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.

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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.

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Medicaid Regulations Home Care Medicare 97

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.

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Regulations Performance improvement Patient Safety Hospitals 52

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

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Medicaid Nursing Regulations Home Care 83

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.

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Medicaid Regulations Home Care Nursing 105

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.

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Medicaid Regulations Integration Healthcare 270

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.

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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]

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Medicaid Regulations Prevention Accountability 52

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.

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Medicaid Regulations Accountability Medicare 75

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.

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Regulations Medicaid Healthcare 104

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.

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Medicaid Accountability Quality Assurance Home Care 95

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.”.

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Home Care Regulations Medicaid Nursing 91

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.

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Medicaid Prevention Health Data Quality of Care 64

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.

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Medicaid Regulations Federal Healthcare Medicare 52

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.

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Medicaid Medicare Regulations Doctors 59

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.

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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.

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Medicaid Regulations Medicare Integration 59

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?

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Healthcare Finance Regulations Patient Safety Patient Experience 305

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.

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Medicaid Nursing Medical Practitioners Regulations 64

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.

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Medicaid Regulations Accountability Healthcare 52

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.

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Medicaid Regulations Medicare 62

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.

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Medicaid Hospice Care Integration Regulations 102

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.

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Telemedicine Primary Care Regulations Doctors 315

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.

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Medicaid Medicare Regulations Healthcare 97

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.

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Medicaid Nursing Regulations Hospitals 59

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.

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Regulations Medicaid Medicare Healthcare 292

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.

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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.

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Medicare Regulations Medicaid Home Care 123

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.

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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.

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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.

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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.

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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.

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Medicaid Primary Care Prevention Regulations 52

NASHP

AUGUST 30, 2023

The Centers for Medicare and Medicaid Services (CMS) promulgated final regulations for REHs at 87 Fed.Reg. To qualify for Medicare reimbursement, REHs must be licensed by the state in which they operate and meet conditions of participation set out in federal regulations cited above and sub guidance issued by CMS. 1395x(kkk)(2).

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Hospitals Regulations Medicare Medicaid 121

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.

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Medicaid Regulations Medicare Integration 96

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).

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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.

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