reduced hospitalization costs. Please refer to our prior blog for more information on CalAIM.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

HIT Consultant

FEBRUARY 21, 2024

Don Rucker, MD – Chief Strategy Officer, 1upHealth CMS and Medicare are trying to change the dynamics of American healthcare. For the last 20 years, Medicare Fee for Service has been the hotspot of spending and value. Now fast forward to today and Medicare Advantage has more beneficiaries.

Medicare 52

Medicare Medicare Doctors Medicaid 52

Hall Render

NOVEMBER 17, 2023

The Centers for Medicare and Medicaid Services (“CMS”) Medicare Advantage final rule for 2024 (“Final Rule”) clarified that Medicare Advantage plans must adhere to the “two-midnight rule” when making coverage determinations for inpatient services. The Final Rule went into effect on June 5, 2023, and can be found here.

Medicare 40

Medicare Medicare Hospitals Medicaid 40

Healthcare It News

JUNE 13, 2023

WHY IT MATTERS Food as medicine programs, designed for patients with complex health and social needs, may reduce avoidable hospitalizations and emergency room visits. KFF's online Medicaid Waiver Tracker has information on which state Medicaid programs are granted 1115 waivers.

Medicaid 195

Medicaid Medicaid HIPAA Hospitals 195

Healthcare Law Blog

NOVEMBER 13, 2023

On November 6, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released the contract year 2025 proposed rule for Medicare Advantage (“MA”) organizations and Part D sponsors (the “Proposed Rule”). The UM committee was established in April 2023 in the 2024 Medicare Advantage and Part D Final Rule (CMS-4201-F).

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Healthcare IT News - Telehealth

MAY 14, 2021

Mayo Clinic and Kaiser Permanente announced this week that they will collaborate to build capacity for hospital-at-home care. Technology aimed at blurring the lines between at-home care and in-hospital services has taken on a renewed spotlight amidst the COVID-19 pandemic, when patients and providers have sought to avoid potential spread.

Hospitals 194

Hospitals COVID-19 Medicaid Medicaid 194

Health Law RX

FEBRUARY 21, 2024

The Centers for Medicare & Medicaid Services (CMS) has revised certain payment policies under the Medicare physician fee schedule, and updated provider and supplier enrollment regulations. CMS recently published a final rule (the Final Rule ) effective January 1, 2024.

Medicare 52

Medicare Medicare Licensing Compliance 52

Medisys Compliance

MAY 19, 2022

The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. During the COVID-19 public health emergency, any health care provider who is eligible to bill Medicare can bill for telehealth services regardless of where the patient or provider is located. Eligible services.

COVID-19 52

COVID-19 Medicare Medicare Medical Billing 52

Kaiser Health News

DECEMBER 10, 2021

The Cuthbert home where Gipson lived was less than a mile from Southwest Georgia Regional Medical Center, but the ambulance couldn’t take her to the one-story brick hospital because it had closed three months earlier, in October 2020. “If the hospital was still open, it could have saved her.” that closed in 2020. .

Hospitals 136

Hospitals Medicaid Medicaid COVID-19 136

Fierce Healthcare

JULY 13, 2023

The Centers for Medicare & Medicaid Services has released its proposed Medicare payment rates and policy updates under the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory S | The CY 2024 OPPS and ASC Payment System Proposed Rule includes a 2.8%

Payment Systems 98

Payment Systems Medicare Medicare Medicaid 98

Healthcare IT News - Telehealth

NOVEMBER 8, 2022

Orlando Health on Monday announced that it's been approved by Florida's Agency for Health Care Administration to start delivering hospital-level acute care in adult patients’ homes. " Here are some tips for how health systems should be preparing now for the future of hospital-at-home. WHY IT MATTERS. ON THE RECORD.

Hospitals 109

Hospitals Nurses COVID-19 Medicaid 109