Electronic Health Reporter

APRIL 23, 2020

The Office of the National Coordinator for Health IT (ONC) and the Centers for Medicare & Medicaid Services (CMS), in conjunction with the HHS Office of Inspector General (OIG) announced a policy of enforcement discretion […].

COVID-19 70

COVID-19 Public Health Medicaid Medicaid 70

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 Compliance Health Insurance 100

YouCompli

MARCH 29, 2023

In this article, she discusses several issues that hospitals and health systems need to consider as a result of the scheduled end of the COVID-19 public health emergency. Department of Health & Human Services (HHS) reports that 80% of the U.S. population previously received at least one COVID-19 vaccination.

Public Health 52

Public Health COVID-19 COVID-19 Vaccine Medicare 52

HIT Consultant

MARCH 8, 2022

The steep incline in unemployment and fears that millions of people would lose their health coverage drove the declaration of the national public health emergency (PHE) on January 31, 2020. Under the PHE, states must keep Medicaid enrollees continuously covered, irrespective of their circumstances. .

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Public Health Medicaid Medicaid Health Insurance 98

HIT Consultant

NOVEMBER 9, 2023

Director of Healthcare Strategy, LexisNexis Risk Solutions During the peak of the Covid-19 pandemic, over 10 million Americans enrolled in Medicaid – nearly a 14% increase from the beginning of 2020. A month before the public health emergency ended on May 11, 2023, 87 million individuals were enrolled in Medicaid.

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Medicaid Medicaid Health Insurance Health Outcomes 64

Kaiser Permanente

JANUARY 1, 2022

Medicaid and the Children’s Health Insurance Program (CHIP) have served as critical supports to children, pregnant women, parents, seniors, and individuals with disabilities – covering 80 million individuals during the COVID-19 pandemic. Since February 2020, Medicaid enrollment has grown sharply to cover an additional 9.9

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Medicaid Medicaid Medicare Medicare 92

Medisys Compliance

DECEMBER 23, 2022

The internet is ringing with the news of the CMS Updates Final rule for the 2023 Medicare Physician Fee Schedule. The finalized 2023 Medicare Physician Fee Schedule was announced by the Centers for Medicare & Medicaid Services (CMS) on November 1 2022. Medicare reimbursement for telehealth services.

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Medicare Medicare Medical Billing Medical Billing Outsourcing 98

Health Law Advisor

AUGUST 14, 2023

2] This means, in most cases, that Medicare beneficiaries must now come to a physician practice’s office location to pick up their DME – including IUCs – when the DME items are furnished and billed by physicians or their practices. The IOAS exception does NOT apply.

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COVID-19 Medicare Medicare Public Health 52

Medisys Compliance

MAY 19, 2022

During the COVID-19 Public Health Emergency (PHE), reimbursements for telehealth continue to evolve. The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. See this list of telehealth services from the Centers for Medicare & Medicaid Services.

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COVID-19 Medicare Medicare Medical Billing 52

Healthcare Law Blog

SEPTEMBER 6, 2022

In response to the COVID-19 Public Health Emergency (the “PHE”), the Centers for Medicare and Medicaid Services (“CMS”) issued numerous “blanket waivers” to increase access to medical services, and ease the regulatory burden on providers across the health care industry.

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COVID-19 Public Health Medicare Medicare 52

MedTrainer

MAY 4, 2023

The end of the federal Public Health Emergency (PHE) will reinstate regulations that have been absent for years… and many healthcare workers have never had to follow. There are plenty of compliance implications for the end of the Public Health Emergency on May 11, 2023 , and an assessment is a great place to start.

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Public Health Compliance COVID-19 COVID-19 Vaccine 52

Kaiser Health News

FEBRUARY 8, 2022

The penalties — a 1% reduction in Medicare payments over 12 months — are based on the experiences of Medicare patients discharged from the hospital between July 2018 and the end of 2019, before the pandemic began in earnest. Paradoxically, all those hospitals have five stars, the best rating, on Medicare’s Care Compare website.

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Medicare Medicare Hospitals COVID-19 123

HIPAA Journal

SEPTEMBER 29, 2022

The Government Accountability Office (GAO) recently conducted a review of Medicare telehealth services provided during the COVID-19 pandemic, when a waiver was in place that greatly expanded access to telehealth and virtual visits. Between April and December 2019, 5 million Medicare telehealth visits were conducted.

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Medicare Medicare COVID-19 HIPAA 73

Bill of Health

FEBRUARY 23, 2023

Over the course of the COVID-19 pandemic, now entering its fourth year in 2023, legislators, executives, and judges at every level of government have sought measures to derail efficacious public health interventions. And that’s where they are wrong. Some victories came easy.

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COVID-19 Public Health COVID-19 Vaccine Governance 176

Healthcare IT News - Telehealth

SEPTEMBER 15, 2020

expressing support for the Telehealth Modernization Act and stressing the urgency of safeguarding access to virtual care before the public health emergency is set to expire. Lamar Alexander, R-Tenn., WHY IT MATTERS. In its letter, the CHI supported these provisions and urged Alexander and his colleagues to go further.

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COVID-19 Medicare Medicare Public Health 184

McBrayer Law Blog

FEBRUARY 23, 2022

More > Tags: Audit , Centers for Medicare & Medicaid Services , CMS , COVID-19 , Healthcare Compliance Issues , Medicaid , Medicare , regulatory compliance. Just as the pandemic may finally be easing, federal focus on use of COVID-19 resources promises to increase healthcare providers’ stress.

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Compliance COVID-19 Regulatory Compliance Medicaid 97

Hall Render

JULY 28, 2023

Starting on August 1, 2023, Medicare validation edits will be activated to require service location addresses on the UB-04 hospital claim form to match exactly with the service location enrolled in Medicare’s Provider Enrollment, Chain, and Ownership System (“PECOS”).

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Medicare Medicare Compliance COVID-19 40

Healthcare It News

SEPTEMBER 9, 2022

The Centers for Medicare and Medicaid Services is inviting patients and their families, providers, clinicians, consumer advocates, healthcare professional associations, individuals serving underserved communities and all CMS stakeholders serving populations facing disparities in health and healthcare to submit public comments by November 4.

COVID-19 202

COVID-19 Medicaid Medicaid Public Health 202

Compliance Now

MARCH 15, 2022

In addition to the extension of telemedicine protections for HDHPs, the 2022 CAA expands the scope of telehealth services that Medicare will cover. The legislation also allows both Medicare and Medicaid to continue covering select telehealth services for 151 days after the COVID-19 public health emergency ends.

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COVID-19 Telemedicine Medicare Medicare 189

Healthcare IT News - Telehealth

FEBRUARY 3, 2023

The Telehealth Benefit Expansion for Workers Act would amend the Public Health Service Act, the Employee Retirement Income and Security Act of 1974 and the Internal Revenue Code of 1986 to allow employers to treat benefits for telehealth services like excepted benefits. In an announcement about the bipartisan bill, Rep.

Public Health 155

Public Health COVID-19 Medicare Medicare 155

MedTrainer

SEPTEMBER 20, 2023

If you want to obtain or retain CMS certification in order to be reimbursed by services provided to patients with a Medicare/Medicaid health plan, you must comply with HIPAA rules and regulations. There are several accrediting organizations that require facilities to meet or exceed Medicaid and Medicare guidelines.

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Medicaid Medicaid Medicare Medicare 97

Healthcare IT News - Telehealth

JANUARY 25, 2021

According to a press statement from Thompson's office, it would: Eliminate most geographic and originating site restrictions on the use of telehealth in Medicare and establishing the patient’s home as an eligible distant site. This is a common-sense step to make sure our policies keep pace with our technology," he added.

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COVID-19 Medicare Medicare Telemedicine 204

Healthcare IT News - Telehealth

JUNE 2, 2021

It's become common knowledge, at this point, that the flexibilities enabled by the federal government at the start of the COVID-19 public health emergency prompted an atmospheric jump in telehealth use. " The uncertainty about when the public health emergency will lift creates "a lot of anxiety," said Hayes.

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COVID-19 Public Health Federal Policy Medicare 211

HIT Consultant

AUGUST 2, 2022

– Brave Health , a virtual-first behavioral health provider focused on serving Medicaid and Medicare populations, today announced an innovative referral partnership with MedArrive. Today, access to basic behavioral health services for the nation’s most vulnerable populations is a public health crisis.

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Medicaid Medicaid Telemedicine Public Health 97

Provider Trust

MARCH 16, 2022

Exclusions are administrative actions that are placed upon an individual or entity by HHS OIG, a state agency or Medicaid Fraud Control Unit (MFCU), or by one of the many agencies associated with SAM.gov. Additionally, there are varying, disparate State Medicaid exclusions sources that require periodic screening.

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Medicaid Medicaid Medicare Medicare 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. However, such allowance is not extended beyond March 31, 2023.

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Medicare Medicare Compliance Public Health 52

Healthcare Law Today

JANUARY 20, 2022

While the opioid crisis has been a declared public health emergency (PHE) since October 26, 2017, overdose deaths remain at an all-time high and have only been exacerbated by the COVID-19 pandemic. In the 12-month period starting in April 2021, over 100,000 people have died from drug overdoses, a 28.5% The New Rule and the SUPPORT Act.

Medicare 52

Medicare Medicare COVID-19 Public Health 52

Provider Trust

JANUARY 25, 2024

Ensuring the Financial Integrity of HHS Programs In fiscal year (FY) 2022, improper payments within healthcare programs like Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) were estimated at a staggering $131.6 With Medicaid, the challenges are equally formidable.

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Fraud Medicaid Medicaid Medicare 52

Healthcare IT News - Telehealth

OCTOBER 2, 2020

Department of Health and Human Services to issue guidance to states about how to increase access to telehealth under Medicaid and the Children’s Health Insurance Program. Existing strategies states can use to integrate telehealth and other virtual health care services into value-based health care models.

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US Department of Health and Human Services COVID-19 Medicaid Medicaid 144

Healthcare IT News - Telehealth

JUNE 30, 2020

"Much of this transformation is dependent on temporary flexibilities extended to health systems and providers that are limited to the duration of the COVID-19 public health emergency declaration," the letter read. Lamar Alexander, R-Tenn., Meanwhile, U.S. Butterfield, D-N.C., and Glenn Thompson, R-Pa.,

US Department of Health and Human Services 192

US Department of Health and Human Services COVID-19 Telemedicine Medicare 192

Bill of Health

DECEMBER 6, 2023

To assess the prevalence of ghost networks, Senate Finance Committee staffers conducted a secret shopper study of 120 mental health provider listings across 12 Medicare Advantage plans. The Consolidated Appropriations Act of 2023 requires Medicaid plans to publish and update accurate and searchable provider directories.

Governance 144

Governance Medicaid Medicaid Medicare 144

Healthcare IT News - Telehealth

SEPTEMBER 27, 2021

The brief, which examined oversight efforts as of January and February 2020, stemmed from a survey of Medicaid directors from 37 states, as well as structured interviews with relevant stakeholders. Conduct evaluations and support state efforts to evaluate the effects of telehealth on access, cost and quality of behavioral health services.

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Fraud COVID-19 Medicaid Medicaid 176

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”).

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare IT News - Telehealth

APRIL 30, 2021

senators has reintroduced the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 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.

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COVID-19 Medicare Medicare Public Health 214

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

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”).

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Hospitals Medicare Medicare Medicaid 66

Healthcare IT News - Telehealth

MARCH 18, 2020

" Covered entities seeking to use audio or video communication tech to reach patients where they live "can use any non-public facing remote communication product that is available to communicate with patients," said the agency. ON THE RECORD.

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COVID-19 HIPAA Nursing Homes Medicare 187