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

Home Health Care

NOVEMBER 18, 2021

Both Intergen and Amazing Home Care primarily serve New York’s Medicaid population, according to a recent announcement from New York City Mayor Bill de Blasio’s office. “In To any company in New York City that thinks they can get away with withholding workers’ rights and violating our laws: We will hold you accountable.”.

Accountability 105

Accountability Home Care Medicaid Regulations 105

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 100

Medicaid Hospice Care Integration Regulations 100

Healthcare It News

AUGUST 29, 2022

Galileo first launched with in-home care for Medicare and Medicaid patients, creating a framework to include social determinants of health in clinical analysis and to bridge gaps in healthcare education. "I first helped her switch her Galileo account into Spanish. "She had recently moved to the U.S. to live with her family.

Telemedicine 254

Telemedicine Primary Care Medicaid Urgent Care 254

Briggs Healthcare

JANUARY 31, 2023

Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), finalized the policies for the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program, which is CMS’s primary audit and oversight tool of MA program payments.

Medicare 40

Medicare Accountability Regulations Medicaid 40

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 57

Medicaid Nursing Regulations Hospitals 57

HIT Consultant

MAY 2, 2023

For decades, the industry lacked a patient-centric approach focused on efficiency, reliability, and accessibility for all populations, especially those enrolled in Medicare Advantage and Medicaid plans. In a recent study , 21% of U.S. adults without access to a vehicle or public transportation skipped needed medical care last year.

Medicaid 96

Medicaid Regulations Medicare Integration 96

NASHP

AUGUST 30, 2023

The Centers for Medicare and Medicaid Services (CMS) promulgated final regulations for REHs at 87 Fed.Reg. As of June 2023, fourteen states passed legislation and/or adopted emergency regulations to allow hospitals in their state to become eligible for the new REH designation. 1395x(kkk)(2). 58640 (August 28, 2023).

Hospitals 119

Hospitals Regulations Medicare Medicaid 119

Home Health Care

FEBRUARY 8, 2024

The Centers for Medicare & Medicaid Services (CMS) wants 100% of traditional Medicare beneficiaries and the “vast majority of Medicaid beneficiaries” in accountable care relationships by 2030. Oak Street Health, which is now also owned by CVS Health, is one of these risk-bearing delivery organizations.

Medicare 114

Medicare Accountable Care Accountability Primary Care 114

Home Health Care

AUGUST 23, 2023

Centers for Medicare & Medicaid Services (CMS) decides to do with its home health final payment rule , industry experts believe providers need to drastically improve their cost reporting data. Over the years, Maxim said she has seen providers cutting corners firsthand when hiring accountants to put together cost reports.

Law Firms 86

Law Firms Medicaid Hospice Care Regulations 86

NASHP

MARCH 22, 2024

State Medicaid programs, behavioral health authorities, public health, departments of insurance, human and social service agencies, departments of education, departments of corrections, housing, and employment can collaborate to align overlapping efforts, align policies, and braid funding and accountability mechanisms.

Accountability 52

Accountability Medicaid Primary Care Quality Improvement 52

NASHP

JANUARY 12, 2024

During the pandemic and with the support of federal American Rescue Plan Act (ARPA) funds, many states increased Medicaid payment rates for these workers with one-time pay increases or bonuses. In 2024, people with Medicare and Medicaid coverage (i.e.,

Medicaid 62

Medicaid Nursing Accountability Integration 62

Home Health Care

NOVEMBER 7, 2023

Centers for Medicare & Medicaid Services (CMS) has stated its objective to enroll all of its Medicare beneficiaries in accountable care relationships by 2030. Currently, roughly 13.2 million Medicare fee-for-service beneficiaries are assigned to an ACO.

Medicare 94

Medicare Accountable Care Home Care Accountability 94

HIT Consultant

OCTOBER 30, 2023

Under the Medicare Shared Savings Program, a healthcare provider that is an Accountable Care Organization (ACO), ACO participant, or ACO provider or supplier would be deemed ineligible to participate in the program for a period of at least one year.

Medicare 98

Medicare Accountable Care Healthcare Providers Regulations 98

NASHP

APRIL 15, 2022

CalAIM: Leveraging Medicaid Managed Care for Housing and Homelessness Supports April 15, 2022 / by Allie Atkeson. Driven by challenges facing individuals with complex care needs, states are increasingly working to address the physical, behavioral, and social needs of their Medicaid beneficiaries. Download the report (PDF).

Medicaid 57

Medicaid Public Hospital Hospitals Nursing 57

Bill Of Health

OCTOBER 28, 2022

Each month, members of the Program On Regulation, Therapeutics, And Law (PORTAL) review the peer-reviewed medical literature to identify interesting empirical studies, policy analyses, and editorials on health law and policy issues. Holding Pharmaceutical and Medical Device Executives Accountable as Responsible Corporate Officers.

Pharmaceuticals 96

Pharmaceuticals Regulations Accountability Medicaid 96

Sheppard Health Law

NOVEMBER 2, 2023

According to the Congressional Research Service, which analyzed data from the Centers for Medicare & Medicaid Services (“CMS”) National Health Expenditure Accounts (“NHEA”) on the personal health expenditures for LTSS by payer, in 2021, an estimated $467.4 billion was spent on LTSS. This represents 13.2% of LTSS spending. [5]

Medicaid 52

Medicaid Medicare Accountability Nursing 52

Bill Of Health

OCTOBER 27, 2023

To illustrate the issue, consider that the Privacy Rule of the Health Insurance Portability and Accountability Act (HIPAA) expressly covers genetic information as a form of health data. Namely, legal protections concerning personal health data may not apply when the entity offering the service is decidedly not a “provider.”

Biotechnology 62

Biotechnology Regulations Medical Services Health Data 62

NASHP

OCTOBER 28, 2022

The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule affecting eligibility determination and enrollment policies in Medicaid and the Children’s Health Insurance Program (CHIP) and which is related to their earlier request for input on how to improve access to coverage and care in these programs.

Medicaid 73

Medicaid Regulations Medicare Accountability 73

Home Health Care

DECEMBER 23, 2022

In September, CityBlock teamed up with MDwise, the second-largest Medicaid managed care organization in Indiana. We are purposefully partnering with entities that are working with patients who are on Medicaid or dual-eligible beneficiaries,” Matthews said. “We’re I’m very nervous about that.

Primary Care 97

Primary Care Medicaid Regulations Accountability 97

NASHP

AUGUST 30, 2023

The Centers for Medicare and Medicaid Services (CMS) promulgated final regulations for REHs at 87 Fed.Reg. As of June 2023, fourteen states passed legislation and/or adopted emergency regulations to allow hospitals in their state to become eligible for the new REH designation. 1395x(kkk)(2). 58640 (August 28, 2023).

Hospitals 52

Hospitals Regulations Medicare Medicaid 52

Sheppard Health Law

JUNE 2, 2023

Thus, the Court reversed the circuit court, finding that a FCA defendant “could have the scienter required by the FCA if they correctly understood [the regulation] and thought that their claims were inaccurate.

Regulations 52

Regulations Accountability Medicaid Prevention 52

NASHP

DECEMBER 10, 2021

The information on this map comes from a 50-state survey of a variety of stakeholders, ranging from Medicaid officials to Community Health Workers, on their states’ approaches?to?integrating?CHWs ACO Accountable Care Organizations. MHP Medicaid Health Plans. RAE Regional Accountable Entity. Medicaid Reimbursement.

Medicaid 120

Medicaid Primary Care Prevention Nursing 120

Home Health Care

FEBRUARY 1, 2023

The state then told Medicaid providers that it was committed to compensating them for the added costs associated with the wage increase, which could be as much as $5 billion in 2023, per the New York state government. “It I think they’re also vulnerable to abuse and an overuse of the Medicaid benefit.

Home Care 84

Home Care Medicaid Law Firms Nursing 84

Home Health Care

JUNE 17, 2022

Centers for Medicare & Medicaid Services (CMS) released its FY 2023 home health proposed payment rule late Friday. It comes with a decrease to payment rates by 4.2%, or $810 million less compared to 2022 rates. That has been made clear to CMS in the 2021 rulemaking and in multiple discussions since.”

Accountability 111

Accountability Medicaid Home Care Medicare 111

Triage Health Law

FEBRUARY 24, 2023

In January 2021, the Centers of Medicare and Medicaid Services (“CMS”) implemented the Price Transparency Regulations (“PTR”) which required hospitals to publish prices for all their services on their websites in a user-friendly format — improving consumer access to pricing information when shopping for health services.

Hospitals 64

Hospitals Regulations Accountability Medicaid 64

Home Health Care

JANUARY 26, 2022

Centers for Medicare and Medicaid Services (CMS) stopped reimbursing InnovAge for new clients. We are committed to restoring trust with our regulators to being the leading steward of the PACE program. PACE is a Medicare and Medicaid program that helps keep people in their communities instead of nursing homes.

Regulations 92

Regulations Care Transition Medicaid Medicare 92

NASHP

MARCH 22, 2024

As major purchasers, administrators, and regulators of behavioral health treatment and supports, states play a critical role in system transformation. In addition to expanding Medicaid, North Carolina’s FY2024 budget allocates over $835 million for mental health and substance abuse investments under Medicaid.

Medicaid 52

Medicaid Urgent Care Primary Care Hospitals 52

Sheppard Health Law

MAY 31, 2022

However, traditional healthcare players, subject to the Health Insurance Portability and Accountability Act (“HIPAA”), may also find themselves innovating in this space (and grappling with how to stand up a HIPAA compliance program in the metaverse). Medical Device Regulations.

Regulations 90

Regulations Life Sciences Medicare Healthcare 90

Healthcare It News

MARCH 18, 2022

Norden is particularly passionate about funding companies focused on the Medicaid population – a traditionally tricky and often ignored area. In fact, digital health companies only account for less than $10 billion of that $4 trillion in spending. What's happening in this area of digital health?

Medicaid 353

Medicaid Telemedicine Hospitals Clinical Practice 353

Briggs Healthcare

AUGUST 19, 2022

Lebanon had “sufficient” nursing staff to meet residents’ needs and that the facilities were operating and providing services in compliance with all applicable Federal, State, and local laws, regulations, and codes. Counts Ten through Twelve charge Gilbert and Mt.

Nursing 74

Nursing Rehabilitation Medicaid Medicare 74

p3care

MAY 20, 2022

Each performance category accounts for a particular percentage of the overall score, which determines how much payment adjustment a clinician will receive for the following MIPS year’s performance. The rules and regulations relating to each category also change or are updated every year.

Prevention 246

Prevention Doctors Healthcare Providers Regulations 246

HIT Consultant

AUGUST 28, 2023

Eyal Feldman is Founder & CEO of Stampli Is Accounts Payable the weakest link in your medical facility’s growth strategy? Why poor Accounts Payable practices can hinder medical facility growth Making the AP process efficient and scalable is important in any industry.

Accountability 103

Accountability Regulations Medicaid Medicare 103

Sheppard Health Law

MARCH 7, 2023

The Centers for Medicare & Medicaid Services (“CMS”), on behalf of the U.S. Department of Health and Human Services (“HHS”), recently issued a proposed rule to adopt standards under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) for “health care attachment” transactions (the “Proposed Rule”).

Regulations 52

Regulations Healthcare Providers Medicaid Medicare 52

Briggs Healthcare

MARCH 2, 2022

“The purpose of this primer is to provide updated information to the patient safety community about the challenges of ensuring the safe care of older adults in Medicare and Medicaid certified nursing homes (NHs) associated with the COVID-19 pandemic, and the federal and state efforts taken to mitigate these challenges. Conclusion.

Nursing 98

Nursing Patient Safety Quality of Care Regulations 98

Home Health Care

MARCH 30, 2023

Conversely, home health care’s voices advocated with a more somber tone, concerned about worsening patient access and businesses shuttering if the Centers for Medicare & Medicaid Services (CMS) doesn’t renege on payment cuts promised for next year and beyond.

Medicare 109

Medicare Accountability Hospitals Home Care 109

Healthcare Success

JULY 5, 2022

You're selling a product or service regulated by the state (or county). Understanding how these compensation models may influence your target doctors and account for them is essential. You’re selling a product or service with significant state or local competition.

Doctors 154

Doctors Private Practices Accountability Hospitals 154