Healthcare Law Blog

FEBRUARY 12, 2024

CMS approved $500 million in infrastructure spending for NYS to establish social care networks (“ SCNs ”) to provide HRSN screening and referral services to Medicaid beneficiaries that are targeted populations for HRSN services. Medicaid Hospital Global Budget Initiative CMS authorized up to $2.2

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Innovaare Compliance

DECEMBER 11, 2023

Before the Medicare Advantage Open Enrollment Period (MA OEP) [1] begins on January 1, 2024, Medicare Advantage Organizations (MAOs) still have time to review if they are completely ready for a new contract year. This blog article focuses on some of the “must make” changes to take effect as of January 1, 2024, or before.

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Modern Healthcare

JULY 3, 2023

Nursing homes, rehab providers and psychiatric hospitals urged the Centers for Medicare and Medicaid Services to account for economic conditions in fiscal 2024 rates

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Modern Healthcare

MARCH 31, 2023

The Centers for Medicare and Medicaid Services estimates health insurance companies will see a 3.32% increase in Medicare Advantage revenue next year.

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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.

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Medisys Compliance

AUGUST 21, 2024

In 2024, the Centers for Medicare & Medicaid Services (CMS) introduced several crucial updates to radiation oncology billing guidelines. In 2024, CMS has updated several areas to reflect changes in medical practices and technological advancements in radiation therapy.

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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%

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Healthcare Law Blog

AUGUST 11, 2023

On July 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed rule (the “Proposed Rule”) for the 2024 Medicare Physician Fee Schedule (“PFS”). CMS projects that the Proposed Rule will lead to growth in the Medicare Shared Savings Program (“MSSP”).

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HIT Consultant

SEPTEMBER 27, 2024

Power 2024 U.S. Power 2024 U.S. The data is based on responses from 4,070 healthcare customers who utilized telehealth services in the past year, collected between September 2023 and July 2024. In contrast, Medicare and private insurance beneficiaries, suburban residents, and older generations report lower satisfaction.

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Hall Render

DECEMBER 12, 2023

On November 16, 2023, the Centers for Medicare & Medicaid Services (“CMS”) published proposed changes to the Medicare provider enrollment requirements in the Calendar Year 2024 Physician Fee Schedule final rule (“Final Rule”).

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Innovaare Compliance

DECEMBER 25, 2023

Summary of the HPMS Memo Generated by USHER (Inovaare’s AI-powered Compliance Assistant) The Centers for Medicare and Medicaid Services (CMS) issued a memorandum detailing several announcements relating to its 2024 CMS program audit. Prepare for both routine and focused audits to be conducted in 2024 by CMS.

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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.”

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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.”

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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.

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MedTrainer

AUGUST 8, 2024

As of March 2024, over 67 million in the United States are Medicare beneficiaries. Medicare is the single largest payer for healthcare services in the United States. In FY2021, the Centers for Medicare and Medicaid Services ( CMS ) reported that Medicare processed more than 1.1 Here’s what you need to know.

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MedTrainer

JANUARY 10, 2024

It’s that time of the year to check your records for 2023 compliance deficiencies and set your organization up for success in 2024. Release of Industry-Specific Compliance Program Guidance (ICPG) is anticipated in 2024. It may seem a little early to do some spring cleaning, but not when it comes to compliance!

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Bill of Health

SEPTEMBER 25, 2024

In June 2024, the U.S. The plaintiffs argue that those enrolled in the SSI program at the time of hospitalization qualify, whereas the Department of Health and Human Services (HHS), which oversees the Centers for Medicare and Medicaid Services, argues that only those entitled to receive SSI cash payments qualify.

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Verisys

FEBRUARY 9, 2024

January 2024 Bad Actor Roundup By Verisys Each month we will give a roundup of recent healthcare fraudsters and compliance busters. Here is a round up of bad actors: Physician Fraud Glastonbury Psychologist Admits Defrauding Medicaid of More Than $1.6 The post January 2024 Bad Actors Roundup appeared first on Verisys.

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Medisys Compliance

APRIL 23, 2024

This comprehensive guide explores the key medical billing best practices for 2024, empowering healthcare providers to optimize their revenue cycle and minimize administrative burdens. Utilize resources from the Centers for Medicare & Medicaid Services (CMS) and your local healthcare associations.

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Compliance Now

SEPTEMBER 28, 2023

By Lee Spiegel , Compliance Director, MZQ Consulting By October 13, 2023, plan sponsors that offer prescription drug coverage must provide notices of creditable or non-creditable coverage to Medicare-eligible individuals. Have a deductible that is no more than $250/year.

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Compliance Now

SEPTEMBER 28, 2023

By Lee Spiegel , Compliance Director, MZQ Consulting By October 13, 2023, plan sponsors that offer prescription drug coverage must provide notices of creditable or non-creditable coverage to Medicare-eligible individuals. Have a deductible that is no more than $250/year.

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Health Care Law Brief

APRIL 3, 2023

On Friday, March 31, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ( Rate Announcement ). 1395w-23): Medicare Advantage Organizations (MAOs) are paid a base rate by CMS.

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Center for Health Insurance Reform

MARCH 31, 2023

With the twin goals of building on the enrollment gains and improving the consumer experience, the Centers for Medicare & Medicaid Services (CMS) has proposed an annual set of requirements. Stakeholder Perspectives on CMS’s 2024 Notice of Benefit and Payment Parameters: Health Insurers

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Hall Render

NOVEMBER 29, 2023

On November 2, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule Final Rule (“Final Rule”) for calendar year (“CY”) 2024. These changes become effective on January 1, 2024.

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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.

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The Health Law Firm

JANUARY 8, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule (PFS). percent in 2024. Indest III, J.D.,

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Hall Render

OCTOBER 22, 2024

Effective October 1, 2024, the Centers for Medicare & Medicaid Services (“CMS”) introduced significant updates to the CMS-855A form , specifically requiring a new Skilled Nursing Facility (“SNF”) Attachment for every SNF. Accompanying guidance to the revised form may be found here.

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Hall Render

DECEMBER 20, 2023

As summarized below, the Final Rule finalizes these proposed revisions to take effect on January 16, 2024. Finalized Revisions to Form CMS-855A For SNFs, the aforementioned data would be reported by completing the Form CMS-855A Medicare enrollment application (“CMS-855A” or “Form”).

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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.

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Medisys Compliance

APRIL 11, 2024

A New Era for Mental Health Access The landscape of mental healthcare in the United States underwent a significant change on January 1, 2024. Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) can now directly bill Medicare for services they furnish and diagnose.

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Compliancy Group

FEBRUARY 12, 2024

In one incident, a New Jersey pharmacy admitted to conspiracies to defraud benefits providers, including Medicare and Medicaid, of $65 million for medications never provided to patients. In the other fraud scheme, Medicare patients were billed an estimated $2 billion for urinary catheters they never received. Attorney Philip R.

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Healthicity

MAY 7, 2024

The OIG's April 2024 Work Plan updates feature crucial audits in Medicaid payments, pharmacy benefit management, & peripheral vascular procedures.

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Innovaare Compliance

FEBRUARY 25, 2024

The Centers for Medicare & Medicaid Services (CMS) uses the Hierarchical Condition Category (CMS-HCC) medicare risk adjustment model to determine monthly capitation fees for Medicare Advantage (MA) plans. June 3, 2024, is the deadline for submitting bids for Parts C and D. PDT on June 3, 2024.

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Hall Render

MARCH 8, 2024

On January 30, 2024, the Centers for Medicare and Medicaid Services (“CMS”) issued a Request For Information (“RFI”) seeking input from interested parties regarding Medicare Advantage (“MA”) data. Comments are due on or before May 29, 2024 to be assured consideration.

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Provider Trust

JANUARY 25, 2024

Though HHS has made efforts to address the challenges outlined in this year’s report, there are still many opportunities for improvement in 2024. We’ve broken down the report’s primary themes and how they affect healthcare organizations moving forward in 2024. With Medicaid, the challenges are equally formidable.

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Medisys Compliance

FEBRUARY 9, 2024

Several significant updates affecting wound care billing took effect in January 2024. Here’s a breakdown of three key wound care billing updates for 2024 that you need to know: 3 Key Wound Care Billing Updates for 2024 1. This change aims to improve transparency and ensure appropriate reimbursement for these devices.

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Healthcare IT News - Telehealth

AUGUST 29, 2024

The American Telemedicine Association and ATA Action in a letter to the Centers for Medicare and Medicaid Services seeks to preserve pandemic-era Medicare telehealth flexibilities that it says are responsible for improving access to healthcare across the U.S. Permit access virtual cardiac and pulmonary rehabilitation services.

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