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

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

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

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

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

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.

Medicare 80

Medicare Medicare Medicaid Health Insurance 80

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

Health Insurance 97

Health Insurance ACA Medicaid Medicaid 97

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!

Compliance 94

Compliance Fraud HIPAA Compliance Officers 94

Healthcare It News

APRIL 5, 2024

During open enrollment for the 2024 plan year, the AI agent handled 14.5% of calls to affiliated brokers or Nevada Medicaid – about 2,100 additional calls. of the call center's demand, approximately 2,700 calls. Also, it transferred another 9.6%

US Department of Health and Human Services 275

US Department of Health and Human Services Medicaid Medicaid Hospitals 275

Fierce Healthcare

JANUARY 29, 2024

In 2024, 50 accountable care organizations are new to the Medicare Shared Savings Program and 71 ACOs renewed participation, according to new numbers released by Centers for Medicare & Medicaid | CMS released new data Monday showing ACO participation in the Medicare Shared Savings Program, with 19 ACOs set to participate in a new payment option, (..)

Medicare 111

Medicare Medicare Medicaid Medicaid 111

Medisys Compliance

JULY 15, 2024

Introduction As an internal medicine practitioner, staying updated with the latest Medicare billing changes is crucial for maximizing reimbursements and ensuring compliance. In 2024, several significant updates have been introduced that directly impact the billing processes for internal medicine.

Medicare 59

Medicare Medicare Medical Billing Outsourcing COVID-19 59

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 Compliance COVID-19 100

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 Compliance COVID-19 100

Healthcare It News

OCTOBER 25, 2022

With those flexibilities due to sunset 151 days after the federal Public Health Emergency expires, HIMSS is calling on its members to contact their senators and representatives and urge them to extend coverage of telehealth services under Medicare until at least December 31, 2024.

COVID-19 252

COVID-19 Medicaid Medicaid Public Health 252

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.

Patient Satisfaction 105

Patient Satisfaction Medicaid Medicaid Public Health 105

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”).

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

Fierce Healthcare

NOVEMBER 1, 2023

Centers for Medicare & Medicaid Services (CMS) released a rule Wednesday that increases the 2024 home health payments by 0.8%, or $140 million. | CMS' new proposed rule will increase home health payments by 0.8%, or $140M, among other changes.

Medicaid 119

Medicaid Medicaid Medicare Medicare 119

Healthcare IT Today

JANUARY 14, 2024

The American Telehealth Association announced its policy priorities for 2024 ; they include making Medicare telehealth flexibilities permanent before the end of the year and removing the in-person requirement for the remote prescribing of controlled substances. Wellness app Vivoo launched an at-home digital UTI test.

Medicaid 97

Medicaid Medicaid FDA Medicare 97

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.

Medicare 100

Medicare Medicare Medicaid Medicaid 100

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.

Medicare 100

Medicare Medicare Medicaid Medicaid 100

Modern Healthcare

MARCH 31, 2023

The Centers for Medicare and Medicaid Services proposed a 2.8% increase in hospice payments for fiscal 2024, which would amount to $720 million across the sector.

Medicaid 112

Medicaid Medicaid Medicare Medicare 112

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.

Medicare 122

Medicare Medicare Medicaid Medicaid 122

Medisys Compliance

JULY 19, 2024

Introduction The landscape of Medicare and Medicaid billing for behavioral health services has undergone significant changes recently. Expanded Telehealth Services One of the most notable changes in Medicare/Medicaid billing for behavioral health is the expanded coverage for telehealth services. All rights reserved.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Fierce Healthcare

JUNE 12, 2023

Industry hospital groups are pushing the Centers for Medicare & Medicaid Services to consider a higher annual pay bump and to shed some light on why it believes the number of uninsured patients | Public comments submitted to CMS by the hospital lobby were critical of a "woefully inadequate" 2.8%

Hospitals 121

Hospitals Payment Systems Medicaid Medicaid 121

Healthcare IT Today

MARCH 9, 2024

Read more… Bonus Features for March 3, 2024: 75% of healthcare leaders expect widespread implementation of AI in 3 years, yet 78% of orgs lack knowledge on how to train employees to use AI. Dina raised $7 million in Series B funding ; the company supports network management for Medicare Advantage and Managed Medicaid.

Medicaid 96

Medicaid Medicaid Medicare Medicare 96

Bill of Health

MARCH 27, 2024

Spravato is covered by Medicare Part B , which pays 80% of expenses. Luckily, many insurers do— Cigna , Aetna , Blue Cross Blue Shield , United Healthcare , Medicaid , and Medicare all provide coverage. As of early 2024, Enthea’s ancillary coverage only provides benefits for ketamine therapy.

FDA 203

FDA Medicare Medicare Health Insurance 203

Medisys Compliance

DECEMBER 23, 2022

The internet is ringing with the news of the CMS Updates Final rule for the 2023 Medicare Physician Fee Schedule. The finalized 2023 Medicare Physician Fee Schedule was announced by the Centers for Medicare & Medicaid Services (CMS) on November 1 2022. Medicare reimbursement for telehealth services. Conclusion.

Medicare 98

Medicare Medicare Medical Billing Medical Billing Outsourcing 98

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

Medicaid 52

Medicaid Medicaid Hospitals Nurses 52

Healthcare IT Today

APRIL 29, 2024

This news builds on the company’s recent momentum, including new and expanded payer partnerships to support Medicaid and Medicare lives and notable results for its award-winning Crisis Care program for individuals with elevated suicide risk. Originally announced March 26th, 2024

Medicaid 123

Medicaid Medicaid Medicare Medicare 123

Natalia Mazina

FEBRUARY 22, 2024

CMS finally mandated that PBMs implement the DIR fees at the point of sale starting January 1, 2024. DIR fees were implemented with the creation of the Part D program through the passage of the Medicare Modernization Act of 2003. 2 As of 2018, DIR fees have increased to over six percent of the overall Medicare drug sales.

Medicare 137

Medicare Medicare Patient Advocacy Medicaid 137

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

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.

Medicare 100

Medicare Medicare Medicaid Medicaid 100

Center for Health Insurance Reform

AUGUST 11, 2023

The Centers for Medicare & Medicaid Services has published proposed rate changes for 2024 Marketplace plans. CHIR dug into the rate requests from select states with early rate filing deadlines to see what’s behind the premiums consumers could be facing in 2024, both on- and off-Marketplace.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

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.

Medicare 52

Medicare Medicare Compliance Medicaid 52

Innovaare Compliance

JUNE 28, 2024

The upcoming Medicare Prescription Payment Plan (M3P), set to launch in January 2025, marks a significant shift in Medicare’s approach to prescription drug coverage. Understanding the Medicare Prescription Payment Plan M3P introduces a novel approach to managing prescription drug costs for Medicare beneficiaries.

Medicare 94

Medicare Medicare Prescription Drug Pricing Compliance 94

Healthcare IT News - Telehealth

MAY 30, 2023

Some of those expansive measures, like expanded Medicare reimbursement for telehealth, will remain, at least temporarily, and others, like continuous Medicaid enrollment, will be phased out entirely in the next few months. What does the end of the PHE mean for the future of telemedicine?

Telemedicine 199

Telemedicine COVID-19 Governance Medicare 199

Healthcare IT Today

APRIL 11, 2024

In addition, it covers up to 60 million lives, representing 9 out of every 10 Medicare lives and partners with 5 of the Top 6 Medicare Advantage health plans. Originally announced March 12th, 2024 This marks Innovaccer’s second acquisition in 3 months. “We

Medicare 124

Medicare Medicare Medicaid Medicaid 124