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CMS Revises Fiscal Year (FY) 2023 State Performance Standards System (SPSS) Guidance

Briggs Healthcare

CMS works with the State Survey Agencies to strengthen oversight so that the care provided in nursing homes and other acute and continuing care providers and suppliers is of the highest quality. Resources to Improve Quality of Care: Check out CMS’s new Quality in Focus interactive video series.

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HCPCS vs CPT: Everything You Need to Know

Etactics

H Codes - Rehabilitative services. R0070 - The transportation of personnel and portable X-ray equipment to nursing homes or other residency. These codes provide data about the quality of care given. C Codes - Temporary outpatient hospital prospective payment system. D Codes - Dental procedures. Anesthesia. Laboratory.

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NAHC’s Bill Dombi: Horizontal Integration, Workforce Innovation to Accelerate in 2022

Home Health Care

That will shape the future a lot for home health care because it puts in the minds of all regulators, all payers, Medicare Advantage included, “I should take a deeper look at this.” Reduced hospitalizations means greater chance of rehabilitation, restoration, maintenance of the patient’s condition and avoidance of fatalities.

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Weighing Policy Trade-offs: Building State Capacity to Address Health Care Consolidation

NASHP

Evidence suggests that vertical integration and growing consolidation in health care leads to higher hospital and provider prices and higher total spending — all while having little to no impact on improving quality of care for patients, reducing utilization, or improving efficiency.

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Behavioral Health System Modernization along the Continuum

NASHP

North Carolina’s InCK program , led by Duke University and the University of North Carolina at Chapel Hill, brings together partners from Medicaid, behavioral health, child welfare, juvenile justice, education, Title V, mobile crisis, and more to coordinate care and address the health and social needs of children in five counties.

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National Care Coordination Standards for Children and Youth with Special Health Care Needs (CYSHCN): Proceedings from the National Forum on Care Coordination for CYSHCN

NASHP

High-quality, integrated care requires strong system-level partnerships, information and data sharing, and family-centered practices. In spite of these barriers, and to help address them, states have implemented innovations to improve integrated care coordination for CYSHCN.

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CMS Promotes Competition, Transparency, Health Equity and More in the CY2025 Medicare Advantage and Part D Proposed Rule

Sheppard Health Law

Enhance Guardrails for Agent and Broker Compensation Over the last few years, CMS has issued new regulations and subregulatory guidance intended to address abusive marketing practices by third party marketing organizations (“TPMOs”) that sell MA and Part D plans.