C&M Health Law

DECEMBER 23, 2022

The regulations impact CMS-regulated payers and provide incentives for providers and hospitals that participate in the Medicare Promoting Interoperability Program and the Merit-based Incentive Payment System (MIPS). The below summary does not focus on the Medicaid and Children’s Health Insurance Program (CHIP) Fee for Service (FFS) proposals.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Compliancy Group

AUGUST 31, 2023

They are responsible for: Monitoring adherence to healthcare compliance laws and regulations Identifying potential risks or violations Implementing corrective actions when necessary Compliance officers also act as resources for staff members by providing education and training on compliance-related topics.

Compliance 52

Compliance Compliance Officers Fraud Compliance Framework 52

AIHC

APRIL 10, 2024

Does the covered entity need to engage other resources to assist in risk management? Additional Resources Review the HIPAA provisions and how the HITECH Act strengthens the HIPAA enforcement. Is executive leadership and/or management involved in risk management and mitigation decisions? There is a lot of information available.

Compliance 99

Compliance US Department of Health and Human Services HIPAA Electronic Medical Records 99

AIHC

OCTOBER 20, 2023

Healthcare executives are challenged with finding resources, talent and motivation to lead the workforce in a direction to improve both patient outcomes and reimbursement, in addition to dealing with a shortage of physicians and nurses to staff facilities. The problem, what is being measured, and how?

Health Outcomes 59

Health Outcomes Medicare Medicare Governance 59

Healthcare Blog

AUGUST 23, 2023

Staffing shortages, healthcare access disparities, and emergency situations requiring triage of resources and equipment can happen anytime. link] Centers for Medicare & Medicaid Services. Ethics Topics. It is critical for an organization to have strategies for promoting ethical behavior in healthcare compliance.

Compliance 56

Compliance Nurses Regulatory Compliance Medicaid 56

Verisys

DECEMBER 22, 2021

133 also covers several other topics related to billing and directory operations not mentioned above. While the three regulations combined place a strain on healthcare information technology resources, there is hope. Ensure key provider attributes are verified and up to date. Participate in workgroup meetings.

Compliance 52

Compliance Regulatory Compliance Healthcare information Technology Health Insurance 52

Healthcare IT News - Telehealth

JUNE 12, 2023

A 2019 survey by the Assistant Secretary for Planning and Evaluation’s Office of Health Policy found that the highest rates of telehealth visits happened among people with Medicaid (29.3%) and Medicare (27.4%), Black individuals (26.8%), and those earning less than $25,000 (26.7%).

Telemedicine 178

Telemedicine Hospitals Medicaid Medicaid 178

AIHC

APRIL 25, 2022

Many organizations have centralized security management to make sure mobile devices accessing their internal networks or resources are compliant with their security policies. As AIHC advises, another resource is legal advice through your malpractice insurance company. Click Here for Cross-State Licensing information.

HIPAA 52

HIPAA Compliance COVID-19 Compliance Officers 52

CMS.gov

MARCH 1, 2019

Administrator, Centers for Medicare & Medicaid Services. Medicare Parts A & B. My primary mission as the Administrator of the Centers for Medicare and Medicaid Services (CMS) is to deliver on President Trump’s commitment to strengthen and modernize Medicare for the millions of Americans who depend on us every day. .

Medicare 38

Medicare Medicare Medicaid Medicaid 38

HIT Consultant

OCTOBER 14, 2021

“The explosion of telehealth will certainly be a hot topic at HLTH. Providers need more supportive resources to be successful in more meaningful and broadly distributed risk models. Virtual and hybrid care, policy changes, and wearable devices are some of the larger topics we will see because of the pandemic.

COVID-19 95

COVID-19 FDA Medicare Medicare 95

Healthcare IT Today

NOVEMBER 9, 2022

Specifically, what if the Center for Medicare & Medicaid Services (CMS) rescinds the emergency orders it has put in place during the COVID-19 pandemic? As usual, sites that are already flush with cash and well-endowed with resources can find more cost savings. The change took place in almost a twinkling of an eye.

COVID-19 96

COVID-19 Doctors Telemedicine Medicare 96

Pharmacy Law Blog

FEBRUARY 13, 2018

On November 22, 2017, a Florida woman who was accused of a $45 million Medicare fraud, received a six-and-a-half-year prison sentence, following a 2016 U.S. Prior to her guilty plea, she was accused of Medicare fraud and Anti-Kickback Statute violations allegedly through paying patients. By George F. Indest III, J.D.,

Fraud 40

Fraud Medicare Medicare Governance 40

CMS.gov

MARCH 14, 2019

Administrator, Centers for Medicare & Medicaid Services. Medicaid & CHIP. It’s not surprising that many of these same people are now working double time to pull us into the big government abyss of Medicare for All. That’s why CMS is releasing a set of new resources to support state monitoring and evaluation efforts.

Medicaid 31

Medicaid Medicaid Governance Medicare 31

MedTrainer

AUGUST 25, 2023

While YouTube has become a go-to resource for tutorials, entertainment, and educational content — all of which are indeed free — finding healthcare compliance training you can trust isn’t easy. Let’s review 15 reasons why you shouldn’t use YouTube for healthcare compliance trainings, along with your best alternative option.

Compliance 52

Compliance HIPAA ADA Medicaid 52

Hall Render

JULY 14, 2023

On Friday, June 20, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update (“PPS Rule”), which has since been published in the Federal Register and is currently open for comment.

Medicare 52

Medicare Medicare Payment Systems Governance 52

CMS.gov

NOVEMBER 15, 2018

Administrator, Centers for Medicare & Medicaid Services. Approximately 60 million people live in rural areas – including millions of Medicare and Medicaid beneficiaries. Also, Medicare will now pay separately for Remote Evaluation of Recorded Video and/or Images Submitted by the Patient. Jeremy.Booth@c….

Medicare 50

Medicare Medicare Payment Systems Medicaid 50

Hall Render

MAY 2, 2023

After 30 days, new patients admitted to nursing homes with a mental illness or intellectual disability should receive the assessment as soon as resources become available. The CMS Memo provides that this means that all new SNF stays beginning on or after May 12, 2023 will require a qualifying hospital stay before Medicare coverage.

Nursing Homes 40

Nursing Homes Public Health Nurses COVID-19 40

CMS.gov

MARCH 2, 2018

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Funding Opportunity: Measure Development for the Quality Payment Program. They are concrete quality topics which reflect core issues that are most vital to high quality care and better patient outcomes. Jeremy.Booth@c…. Fri, 03/02/2018 - 16:30. Kate Goodrich, M.D.,

Medicare 20

Medicare Medicare Patient Advocacy Medicaid 20

CMS.gov

MARCH 6, 2013

By: Christine Stahlecker, Director, Administrative Simplification Group, Office of E-Health Standards and Services, Centers for Medicare & Medicaid Services. We also have helpful resources to help you stay up to date on ICD-10 and other administrative simplification initiatives.

ACA 30

ACA HIPAA Medicaid Medicaid 30

CMS.gov

NOVEMBER 16, 2018

2018 Medicare Fee-For-Service improper payment rate is lowest since 2010. Administrator, Centers for Medicare & Medicaid Services. 2018 Medicare Fee-For-Service improper payment rate is lowest since 2010 Significant progress in saving $4.59B in estimated improper payments for the Medicare Fee-For-Service program.

Medicare 20

Medicare Medicare Overpayments Overpayment 20

Hall Render

JANUARY 11, 2023

For example, reimbursement under Medicare and Medicaid for certain telemedicine services was significantly increased due to the COVID-19 pandemic. Other Resources. Whether an app is considered a low-risk device or if it implicates FDA application or submission requirements will continue to require careful judgment.

Compliance 40

Compliance HIPAA FDA Due Diligence 40

AIHC

FEBRUARY 15, 2023

Both leaders and managers have to seek accomplishment with resources at their disposal, but true leadership requires more. Another mentor, the Chief Financial Officer (CFO) took the time to teach me how to navigate the Medicare & Medicaid rules and regulations which I, in turn, used to win huge appeals for my organization.

Compliance 52

Compliance Nurses Medicaid Medicaid 52

CMS.gov

APRIL 15, 2019

Administrator, Centers for Medicare & Medicaid Services. The SSAs visit and survey every Medicare and Medicaid participating nursing home in the nation at least annually to ensure they are meeting CMS’ health and safety requirements as well as state licensure requirements. Jeremy.Booth@c…. Mon, 04/15/2019 - 19:22.

Nursing Homes 51

Nursing Homes Nurses Compliance Medicare 51

MRO Compliance

JUNE 23, 2022

I recently wrote an article titled “Revenue Integrity: How to Reduce Costs and Retain Revenue” where I provided several tips on how to assess costs and resources and how to better prepare for audits to avoid denials. Denial volume is on the rise, which is why auditing has become increasingly difficult. Provide business intelligence reporting.

Medicaid 130

Medicaid Medicaid Medicare Medicare 130

Healthcare IT News - Telehealth

DECEMBER 5, 2022

What I have been most excited about is the acceleration in the concrete steps that Centers for Medicare and Medicaid Services states and accreditation organizations are taking to inspire action in the space of health equity. " Melissa Sherry, Unite Us.

US Department of Health and Human Services 168

US Department of Health and Human Services Medicaid Medicaid Department of Veterans Affairs 168

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

Healthcare Law Blog

JANUARY 11, 2023

Morgan Healthcare Conference, you would know that all three are waiting to see what the upcoming final rule on Medicare Advantage risk adjustment data validation (known as RADV) audits will mean for the industry when it drops in February. The average HCC-RAF score is supposed to be a 1.0, range, with a 1.3 – 1.4 to perhaps a 2.3

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare IT Today

JANUARY 5, 2024

With legislation currently being drafted for nurses to receive the same reimbursement doctors and physicians do, this will likely become a top-of-mind topic in 2024. The recent Humana/Cigna news will be the first of many health plan mergers in 2024 as payers seek to align strategies and optimize resources.

Nurses 110

Nurses Medicare Medicare Health Outcomes 110

Healthcare Law Blog

JANUARY 13, 2023

One of the topics I followed with keen interest this week at the J.P. All of these companies focus on therapy, supportive resources, and, in some cases, psychiatry. Centene’s CEO, Sarah London, said, as to the Medicaid program, “for both pharmacy and behavioral health, the math doesn’t make sense when you do it separately.

COVID-19 98

COVID-19 Medicaid Medicaid Nurses 98

Healthcare IT Today

FEBRUARY 27, 2024

The previous article in this series introduced the topic of generative AI in the back office of healthcare. This article starts to look at healthcare generative AI use cases. Is it any surprise that new technologies in health care pop up quickly in the area of reimbursements? Payments are the constant obsession of every manager.

Medicaid 96

Medicaid Medicaid Doctors Medicare 96

Healthcare IT Today

SEPTEMBER 19, 2023

While the key components of privacy (administrative, uses and disclosures, individual rights, and general security) are all necessary today, I would put privacy, security, breach – and relevant 21 Century Cures Interoperability topics – all together and make sure everyone handling any type of sensitive information be subject to these rules.

Hospitals 121

Hospitals HIPAA Nurses Governance 121

Hall Render

JANUARY 5, 2024

Retina Group of Washington reports massive data breach A trifecta of viruses in the D.C. region has health officials worried Half of Black D.C. MU hopes to change that Missouri orthopedic hospital adds Velys robot for joint replacements MONTANA University of Montana alumni keep health care local in small-town Montana Missoula Providence St.

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40

Hall Render

MARCH 28, 2023

The end of the PHE has a significant impact on skilled nursing facilities (“SNFs”) as it ends the remaining regulatory blanket waivers, revisits resident Medicaid eligibility and changes many COVID regulations that were issued during the PHE. CMS will end this waiver at the end of the PHE. When the PHE ends, the hotlines will be shut down.

Public Health 40

Public Health Nurses Nursing Homes COVID-19 40

Healthcare IT News - Telehealth

JUNE 4, 2021

"Failing quickly allows us to reallocate resources from a project that will never reach fruition to other endeavors," he said. We provided at-the-elbow support for physicians and opened bridge lines with all needed IT resources to support quick resolution to any issues." " Adding cybersecurity resources.

US Department of Health and Human Services 139

US Department of Health and Human Services COVID-19 Doctors Nurses 139

Hall Render

OCTOBER 6, 2023

Mary’s ‘modernization’ project UChicago Medicine AdventHealth Bolingbrook Hospital Names New CFO Nurses asks lawmakers for staffing mandates, hospital leaders disagree Loyola Medicine Burr Ridge outpatient medical center trades for $59.95

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

OCTOBER 6, 2023

Mary’s ‘modernization’ project UChicago Medicine AdventHealth Bolingbrook Hospital Names New CFO Nurses asks lawmakers for staffing mandates, hospital leaders disagree Loyola Medicine Burr Ridge outpatient medical center trades for $59.95

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Healthcare Law Blog

JANUARY 14, 2022

And since the conference was virtual, what better topic to start us off today than a consideration of the new Virtual-First trend that surfaced in 2021. That provider could address the patient’s needs virtually and connect the patient to in-person resources when necessary. One of every four Medicaid patients is estimated by the U.S.

US Department of Health and Human Services 52

US Department of Health and Human Services Hospitals Medicaid Medicaid 52