Home Health Care

NOVEMBER 22, 2023

Centers for Medicare & Medicaid Services’ (CMS) Acute Hospital Care at Home waiver was a major boost for organizations hoping to implement or expand hospital-at-home programs. With this in mind, some are wondering if state Medicaid agencies could be a way to further the hospital-at-home movement.

Medicaid 101

Medicaid Hospitals Medicare Regulations 101

Fierce Healthcare

DECEMBER 8, 2023

A House vote on transparency regulations in healthcare could occur next week, potentially having substantial ramifications on how PBMs and hospitals operate. | Bipartisan anticipation is in the air for a potential vote in the House this week that would bring transparency to PBMs and ban spread pricing in Medicaid, but hospital groups are firmly opposed (..)

Regulations 293

Regulations Medicaid Hospitals Healthcare 293

Home Health Care

FEBRUARY 14, 2024

One way to do so would be by mirroring the regulatory model state Medicaid programs use for home- and community-based services. The report suggests that the Medicaid model is the answer. Medicaid] has always kind of relied on that regulated agency model that the states have kind of set up around caregivers entering the home.

Home Care 64

Home Care Medicaid Regulations Medicare 64

Home Health Care

NOVEMBER 8, 2021

Since the Centers for Medicare & Medicaid Services (CMS) released its interim emergency regulation relating to the federal government’s vaccine mandate last Thursday, more clarity has come to the surface. The post ‘Layer Upon Layer of Regulation’: Breaking Down the CMS Vaccination Mandate appeared first on Home Health Care News.

Regulations 96

Regulations Medicaid Medicare 96

Home Health Care

AUGUST 14, 2023

Centers for Medicare & Medicaid Services (CMS) – which would require at least 80% of Medicaid reimbursement for home- and community-based services go toward worker compensation – received over 2,100 submissions during its public comment period. A proposed rule from the U.S.

Medicaid 95

Medicaid Regulations Home Care Medicare 95

Readiness Rounds

OCTOBER 3, 2023

The Tightening Grip of CMS Regulations 2. The rules of unannounced visits from regulatory bodies have been significantly tightened by the Centers for Medicare & Medicaid Services (CMS) making it crucial for healthcare facilities to be constantly prepared. Headlines: 1. Key Takeaways 5.

Regulations 52

Regulations Performance improvement Patient Safety Hospitals 52

NASHP

JUNE 30, 2023

During the COVID-19 public health emergency (PHE), states instituted Appendix K amendments to 1915(c) home-and community-based waivers and 1115 demonstration waivers to ensure that Medicaid beneficiaries were able to receive needed services during the pandemic. Information was collected between May 9 and June 23, 2023. Hartford Foundation.

Medicaid 105

Medicaid Regulations Home Care Nursing 105

Home Health Care

MAY 11, 2023

Centers for Medicare & Medicaid Services (CMS) recent proposed rule for Medicaid may cap business for certain providers , but industry experts believe the government agency is likely foreshadowing its intentions for the final rule. Industry advocates do not believe the 80% threshold will stand in the final rule. “I

Medicaid 76

Medicaid Nursing Regulations Home Care 76

NCQA

JUNE 27, 2023

More states are contracting with managed care organizations (MCO) to provide Medicaid long-term services and supports (LTSS). In July, NCQA will update these programs to further align with best practices and federal regulations. Increase Alignment with Federal Provisions: LTSS Distinction helps MCOs meet HCBS waiver regulations.

Medicaid 52

Medicaid Care Transition Quality Improvement Regulations 52

Sheppard Health Law

FEBRUARY 3, 2023

New Subpart 521-1: Compliance Programs The adopted regulations represent substantial changes to 18 N.Y.C.R.R. Part 521 governing the implementation and operation of effective compliance programs for certain “required providers,” including, now for the first time, Medicaid managed care organizations (MMCOs). [1]

Medicaid 52

Medicaid Regulations Prevention Accountability 52

Healthcare It News

DECEMBER 29, 2023

This past week, New York Governor Kathy Hochul signed Senate Bill 1196a/Assembly Bill 1673a into law directing all state-regulated health plans, including Medicaid, to cover comprehensive biomarker testing, clearing the path for more patients to access precision medicine treatments.

Medicaid 240

Medicaid Regulations Integration Healthcare 240

Briggs Healthcare

FEBRUARY 21, 2022

The Informational Letter is directed to Iowa Medicaid Providers, but it contains a message that I thought was worth sharing. Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare. The Iowa Department of Human Services issued IL 2315-MC-FFS-CVD on Sunday, February 20, 2022.

Regulations 104

Regulations Medicaid Healthcare 104

Home Health Care

MAY 4, 2023

Centers for Medicare & Medicaid Services’ (CMS) latest proposed rule , which includes a provision that would require at least 80% of Medicaid payments to go toward compensation for personal care workers. The heightened attention on personal care services leads to necessary sophistication, oversight and regulation.

Medicaid 69

Medicaid Regulations Accountability Medicare 69

Sheppard Health Law

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 cost effective.

Medicaid 52

Medicaid Regulations Federal Healthcare Medicare 52

HIT Consultant

AUGUST 31, 2023

Adimika Arthur, Executive Director, HealthTech 4 Medicaid Manisha Sharma, Senior Medical Director, Promise Health Plan Blue Shield of California During the pandemic, Medicaid enrollment grew by nearly 30% to cover more than 93 million Americans , due in large part to COVID-19 provisions that included continuous Medicaid enrollment.

Medicaid 64

Medicaid Prevention Health Data Quality of Care 64

Home Health Care

APRIL 22, 2024

The “Ensuring Access to Medicaid Services” rule has been finalized. First proposed by CMS in April of 2023 , the goal of the rule is to enhance access to HCBS for Medicaid beneficiaries. First proposed by CMS in April of 2023 , the goal of the rule is to enhance access to HCBS for Medicaid beneficiaries.

Home Care 115

Home Care Medicaid Accountability Regulations 115

Triage Health Law

JANUARY 11, 2023

Pursuant to federal regulations that took effect on January 1, 2023, individuals who lose Medicaid coverage will be granted a special enrollment right to enroll in Medicare Part B coverage. [1] This is however changing and Ohio is an example.

Medicaid 59

Medicaid Medicare Regulations Doctors 59

Home Health Care

APRIL 28, 2023

Centers for Medicare & Medicaid Services (CMS) proposed a new rule that would make major changes to the way that home care workers are compensated under Medicaid. The bulk of its business is in Medicaid. Anderson also noted that home care agencies working under Medicaid often vary in size. On Thursday, the U.S.

Medicaid 90

Medicaid Accountability Quality Assurance Home Care 90

Home Health Care

JULY 11, 2022

Many Pennsylvanians with physical disabilities are covered by Medicaid, which pays for at-home caregivers. Pennsylvania has three Medicaid managed care organizations, which receive state funding to pay for the caregivers. What the proposal does. I think it’s going to be something that SEIU attempts in other states.”.

Home Care 85

Home Care Regulations Medicaid Nursing 85

NASHP

AUGUST 19, 2022

Emerging State Innovations in Developing a Medicaid Community-Based Palliative Care Benefit August 19, 2022 / by Salom Teshale and Wendy Fox-Grage. Research has found relationships between palliative care consultation and lower hospital costs for Medicaid beneficiaries, indicating that palliative care can contain costs.

Medicaid 59

Medicaid Regulations Medicare Integration 59

NASHP

APRIL 15, 2022

Midwife Medicaid Reimbursement Policies by State April 15, 2022. You can also download the charts on Certified Nurse-Midwife State Medicaid Reimbursement Policy and Midwife Licensing and State Medicaid Reimbursement Policy. Certified Nurse-Midwife State Medicaid Reimbursement Policy. Medicaid Reimbursement.

Medicaid 64

Medicaid Nursing Medical Practitioners Regulations 64

Healthcare ECONOMIST

NOVEMBER 21, 2021

Where does the Centers for Medicare and Medicaid Services see Medicaid and the Children’s Health Insurance Program (CHIP) heading in the future. Medicaid coverage is a difficult proposition. Not only that, 70% of Medicaid beneficiaries are covered by private plans that States pay to administer the benefit.

Medicaid 62

Medicaid Regulations Medicare 62

Briggs Healthcare

MARCH 22, 2023

Mary Madison, RN, RAC-CT, CDP Clinical Consultant – Briggs Healthcare The OIG has posted its annual report on Medicaid fraud for FY2022. The 29-page report highlights: Here’s the Table of Contents: Reducing Medicaid fraud is a top priority for OIG, and its role in overseeing MFCUs helps achieve that priority.

Medicaid 52

Medicaid Regulations Accountability Healthcare 52

NASHP

OCTOBER 22, 2021

Supporting the Continuum of Care for Serious Illness in Medicaid Managed Care October 25, 2021 / by Salom Teshale, Kitty Purington, Wendy Fox-Grage, and Mia Antezzo. Delivery system transformation: Leading states such as Minnesota have long used Medicaid MCO contracts to address the needs of complex populations and those with serious illness.

Medicaid 102

Medicaid Hospice Care Integration Regulations 102

Healthcare It News

DECEMBER 16, 2022

What does 2023 hold for healthcare technology, as innovation continues at rapid speed, policymakers and regulators try to keep up with the pace of change – and health systems large and small deal with significant budgetary shortfalls that could hamper their ability to build out their digital transformation efforts?

Healthcare Finance 275

Healthcare Finance Regulations Patient Safety Patient Experience 275

Briggs Healthcare

DECEMBER 2, 2021

While CMS remains confident in its authority to protect the health and safety of patients in facilities certified by the Medicare and Medicaid programs, it has suspended activities related to the implementation and enforcement of this rule pending future developments in the litigation.

Medicaid 97

Medicaid Medicare Regulations Healthcare 97

Home Health Care

APRIL 12, 2024

In past years, Medicare-certified home health agencies and Medicaid personal care services providers have been big focus areas for government watchdogs. Once implemented, EVV could increase the risk that Medicaid beneficiaries’ needs are not being met, potentially compromising their health and safety,” OIG’s work plan states.

Medicaid 89

Medicaid Medicare Home Care Regulations 89

NASHP

DECEMBER 23, 2022

With more than 40 percent of births financed by Medicaid, the Centers for Medicare & Medicaid Services (CMS) has developed an action plan that corresponds with goals outlined in the White House blueprint. Implement Medicaid benefit. Identify community assets, engage the provider community, and build infrastructure.

Medicaid 59

Medicaid Nursing Regulations Hospitals 59

Healthcare It News

MAY 31, 2023

They also said clinicians reported needing more formal training on how to communicate more effectively over a virtual platform and about state regulation. Regulations that varied widely also affected their use of telehealth platforms. But the telehealth boom during the pandemic proved virtual primary care inspires several value-ads.

Telemedicine 286

Telemedicine Primary Care Regulations Doctors 286

NASHP

DECEMBER 13, 2021

Toolkit: New Legislative and Medicaid Models to Lower Drug Prices. For additional information and greater detail, see NASHP’s brief “ State Strategies to Lower Drug Prices: New Legislative and Medicaid Models.” Medicaid Models. Massachusetts Health Policy Commission: Final Regulation for Drug Pricing Review.

Medicaid 52

Medicaid Regulations Prevention Pharmaceuticals 52

Home Health Care

JANUARY 31, 2024

The Medicare enrollment process undergoes annual changes at the Centers for Medicare & Medicaid Services (CMS) to ensure it remains up to date with evolving regulations, policies and health care practices. A number of changes went into effect on Jan. 1, and several of them will affect home health agencies. They recognize that.

Medicare 118

Medicare Regulations Medicaid Home Care 118

Healthcare It News

OCTOBER 4, 2022

The Electronic Healthcare Network Accreditation Commission and The CARIN Alliance have partnered to bring both the CARIN Code of Conduct and EHNAC’s criteria review process to health plans, health systems, EHR vendors and others for reporting to the Centers for Medicare & Medicaid Services on their data practices and privacy protections.

Regulations 262

Regulations Medicaid Medicare Healthcare 262

HIT Consultant

JUNE 16, 2022

As a result, the Centers for Medicare and Medicaid Services (CMS) has since issued new guidance regarding the IDR process for disputing parties. Both payers and providers will need to be prepared to adapt and pivot accordingly to uphold the regulations and protect those who matter most – the patients. About Lynne Rinehimer.

Regulations 52

Regulations Hospitals Medicaid Medicare 52

NASHP

APRIL 4, 2024

Almost half (24) of the states have a palliative care advisory council, coalition, or task force created through state legislation or regulation to guide work to support and expand care for those with serious illness. Hartford Foundation Paul J.

Regulations 98

Regulations Medicaid 98

Briggs Healthcare

FEBRUARY 9, 2022

The Medicare and Medicaid certification of providers and suppliers in a State whose oversight process is substantially deficient may be jeopardized if CMS cannot ensure that the regulatory minimum health and safety standards have been met.

Medicaid 52

Medicaid Medicare Regulations Quality of Care 52

NASHP

SEPTEMBER 28, 2021

State Medicaid Financing of Home Visiting Services in Seven States Eddy Fernandez. Other areas of savings include a reduction of unnecessary emergency department visits and decreased use of public assistance programs such as Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), and Medicaid.

Medicaid 52

Medicaid Nursing Prevention Regulations 52

NASHP

DECEMBER 7, 2022

State Approaches to Community Health Worker Financing through Medicaid State Plan Amendments December 7, 2022 / by Carl Rush, Elinor Higgins , and Sandra Wilkniss. Recent discussions have centered around Medicaid’s role. This brief provides an overview of recent developments in Medicaid State Plan Amendments (SPAs). California.

Medicaid 52

Medicaid Primary Care Prevention Regulations 52