HIT Consultant

AUGUST 24, 2022

The suite of tools in the EHR-integrated eGMS platform guides pharmacists and other healthcare providers to achieve best practice care by providing personalized treatment recommendations, identifying and alerting of patients in glycemic disarray, and providing guardrails that enhance patient safety.

Integration 52

Integration Patient Safety Medicaid Hospitals 52

p3care

JULY 2, 2023

Today, advanced IT has become an integral need for everybody. That’s why every sector has integrated modern technology as a fundamental aspect. Therefore, the EHRs must adhere to the regulations to receive voluntary certification. Likewise, the healthcare sector is no exception to this trend. appeared first on P3Care.

Performance improvement 237

Performance improvement Healthcare Providers Quality of Care Integration 237

Briggs Healthcare

JULY 6, 2022

On September 30, 2019, the Centers for Medicare & Medicaid Services (CMS) published the final rule Medicare and Medicaid Programs; Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction Final Rule , which included revisions for the hospital Conditions of Participation (CoP) for 42 CFR §482.42

Prevention 98

Prevention Hospitals Regulations Medicaid 98

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 85

Medicaid Regulations Medicare Integration 85

HIT Consultant

JUNE 12, 2022

With the passage of the No Surprises Act, a large book of new regulations and requirements for healthcare providers and payers was handed down in an effort to protect patients. Providers and payers must adhere to the regulations or risk being fined. States also have their own regulations.

Regulations 98

Regulations Medicare Patient Experience Medicaid 98

Home Health Care

JUNE 1, 2022

The rules and regulations around it are often inconsistent, but there are also ways for providers to fight back against claim denials. But that has never been technically written into the regulations, Harder said. But it was never written into the regulations specifically, Harder said. It makes sense why, too.

Regulations 77

Regulations Medicaid Medicare Integration 77

HIT Consultant

SEPTEMBER 14, 2022

Edifecs’ automated prior authorization solution integrates with electronic health records (EHR) and leverages artificial intelligence (AI), natural language processing (NLP), and industry standards such as FHIR to instantly deliver authorization. AI-Driven Advances in Prior-Authorization Systems.

Integration 52

Integration Regulations Medicaid Medicare 52

Home Health Care

JANUARY 23, 2023

We have a multi-dimensional, highly integrated need for solutions on the workforce side of it.” When we started looking at it, there were a lot of elements that continued to fuel the belief that Congress, the regulators and the health care world itself is focusing more and more on concentrating health care in the home.”

Medicare 77

Medicare Home Care Medicaid Regulations 77

Bill Of Health

OCTOBER 19, 2023

The traditional model for post-graduate education for medical students, called residency, is regulated by the Accreditation Council for Graduate Medical Education ( ACGME ) and largely funded by the Center for Medicare Services (CMS). There is an urgent need for Congress to ensure this funding through the Center for Medicare Services.

Nursing 109

Nursing Medicare Primary Care Medicaid 109

Bill Of Health

MARCH 27, 2024

Spravato is covered by Medicare Part B , which pays 80% of expenses. Luckily, many insurers do— Cigna , Aetna , Blue Cross Blue Shield , United Healthcare , Medicaid , and Medicare all provide coverage. The FDA does not regulate therapy, which is a state-level issue regulated by state medical boards.

Medicare 80

Medicare Pharmaceuticals Regulations Medicaid 80

Healthcare It News

JANUARY 19, 2022

It is Brooklyn's tertiary care hub serving diverse communities with large Medicaid, Medicare and uninsured populations. " Telemedicine technology and services vendor Amwell could support Maimonides' initiatives and offered options to deeply integrate its virtual visit technology into Maimonides' planned patient mobile app.

Telemedicine 235

Telemedicine Tertiary Care Integration Urgent Care 235

Sheppard Health Law

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”). Refining Definition for Fully Integrated and Highly Integrated D-SNPs (§§ 422.2

Medicare 52

Medicare Medicaid Accountability Integration 52

Bill Of Health

DECEMBER 6, 2023

To tackle this issue, federal and state governments should strengthen the regulation of insurance networks and insurers should address underlying causes of inadequate networks. States should also take steps to empower patients to report inadequate networks to employers or to regulators.

Regulations 57

Regulations Medicaid Medicare Prevention 57

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 As individuals continue to live longer beyond retirement and the U.S.

Medicaid 52

Medicaid Medicare Accountability Nursing 52

Home Health Care

DECEMBER 7, 2023

In 2024, I expect to see continued advancement in the integration of health care and home care fueled by technology and data collection. Daniel Gottschalk​​​​, Co‑CEO of Family Tree Private Care Balancing the need for appropriate home care regulations while preventing overregulation is crucial for the industry.

Home Care 114

Home Care Regulations Nursing Prevention 114

Home Health Care

SEPTEMBER 20, 2023

We’ve built a pretty impressive care model, to date, but there’s always opportunities to continue to be able to advance that by integrating new types of therapy, supply chains, care processes and people,” Kerwar said. Centers for Medicare & Medicaid Services’ (CMS) decision on the Acute Hospital Care at Home waiver.

Hospitals 87

Hospitals Medicare Regulations Patient Experience 87

HIT Consultant

MAY 9, 2023

What You Should Know: MultiPlan , a provider of data-enabled cost management, payment, and revenue integrity solutions for 700+ healthcare payors announced the acquisition of Benefits Science LLC (BST) for $160M in cash and stock. BST was founded in 2012 by a group of MIT-trained experts in data science, including Dimitris Bertsimas, Ph.D.,

Healthcare Analytics 52

Healthcare Analytics Integration Medicare Regulations 52

HIT Consultant

MARCH 28, 2022

Regulation changes can drive innovation. Despite being in the early days of the computer revolution, financial regulators responded by mandating open-source standards for financial data. An integrated platform approach is the solution. Healthcare has an opportunity for a similar boon from open-source data standards.

Healthcare 138

Healthcare Regulations Patient Experience Medicaid 138

p3care

MAY 1, 2023

It’s crucial to guarantee that audits are carried out fully, and objectively following relevant rules or regulations. They can be very severe, including fines, imprisonment, loss of professional licenses, and exclusion from government programs such as Medicare and Medicaid. Therefore, we must spot it at an early stage.

Patient Safety 130

Patient Safety Healthcare Regulations Medicaid 130

NASHP

JANUARY 12, 2024

States have responded to this call for action and are integrating principles of equity and inclusivity into their state plans on aging. In 2024, people with Medicare and Medicaid coverage (i.e., dual eligibles) will continue to enroll in integrated managed care special needs plans or D-SNPs (Dual-Eligible Special Needs Plans).

Medicaid 64

Medicaid Nursing Accountability Integration 64

HIT Consultant

JUNE 9, 2022

New government regulations, like the Centers for Medicare & Medicaid Services’ interoperability rules and the Fast Healthcare Interoperability Resources (FHIR) standard enforcement, have finally been passed that support a seamless flow of medical information. Yet, the tides are turning.

Healthcare 97

Healthcare Regulations Prevention Medicaid 97

HIT Consultant

JUNE 24, 2022

The Innovaccer Health Cloud’s FHIR-enabled Data Activation Platform supports whole-person care by connecting disparate IT silos to enable truly integrated solutions, workflows, and actionable insights at the point of care that can deliver better clinical, engagement, and financial outcomes for all. CARIN Alliance Focus on Interoperability.

Medicaid 52

Medicaid Regulations Medicare Integration 52

HIT Consultant

MARCH 9, 2023

Rajesh Sharma, Vice President and General Manager of Systems Integration, Data Analytics and Interoperability Product Offerings, Gainwell Technologies The Centers for Medicare and Medicaid Services (CMS) has laid the critical groundwork to create a connected healthcare system in which patients, providers, and payers can easily exchange information.

Healthcare 81

Healthcare Prevention Medicaid Integration 81

Health Blawg

JANUARY 9, 2018

The apoplectic response of the regulated community and commentariat to the off-message message conveyed via email moved CMS to issue an official statement more in line with the joint communiqué of December 2016. Fear not, gentle reader. Fear not, gentle reader. most hospitals). Fear not, gentle reader. Fear not, gentle reader.

Regulations 113

Regulations Hospitals Medicare Integration 113

Sheppard Health Law

NOVEMBER 9, 2023

It represents a compilation of OIG’s past guidance regarding basic compliance practices across a wide spectrum of industries and includes new guidance based upon lessons learned from negotiating and monitoring corporate integrity agreements and from enforcement actions and investigations.

Integration 52

Integration Regulations Medicare Pharmaceuticals 52

NASHP

AUGUST 19, 2022

Providing access to palliative care can promote positive outcomes, and avoid costly, unnecessary, and often unwanted treatment, for people with serious illness—many of whom may be dually eligible for Medicare and Medicaid. State Approaches. California was the first state to develop a Medicaid palliative care benefit.

Medicaid 59

Medicaid Regulations Medicare Integration 59

Home Health Care

FEBRUARY 23, 2022

Policy and regulations for home care haven’t kept pace with the growing demand for services and the overall increased visibility of the sector. HCAOA also urges policymakers to fully integrate home care into the health care system. Indeed, there are demographic shifts in the U.S.

Home Care 109

Home Care Medicare Regulations Medicaid 109

Lexis Nexis

DECEMBER 14, 2023

Digital health platforms are advancing capabilities to deliver care through live video chat, asynchronous video and chat, remote patient monitoring, and mobile device integrations. Regulation and industry standards will continue to evolve as healthcare finds its way with AI.

Healthcare 52

Healthcare Urgent Care Life Sciences Regulations 52

Lexis Nexis

JULY 10, 2023

Members also change employers, and sometimes move between Commercial, Medicare and Medicaid coverage types, all with your plan. For example, send the wrong member details of someone else’s medical record, and it’s possible you’ve violated HIPAA privacy regulations in multiple ways.

Integration 52

Integration Medicaid Regulations Prevention 52

Sheppard Health Law

MARCH 7, 2023

The Centers for Medicare & Medicaid Services (“CMS”), on behalf of the U.S. HIPAA’s Administrative Simplification Rule Buried deep within HIPAA lies regulations on administrative simplification. This subtitle of HIPAA (45 C.F.R.

Regulations 52

Regulations Healthcare Providers Medicaid Medicare 52

Home Health Care

DECEMBER 19, 2021

I think that the biggest hurdles the home care industry will face in 2022 are the ramifications that come from overregulation and the outdated regulations of private-duty, private-pay home care. The current regulations have just not kept pace with the number of older adults that need care in this country.

Home Care 127

Home Care Regulations Nursing Hospitals 127

Sheppard Health Law

FEBRUARY 1, 2023

Congress’s expansion of access to telehealth takes steps to ensure continuity of care for Medicare beneficiaries and provides regulators with additional time to determine which flexibilities will become permanent, indicating a success for the telehealth industry as well as a reminder that there is more legislation to come.

Health Data 52

Health Data Regulations Medicare Telemedicine 52

Home Health Care

MAY 3, 2023

One major element of the proposed rule for hospice is an increased focus on integrity in the hospice program. Centers for Medicare & Medicaid Services (CMS) has included what was referred to as “deep dive” into hospice utilization trends, as well as related data, that are cause for concern. “We

Medicare 80

Medicare Home Care Integration Medicaid 80

Home Health Care

JUNE 15, 2022

“It’s really fundamental to not just working with other provider settings and other payers but with policymakers, regulators, etc., Centers for Medicare & Medicaid Services (CMS) to make sure more data is made publicly available. in order to move forward.”. Schiller also said there needs to be more transparency from the U.S.

Home Care 82

Home Care Integration Regulations Patient Experience 82

Sheppard Health Law

APRIL 24, 2023

On April 17, 2023 , the Centers for Medicare & Medicaid Services (“CMS”) released the U.S. The Special Enrollment Period regulations for plan display errors have been adjusted so that consumers will not need to show that they were influenced by a material error related to plan benefits, service area, cost-sharing or premium.

Medicaid 52

Medicaid Regulations Integration Medicare 52

HIT Consultant

APRIL 19, 2024

Medicare providers in hospitals and skilled nursing facilities (SNFs) are adjusting to new split/shared services documentation and billing regulations rolled out by the Centers for Medicare and Medicaid Services (CMS) as part of the 2024 Medicare Physician Fee Schedule (MPFS) final rule.

Regulations 62

Regulations Nursing Medicare Medicaid 62

NASHP

OCTOBER 5, 2023

By defining palliative care in regulations and statute, states can establish a baseline set of reimbursable services that provide support for symptoms and stresses. Kelley and Evan Bollens-Lund in 2018, which was developed through an analysis of Medicare data in addition to working with subject matter experts.

Medicaid 75

Medicaid Regulations Hospitals Medicare 75