Healthcare Law Blog

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). Additional Opportunities for Integration through State Medicaid Agency Contracts.

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

Healthcare IT News - Telehealth

MAY 13, 2020

"For example, the Centers for Medicare and Medicaid Services declared it would reimburse for telemedicine visits in both rural and urban communities, and services could be delivered into patients' homes," study authors wrote. Telehealth has also allowed behavioral health providers to connect with patients in underserved areas.

Telemedicine 218

Telemedicine COVID-19 HIPAA Medicare 218

Health Populi

JUNE 27, 2022

The second bar chart illustrates the per member/per month (PMPM) spend for commercially insured workers, showing growth of over 7% from 2018 to 2019, and nearly 7% drop from 2019 to 2020 in the first year of the pandemic. But flat growth is expected for 2022, Castlight forecasts.

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COVID-19 Health Insurance Medicaid Medicaid 125

Health Populi

SEPTEMBER 14, 2021

a situation that was already challenging for millions of American families before the public health crisis emerged. To provide funding for federal research and programs that address food/nutrition security impacted by COVID-19 and to prevent adverse outcomes in future public health emergencies. month or $99 a year.

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COVID-19 Public Health Medicaid Medicaid 62

Healthcare Law Blog

NOVEMBER 1, 2022

CMS announced today a further extension until February 1, 2023, of the deadline for its publication of the long-awaited final rule on the use of extrapolation and the application of a fee-for-service adjuster (FFS Adjuster) in risk adjustment data validation (RADV) audits of Medicare Advantage organizations (MAOs). FOOTNOTES. [1]

Medicare 52

Medicare Medicare COVID-19 Public Health 52

Health Populi

MAY 14, 2019

The mainstreaming of SDoH speaks to the awareness that health is made where we live, work, play, pray, learn and shop… beyond the health”care” system of hospitals, doctors’ offices, and prescription drug dispensaries. adults between 18 and 64 years of age in December 2018.

Health Insurance 103

Health Insurance Public Health Hospitals Medicaid 103

HIT Consultant

SEPTEMBER 12, 2024

The Centers for Medicare & Medicaid Services (CMS) broached the idea for a National Directory of Health Care Providers and Services (NDH) in 2018, putting out a request for information on the topic in 2022 which underscores the importance of this issue. million providers and organizations in the United States.

Hospitals 59

Hospitals Medicaid Medicaid Public Health 59

MedTrainer

NOVEMBER 29, 2023

The Indiana Family and Social Services Administration (FSSA) is a state’s Medicaid agency that provides essential support and services, such as healthcare, mental health, and social services, to improve the welfare and quality of life for families and individuals in Indiana.

Compliance 52

Compliance Licensing Governance Public Health 52

Kaiser Health News

FEBRUARY 8, 2022

The penalties — a 1% reduction in Medicare payments over 12 months — are based on the experiences of Medicare patients discharged from the hospital between July 2018 and the end of 2019, before the pandemic began in earnest. “It’s very hard to capture patient safety with the surveillance methods we currently have,” he said.

Medicare 127

Medicare Medicare Hospitals COVID-19 127

Jane Sarashon

FEBRUARY 4, 2024

Patients and health plan members continue evolving into medical bill payers, with their homes and budgets baked into the concept. Connectivity as a social determinant of health. These trends began to take hold in the U.S. As the pandemic revealed the risk of food security in U.S.

US Department of Health and Human Services 75

US Department of Health and Human Services Health Insurance Medicare Medicare 75

Innovaare Compliance

MARCH 4, 2024

Until the enactment of the Medicare Modernization Act (MMA) in 2006 [1] , the Centers for Medicare & Medicaid Services does not cover most outpatient prescription drugs under Part B (“Part B drugs”). When a public health emergency (PHE) was in effect, CMS noticed that Part B versus Part D evaluation was omitted.

Medicare 52

Medicare Medicare Nurses Medicaid 52

Health Populi

SEPTEMBER 17, 2020

Census Bureau found that the level of health insurance enrollment fell by 1 million people in 2019 , with about 30 million Americans not covered by health insurance. In fact, the number of uninsured Americans rose by 2 million people in 2018 , and by 1.9 Race matters for health insurance in America.

COVID-19 62

COVID-19 Health Insurance Public Health Health Care Access 62

Healthcare IT News - Telehealth

JUNE 3, 2021

With a PhD background in AI and machine learning, he has helped grow its electronic health record into an integrated platform. He earned a HIMSS Davies Award of Excellence in 2018. CIO and CMIO, Monument Health. As both CIO and CMIO at Monument Health, Lahr is working to change the way rural healthcare is delivered.

COVID-19 98

COVID-19 Department of Veterans Affairs COVID-19 Vaccine Nurses 98

AIHC

JANUARY 28, 2022

The Centers for Medicare and Medicaid Services (CMS) distributes a prospectively determined amount of uncompensated care payments to “Medicare disproportionate share hospitals” or better known as “DSH.” This is calculated based on the hospital’s relative share of uncompensated care nationally.

Medicare 52

Medicare Medicare Hospitals Payment Systems 52

HIPAA Journal

JANUARY 31, 2024

As the chart shows, healthcare security breaches are occurring twice as often as in 2017/2018, with two large healthcare data breaches reported each day on average in 2023. NY Healthcare Provider 2,470,000 Ransomware attack (ransomware group unknown) Florida Health Sciences Center, Inc.

Ransomware 129

Ransomware HIPAA Hospitals Compliance 129

Health Populi

JUNE 14, 2018

parents are sobering up to the risks of social mobility in America for their children: in 2018, 51% of U.S. This is unique compared with people living in other OECD countries, only 37% of whom agree with the education statement. In the U.S., social mobility is not evenly distributed across the generations.

Medicaid 76

Medicaid Medicaid Health Insurance Public Health 76

Health Populi

FEBRUARY 14, 2018

of health spending per person. Three factors will drive healthcare costs to 2026: prices for medical goods and services, changes in income growth, and shifting enrollment from private health insurance to Medicare — driven by the aging of Boomers. That equates to 18.4% of the Gross Domestic Product (GDP) and $12,230.40

Health Insurance 79

Health Insurance Medicare Medicare Medicaid 79

Health Populi

MARCH 1, 2018

To more effectively help patients manage diabetes , CentraForce Health used geospatial mapping of SBDoH data to develop deeper insights into peoples’ health needs and behaviors — such as eating fast food in the past 30 days, sufficient time to eat healthy food, and tendency to follow a doctor’s recommendations.

Health Insurance 82

Health Insurance Medicaid Medicaid Public Health 82

Health Populi

MARCH 26, 2018

Key health service factors among the town leaders are lower rates of chronic disease and hospitalizations, and greater access to primary care. The Healthiest Communities for 2018 are: • Falls Church, VA. So what is it about Virginia and Colorado when it comes to the social determinants of health (SDOHs)? Douglas County, CO.

Health Outcomes 63

Health Outcomes Public Health Medicaid Medicaid 63

AIHC

AUGUST 8, 2023

Because aspiration pneumonia is excluded from Centers for Medical & Medicaid Services (CMS) pneumonia mortality scores, the implicit conclusion is that a hospital can improve its public rating by coding its oldest and sickest patients with pneumonia as having aspiration pneumonia.

COVID-19 40

COVID-19 Governance Hospitals Medicaid 40

Redox

DECEMBER 4, 2020

Lisa is an excellent health tech policy follow, by the way). But unfortunately for us, ubiquity is only part of the story, as this particular function (like many public health apparatus) has withered away in recent years. Since there is no consensus transport standard that states and public health agencies use for the reporting.

Public Health 52

Public Health Governance Doctors Medicare 52

Hall Render

JULY 14, 2023

On Friday, June 20, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update (“PPS Rule”), which has since been published in the Federal Register and is currently open for comment. Speech Therapy 0.21

Medicare 52

Medicare Medicare Payment Systems COVID-19 52

Healthcare IT News - Telehealth

DECEMBER 16, 2020

The virtual trial, to be sure, is not a new concept: One team of researchers counted more than 1,100 trials listed on ClinicalTrials.gov employing connected digital products for remote data collection in both 2017 and 2018, the organization observed. " “Some private insurers stepped in to help, too,” they added.

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COVID-19 Hospitals Doctors Health Insurance 214

Health Populi

JANUARY 18, 2019

Increasingly, as patients bear more first-dollar costs through high-deductible health plans, co-payments and co-insurance sharing, the patient-as-payor has become more sensitive to these prices. Chan School of Public Health with POLITICO looked into Americans’ Health and Education Priorities for the New Congress in 2019.

Prescription Drug Pricing 66

Prescription Drug Pricing Health Insurance Doctors Medicare 66

Redox

FEBRUARY 7, 2019

Oddly, even with its place in the general public’s lexicon, telemedicine utilization is still rather low. According to Deloitte’s 2018 Survey of US Physicians , only 23% of patients have had video visits and just 14% of physicians have video visit capability. Original Source.

Telemedicine 40

Telemedicine Public Health Medicaid Medicaid 40

CMS.gov

JULY 18, 2018

CMS Doubling Down on Health IT; Patients. Thu, 07/19/2018 - 00:03. Administrator, Centers for Medicare & Medicaid Services. It’s 2018—most doctors are using electronic health records (EHRs) and most patients have access to the Internet and a smartphone, providing many ways to view healthcare data securely.

Medicare 35

Medicare Medicare Governance Medicaid 35

Hall Render

NOVEMBER 28, 2023

On November 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update Final Rule (“2024 Final Rule”), which has since been filed in the Federal Register. 7,872 2018 5,851 77.1% 7,589 2019 5,871 79.3%

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

AIHC

FEBRUARY 16, 2024

Because aspiration pneumonia is excluded from Centers for Medical & Medicaid Services (CMS) pneumonia mortality scores, the implicit conclusion is that a hospital can improve its public rating by coding its oldest and sickest patients with pneumonia as having aspiration pneumonia.

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

AIHC

FEBRUARY 16, 2024

Because aspiration pneumonia is excluded from Centers for Medical & Medicaid Services (CMS) pneumonia mortality scores, the implicit conclusion is that a hospital can improve its public rating by coding its oldest and sickest patients with pneumonia as having aspiration pneumonia.

Compliance 52

Compliance US Department of Health and Human Services COVID-19 Hospitals 52

Health Populi

JULY 13, 2021

To complement the consumer study, an additional survey was undertaken among 400 health care providers including primary care physicians and specialists, nurse practitioners, physician assistants, RNs and pharmacists. CVS has been tracking the growing trend of health care consumerism in the U.S. Stress levels among U.S.

COVID-19 71

COVID-19 Health Insurance Medicaid Medicaid 71

Healthcare IT News - Telehealth

MAY 6, 2020

The quickly evolving COVID-19 public health emergency has warranted the growing use of telehealth and non-invasive remote monitoring devices to facilitate patient monitoring while reducing patient and healthcare provider contact and possible exposure to the virus.

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COVID-19 FDA Hospitals Elder Care 191

Healthcare Law Blog

JANUARY 26, 2023

The provisions also prohibit entities that receive federal funds from denying admission or discriminating against any applicant for training or study based on their reluctance or willingness to counsel, recommend, perform, or assist in certain health services or research activities because of their religious beliefs or moral convictions.

ACA 105

ACA Medicaid Medicaid Compliance 105

HIPAA Journal

MAY 29, 2023

reduction in total penalties compared to 2018, falling from $28.7 million in 2018 to just $1.6 million in 2018 (median: $500,000) to just $407,000 in 2022 (median: $183,250). Now that the COVID-19 Public Health Emergency has been declared over, that period of enforcement discretion is due to terminate.

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HIPAA Compliance Due Diligence COVID-19 106

New Jersey Healthcare Blog

JANUARY 12, 2022

Below are the most recent health care related regulatory developments as published in the New Jersey Register from October-December 2021: On October 4, 2021, at 53 N.J.R. 103, which declared a Public Health Emergency for the state in response to COVID-19. 10:37 (Community Mental Health Services Act) with technical amendments.

Licensing 40

Licensing Medicaid Medicaid Nurses 40

Hall Render

FEBRUARY 23, 2024

CT’s Medicaid reimbursement rates lower than peer states: report Better safety training, reporting, escorts for CT home health care workers focus of new legislation D.C. Acquisition of BCBSLA Paused a Second Time It was the biggest health care deal in Louisiana history. What they say sets them apart.

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Nursing Homes Nurses Hospitals Medicaid 40

New Jersey Healthcare Blog

JULY 22, 2022

509(a), Governor Murphy issued an Executive Order updating and clarifying timeframes for requiring covered workers at health care facilities and high-risk congregate settings to be up-to-date with their COVID-19 vaccinations, including having received a booster shot. On April 4, 2022, at 54 N.J.R. See Executive Order No. 290 (2022).

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COVID-19 Vaccine Licensing COVID-19 Public Health 40

Health Populi

FEBRUARY 21, 2019

National health spending in the U.S. every year from 2020 to 2027, the actuaries at the Centers for Medicare and Medicaid Services forecast in their report, National Health Expenditure Projections, 2018-2927: Economic And Demographic Trends Drive Spending And Enrollment Growth , published yesterday by Health Affairs.

Medicare 91

Medicare Medicare Medicaid Medicaid 91