Fierce Healthcare

NOVEMBER 4, 2024

Days before the 2024 presidential election, the Centers for Medicare & Medicaid Services (CMS) released an unpublished version of the final calendar year 2025 physician fee schedule final rule | Digital therapeutics, telehealth, rural heath clinics and opioid treatment programs all got updates in the final 2025 Medicare physician fee schedule rule, (..)

Medicare 126

Medicare Medicare Medicaid Medicaid 126

Healthcare Dive

MARCH 31, 2025

However, potential Medicaid cuts could strain provider finances. The median operating margin for providers that ended their fiscal years early was 1.2% last year, compared with -0.5%

Medicaid 199

Medicaid Medicaid Hospitals 199

Healthcare Dive

JULY 28, 2023

The payer lost 262,700 Medicaid members in the second quarter, dropping its total Medicaid lives to just over 16 million.

Medicaid 130

Medicaid Medicaid 130

HealthIT Answers

MARCH 11, 2025

This is notification that eligible hospitals and critical access hospitals participating in the Centers for Medicare & Medicaid Services Promoting Interoperability Program that there is an upcoming data submission deadline on March 14, 2025, at 11:59 p.m. Pacific Time.

Medicaid 59

Medicaid Medicaid Medicare Medicare 59

HIT Consultant

NOVEMBER 22, 2024

Expand Medicaid: Establish a federal fallback option to cover the millions of uninsured individuals in states that have not expanded Medicaid. Promote Continuous Coverage: Allow states to maintain continuous Medicaid eligibility for adults for 12 months to prevent gaps in coverage.

ACA 98

ACA Health Insurance Medicaid Medicaid 98

Compliancy Group

DECEMBER 18, 2024

In just the first three quarters of 2024, 155 providers have been added to the Texas Health and Human Services Commission Medicaid exclusion list. Over 4 million people in Texas are covered by Medicaid, and the Texas OIG exclusion list provides protection for each of them, as well as for healthcare facilities.

Medicaid 52

Medicaid Medicaid Compliance HIPAA 52

Fierce Healthcare

NOVEMBER 14, 2023

Medicaid enrollment is projected to slide further next year, according to an annual budget survey of Medicaid officials conducted by KFF and Health Management Associates in collaboration with the N | State Medicaid directors once again see redeterminations as one of the biggest challenges they face heading into next year.

Medicaid 125

Medicaid Medicaid 125

HIT Consultant

APRIL 3, 2025

What You Should Know: – Fitch Ratings has released a report revealing an improvement in the median financial performance of Fitch-rated not-for-profit (NFP) hospitals and healthcare systems with early fiscal year ends (FYE) in 2024, compared to the previous year. for hospitals with early 2024 FYE. reported in CY2023.

Hospitals 66

Hospitals Medicaid Medicaid ACA 66

Healthcare IT Today

NOVEMBER 16, 2024

More Insights From the Experts at HLTH 2024. Read more… Healthcare IT Today Podcast : RSNA 2024 Conference Preview. Read more… Tackling Out-of-State Medicaid Claims and Credentialing Challenges. We hope this gives you a chance to catch up on anything you may have missed during the week.

Medicaid 58

Medicaid Medicaid Hospitals 58

HIT Consultant

OCTOBER 22, 2024

Compounding these challenges is the recent introduction of the Healthcare Cybersecurity Act of 2024, which mandates collaboration between CISA and HHS to enhance the cybersecurity of the Healthcare and Public Health Sector. Two potential strategies for implementing these requirements include: 1.

HIPAA 139

HIPAA Compliance Public Health Medicaid 139

Healthcare Dive

APRIL 25, 2024

Despite business growth in the first quarter, Molina reiterated its prior 2024 guidance out of caution that it won’t be able to reprocure the contested contracts.

Medicaid 164

Medicaid Medicaid 164

Compliancy Group

JANUARY 31, 2025

The most shocking part is that the Change Healthcare breach wasnt the only massive breach in 2024. With 2024 behind us, its time to take a look at the years most significant breaches. On June 20, 2024, OCR updated its guidance after courts found a portion of its previous guidance unlawful. Not so shocking? The damage?

Ransomware 52

Ransomware HIPAA Medicare Medicare 52

Fierce Healthcare

JANUARY 10, 2024

Elevance Health is launching a new initiative that aims to put smartphones in the hands of Medicaid members who otherwise cannot connect to virtual services. In the wake of the COVID-19 pandemic, virtual care and digital health tools are more popular than ever.

Medicaid 136

Medicaid Medicaid COVID-19 136

Healthcare Dive

FEBRUARY 28, 2025

Still, executives addressed concerns about potential changes to federal healthcare policy that could impact the provider’s bottom line, including cuts to Medicaid.

Medicaid 173

Medicaid Medicaid 173

Fierce Healthcare

JULY 26, 2024

Centene beat the Street even as Medicaid redeterminations pose a significant headwind heading into the back half of 2024, according to its

Medicaid 120

Medicaid Medicaid 120

Healthcare Dive

NOVEMBER 14, 2023

in the 2024 fiscal year — the largest year-over-year drop since 1998, according to KFF. Enrollment in the safety-net insurance program could plummet 8.6%

Medicaid 164

Medicaid Medicaid 164

Fierce Healthcare

MAY 10, 2024

Below is a roundup of payer-centric news headlines you may have missed during the month of May 2024. This month, Iowa signed into a law a postpartum Medicaid expansion, L.A. Care Health commited $3 million to providers, Aetna settled a lawsuit alleging fertility discrimination, a former NBA champion was sentenced to prison and more.

Medicaid 109

Medicaid Medicaid 109

AIHC

NOVEMBER 12, 2024

Written by Gabriella Neff, RHIA, CHA, CHC, CHRC, CHPC This past year, in 2024, revisions were made to clarify hospital guidelines related to informed consent specifically addressing UIEs (unconsented intimate exams) to patients while under anesthesia. April 1, 2024. April 1, 2024. April 1, 2024. April 3, 2024.

Informed Consent 98

Informed Consent HIPAA Compliance Hospitals 98

Fierce Healthcare

JANUARY 18, 2024

2024 | This week, Humana announced workforce reductions, a study associated Medicaid expansion with reduced lung cancer mortality and Bright Health moved its corporate headquarters. Below is a round-up of payer-centric news for the week of Jan.

Medicaid 113

Medicaid Medicaid 113

MRO Compliance

FEBRUARY 3, 2025

HEDIS audits are important for Medicare and Medicaid health plans because data is used to determine the efficacy of a payer to care for its members. Explore the HEDIS MY 2024 Measure Descriptions Guide. Utilization and Risk Adjusted Utilization. Health Plan Descriptive Information.

Patient Satisfaction 147

Patient Satisfaction Compliance Medicare Medicare 147

Healthcare Dive

FEBRUARY 13, 2025

Health system leaders said Tenet is mostly insulated from proposed policy changes like Medicaid cuts due to its focus on ambulatory surgical centers.

Medicaid 143

Medicaid Medicaid 143

Healthcare IT Today

NOVEMBER 19, 2024

Additionally, Maven will use this capital to bolster its value-based offerings across both fully insured and Medicaid populations. With this funding, Maven will leverage AI to further personalize care to support the diverse needs of its highest-risk members across its commercial, fully-insured and Medicaid lines of business.

Medicaid 109

Medicaid Medicaid COVID-19 Public Health 109

Fierce Healthcare

SEPTEMBER 26, 2023

Expect premiums, benefits and plan choices for Medicare Advantage (MA) and the Medicare Part D prescription drug program to look similar in 2024, the Centers for Medicare & Medicaid Services (C | CMS announced that nearly three-quarters of MA plan beneficiaries will not see their premiums rise.

Medicare 117

Medicare Medicare Medicaid Medicaid 117

Center for Health Insurance Reform

OCTOBER 19, 2023

A number of new and ongoing policy changes will impact the Marketplace in 2024, including special enrollment opportunities tied to the Medicaid “unwinding,” continuing enhanced financial assistance, and administrative flexibilities designed to reduce barriers to enrollment.

ACA 104

ACA Medicaid Medicaid Health Insurance 104

Healthcare IT Today

NOVEMBER 12, 2024

Best Positioned to Deliver Transformative Technology that Accelerates the Industry’s Evolution and its Ability to Improve Health Outcomes HHAeXchange , a leader in homecare management solutions for providers, caregivers, managed care organizations (MCOs), and state Medicaid programs, today announced that it has acquired Sandata Technologies.

Medicaid 116

Medicaid Medicaid Health Outcomes Compliance 116

HIT Consultant

JULY 16, 2024

Anish Sebastian, CEO and Co-founder, Babyscripts A discussion of technology and the Medicaid population inevitably raises the topic of the digital divide — that is, the gap between people who have access to modern information and communications technology (ICTs) and those who don’t. “We But there’s a lot of reasons to be optimistic.

Medicaid 105

Medicaid Medicaid Health Insurance Health Outcomes 105

HealthIT Answers

AUGUST 29, 2023

By Chris Emper - On July 13, the Centers for Medicare & Medicaid Services released a 1,920-page proposed rule that would update payment policies and programs regarding Medicare payments to physicians and other providers under the Physician Fee Schedule on or after January 1, 2024.

Medicare 111

Medicare Medicare Medicaid Medicaid 111

Center for Health Insurance Reform

JUNE 3, 2022

Beginning in 2023, CMS will require QHP provider networks for plans sold on the federal marketplace to meet minimum time-and-distance standards and, beginning in 2024, minimum standards for appointment wait times.

Medicaid 98

Medicaid Medicaid Health Insurance 98

HIPAA Journal

MARCH 28, 2025

The email account was secured the same day, and the forensic investigation confirmed the account was compromised from December 2 to December 4, 2024. This breach also involved a compromised email account and was detected by Restorix on May 30, 2024. Restorix sent notification letters to the affected patients on December 18, 2024.

Licensing 63

Licensing Health Insurance HIPAA Medicaid 63

Healthcare It News

OCTOBER 31, 2022

With the Centers for Medicare & Medicaid Services mandating hospitals be ready to report on SDOH screening quality in 2024, a multi-stakeholder effort to advance an FHIR-based approach is needed to help providers meet CMS requirements, according to HL7 CEO Dr.

Licensing 342

Licensing Medicaid Medicaid Health Outcomes 342

Healthcare IT Today

JANUARY 19, 2025

Personal emergency response system LogicMark expanded access to devices through Medicaid waivers in six states. Medicaid medical group Pair Team transitioned from a C Corporation to a Public Benefit Corporation. Veradigm added SDoH and mortality data to its ambulatory EHR database.

Medicaid 89

Medicaid Medicaid Telemedicine Hospitals 89

Healthcare IT Today

JANUARY 5, 2024

As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. With legislation currently being drafted for nurses to receive the same reimbursement doctors and physicians do, this will likely become a top-of-mind topic in 2024.

Nurses 105

Nurses Medicare Medicare Medicaid 105

Healthcare IT Today

JANUARY 4, 2024

As we kick off 2024, we wanted to start the new year with a series of 2024 Health IT predictions. We believe that trend will accelerate further in 2024 as obesity medication options and supply grow. In 2024, nurse leaders will drive the paradigm shift toward AI-enabled virtual nursing.

Nurses 96

Nurses Medicaid Medicaid Medicare 96

Compliance Now

AUGUST 10, 2023

As background, according to federal Health Insurance Portability and Accountability Act (HIPAA) rules, individuals have 60 days from losing CHIP and Medicaid eligibility to elect coverage under their group plan. The real potential of this number growing daily is what has prompted the Agencies to issue this “request.”

Medicaid 100

Medicaid Medicaid COVID-19 Compliance 100

Compliance Now

AUGUST 10, 2023

As background, according to federal Health Insurance Portability and Accountability Act (HIPAA) rules, individuals have 60 days from losing CHIP and Medicaid eligibility to elect coverage under their group plan. The real potential of this number growing daily is what has prompted the Agencies to issue this “request.”

Medicaid 100

Medicaid Medicaid COVID-19 Compliance 100

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.

Nurses 102

Nurses Medicare Medicare Medicaid 102

Fierce Healthcare

JULY 13, 2023

The Centers for Medicare & Medicaid Services has released its proposed Medicare payment rates and policy updates under the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory S | The CY 2024 OPPS and ASC Payment System Proposed Rule includes a 2.8%

Payment Systems 98

Payment Systems Medicare Medicare Medicaid 98