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. Such documentation could prevent or abbreviate investigational scrutiny and mitigate FCA disputes down the road.

Regulations 52

Regulations Accountability Medicaid Prevention 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

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

APRIL 23, 2024

This article is a part of your HHCN+ Membership On Tuesday, Centers for Medicare & Medicaid Services (CMS) officials vehemently backed the thought process behind the “80-20” wage mandate in home- and community-based services (HCBS). Providers and advocates, on the other hand, continued to argue that the policy could be disastrous.

Home Care 109

Home Care Medicaid Law Firms Quality of Care 109

Etactics

OCTOBER 27, 2023

Let’s go over what medical identity theft is, its consequences, and how to prevent it. Insurance account number or Medicare number. Exclusion from Medicare and Medicaid. How You Can Prevent Medical Theft When it comes to preventing medical identity theft, healthcare providers play an important part in safeguarding PHI.

Prevention 52

Prevention Accountability Healthcare Providers Medicare 52

Etactics

DECEMBER 1, 2023

Preventing denial codes is essential if you want to keep a steady revenue flow. This is an easily preventable billing error, which we are going to go over in this blog. However, Medicare and other insurance cover a variety of different services and supplies, some of which aren’t identified by CPT codes. 71020 - Chest X-ray.

Medicare 52

Medicare Medicaid Medical Services Prevention 52

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

KHN

DECEMBER 21, 2023

” As the recall played out, federal regulators discovered that Medtronic had delayed acting — and warning patients of possible hazards with the pumps — despite amassing tens of thousands of complaints about the rings, government records show. . “No, it hasn’t,” Sharlin said.

Regulations 144

Regulations Patient Safety Doctors Accountability 144

Bill Of Health

OCTOBER 26, 2022

In the post- Dobbs fight to safeguard reproductive healthcare, a new spotlight has been placed on two existing federal laws: the Health Insurance Portability and Accountability Act (HIPAA) and the Emergency Medical Treatment and Active Labor Act (EMTALA). . Becerra prevented the enforcement of CMS’ EMTALA Guidance in Texas.

Medicaid 73

Medicaid Medicare Hospitals Health Data 73

Etactics

AUGUST 4, 2023

Luckily, we have the Health Insurance Portability and Accountability Act (HIPAA). HIPAA is a federal regulation that protects the privacy and security of PHI. No matter what type of media the information is on, such as on a computer or paper, your company must adhere to HIPAA rules and regulations to protect it. Audit controls.

Regulations 52

Regulations Accountability Healthcare Providers Integration 52

NASHP

OCTOBER 22, 2021

Well-coordinated care that anticipates and manages the symptoms and stressors of serious illness can help people with these and other complex conditions reduce pain and suffering , avoid receiving treatment that does not align with their wishes , and prevent overutilization of care. Enhance federal advance care planning requirements.

Medicaid 101

Medicaid Hospice Care Integration Regulations 101

nThrive

SEPTEMBER 29, 2021

The revenue generated from each line-item then flows into the healthcare system’s patient accounting system (PAS) and the patient is billed. There should be an ongoing, documented process established to ensure that you remain compliant with Medicare, services are being accurately charged, and that you are receiving appropriate reimbursement.

Integration 52

Integration Hospitals Regulations Accountability 52

NASHP

APRIL 24, 2023

Additionally, the alarming rise in mental health challenges among children and youth underscores the need to integrate prevention and early intervention approaches across our child-serving systems. But the system remains fragmented and strained under the twin crises of mental illness and escalating overdose deaths.

Medicaid 52

Medicaid Integration Prevention Urgent Care 52

Briggs Healthcare

AUGUST 19, 2022

The Centers for Medicare & Medicaid Services (CMS) plays an important role in protecting the health and safety of all Americans as they journey through the health care system. There’s a lot of information in the CMS Blog. This is especially true during a pandemic, natural disaster, or other emergencies. and Arjun Srinivasan, M.D.,

Medicaid 40

Medicaid Medicare Nursing Rehabilitation 40

NASHP

MARCH 22, 2024

As major purchasers, administrators, and regulators of behavioral health treatment and supports, states play a critical role in system transformation. Invest in prevention and early intervention. This is one section of Modernizing Behavioral Health Systems: A Resource for States. See the full resource guide.

Medicaid 52

Medicaid Urgent Care Primary Care Hospitals 52

NASHP

SEPTEMBER 30, 2022

In many states, hospital markets are already consolidated so it’s not enough to try to prevent consolidation from occurring through pre-transaction review. The model also gives a state’s insurance commissioner or attorney general the ability to add other clauses through regulation that may result in anticompetitive effects.

Hospitals 52

Hospitals Accountability Regulations Quality of Care 52

NASHP

OCTOBER 20, 2022

Yet, states often face barriers to integrated care including a lack of trust across agencies, privacy regulations that may hinder data sharing, and misaligned eligibility, enrollment, and referral systems. High-quality, integrated care requires strong system-level partnerships, information and data sharing, and family-centered practices.

Medicaid 98

Medicaid Integration Quality Improvement Accountability 98

Health Business Group

NOVEMBER 30, 2021

If big primary care providers like Walgreens’ Village MD learn how to manage this opportunity well, Medicare Advantage and commercial risk will follow quickly. RxRevu’s founder is launching a new venture (I’m on the advisory board) to take the concept even further. I don’t think so.

Healthcare 98

Healthcare Primary Care Hospitals Health Data 98

Etactics

JANUARY 12, 2023

HIPAA stands for the Health Insurance Portability and Accountability Act. These regulations apply to anyone and everyone working with PHI. times, accounting for 76% of all attacks. On August 24, staff first discovered a few compromised employee email accounts. What are some HIPAA violations examples? Scary right?

Accountability 52

Accountability Hospitals Regulations Healthcare 52

Icanotes

NOVEMBER 21, 2021

The treatment plan's purpose is to properly account for a patient's mental, psychological and emotional needs concerning substance abuse. Achievable: Attainable goals that prevent a patient from feeling overwhelmed or burdened. A patient's goals should also take their extent of substance dependence and support networks into account.

Accountability 52

Accountability Prevention Regulations Patient Experience 52

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. The licensure and certification of midwives is administered by the Illinois Department of Financial and Professional Regulation.

Medicaid 58

Medicaid Nursing Regulations Hospitals 58

Vie Healthcare

AUGUST 23, 2023

There are then… Of course, we talked about before with the medical device tiers, the regulations. You got to take that into account.’’ So managers, they need to work around all these kinds of things and take it into account.’’ You got to take that into account. Build a business case for that.

Nursing 98

Nursing Hospitals Healthcare Accountability 98

NASHP

APRIL 15, 2022

In January 2021, the Centers for Medicare and Medicaid Services (CMS) released a roadmap for states to address social determinants of health that includes several options for supportive housing services. ECM will be delivered through the managed care 1915(b) waiver and contracting with MCPs and is accounted for in capitation rates.

Medicaid 58

Medicaid Public Hospital Hospitals Nursing 58

Home Health Care

OCTOBER 31, 2022

Centers for Medicare & Medicaid Services (CMS) released its FY 2023 home health final payment rule late Monday. aggregate decrease in 2023, which would have marked one of the steepest home health Medicare cuts in years. For providers with a Medicare certification date prior to Jan. The agency had initially floated a 4.2%

Medicare 132

Medicare Medicaid Home Care Accountability 132

NASHP

MARCH 22, 2024

North Carolina’s comprehensive behavioral health approach included efforts to increase uptake of CoCM through additional training and practice supports and Medicaid rate increases to 120% of Medicare rates for behavioral health providers. An action plan dashboard tracks targets. CMS’s Birth to 5: Watch Me Thrive!

Medicaid 52

Medicaid Integration Primary Care Nursing 52

Etactics

AUGUST 19, 2021

This chews up lots of time for physicians and prevents them from seeing more patients. Over 50% of doctors work 50-80 hours per week (Pacific Companies) Most physicians work 51-60 hours per week, but this only accounts for 26% of physicians. Another quarter work 60-80 hours, so a majority work between 50-80 hours. hours per week.

Doctors 52

Doctors Nursing Primary Care Healthcare 52

Home Health Care

DECEMBER 19, 2021

Occupational Safety and Health Administration (OSHA) regulation requiring workers at companies with 100 or more employees to be vaccinated against COVID-19 or undergo weekly testing has been revived. The Biden administration projects the mandate will save 6,500 lives and prevent 250,000 hospitalizations over six months.

Regulations 105

Regulations Medicaid Medicare Accountability 105

Health Populi

OCTOBER 8, 2019

Thus, administrative complexity, which includes billing and coding waste, and physician time spent reporting on quality measures, accounted for the largest component of waste in American health care. Pricing failure as a waste-factor accounted for nearly another third of total waste in U.S. medical spending. health care. patients).

Pharmaceuticals 104

Pharmaceuticals Life Sciences Medicare Accountability 104

Sheppard Health Law

JANUARY 6, 2023

In addition to funding, the Act modifies certain telehealth provisions, expands and extends components of the Medicare and Medicaid programs, and supports initiatives within the behavioral health and substance use treatment spaces. Medicare Extension & Adjustments. reduction of the Medicare conversion factor.

Healthcare 52

Healthcare Medicaid Medicare Hospitals 52

Etactics

JUNE 2, 2022

Violations of the Health Insurance Portability and Accountability Act could lead to a multitude of severe punishments. When it comes to enforcing this regulation and investigating compliance with it, the Department of Health and Human Services (HHS) of the Office for Civil Rights (OCR) is responsible. Worst case?

Regulations 52

Regulations Prevention Accountability Medicare 52

Sheppard Health Law

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”). Please refer to our January 5, 2023 , November 4, 2022 and May 16, 2022 blog posts for more information.

Medicare 59

Medicare Medicaid Regulations Integration 59

NASHP

DECEMBER 20, 2022

States are taking steps to provide additional prevention, treatment, and recovery services to higher-risk individuals with opioid use disorder (OUD), including those in contact with the criminal legal system. Community Services and Prevention (Intercept 0). Across states, drug violations have led to most arrests in recent years.

Medicaid 52

Medicaid Prevention Integration Hospitals 52

Home Health Care

OCTOBER 11, 2021

How can we help our customers deliver the most efficient care — hence, Careficient — they can while navigating them through the stringent regulator environments we are forced to operate in today? Earlier I mentioned that our staff is nimble, and part of that is that the salesperson becomes the client’s account manager.

Home Care 98

Home Care Accountability Regulations Medicaid 98

NASHP

DECEMBER 3, 2021

According to the Centers for Medicare and Medicaid Services (CMS), enrollment in Medicaid and CHIP increased by 17.1 Most states are at least matching Medicare rates for COVID-19 vaccine reimbursement. Improvement targets are specific to each CCO to account for regional differences in vaccination rates to date.

Medicaid 98

Medicaid Primary Care Medicare Accountability 98

Vie Healthcare

MAY 4, 2023

And as you know, obviously a huge percentage of healthcare spending is funded through Medicare, Medicaid, Tricare, the VA system, and these are all programs that are covered by the False Claims Act. It’s a highly regulated industry. So there’s that instinctual resistance to it. That you have to deal with compliance.

Healthcare 52

Healthcare Nursing Hospitals Doctors 52

Sheppard Health Law

AUGUST 25, 2022

The expansive legislation includes key health care provisions, including drug pricing reforms, inflationary rebates, Medicare Part D benefit redesign, as well as myriad other updates. Medicare Drug Price Negotiation Program. The Inflation Reduction Act (“IRA”) was signed into law by President Biden on August 16, 2022.

Healthcare 52

Healthcare Medicare Pharmaceuticals Medicaid 52