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Days before the 2024 presidential election, the Centers for Medicare & Medicaid Services (CMS) released an unpublished version of the final calendar year 2025 physician fee schedule final rule | Digital therapeutics, telehealth, rural heath clinics and opioid treatment programs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 127

Medicare Medicare Medicaid Medicaid 127

Hall Render

FEBRUARY 17, 2025

According to a statement released on the Center for Medicare and Medicaid Services (CMS) website, effective February 14, 2025, implementation of the Hospice Special Focus Program for calendar year 2025 has ceased so that CMS may further evaluate the program.

Medicare 89

Medicare Medicare Nursing Homes Medicaid 89

HealthIT Answers

APRIL 3, 2025

By Lauren Barca, MHA, RN - The headlines for 2025 Medicare, Medicaid, and dual-eligible programs are rife with concerns about proposed changes. While those worries were certainly a topic of discussion at AHIPs recent Medicare, Medicaid, Duals, and Commercial Markets Forum in Baltimore, Maryland, they werent the only story.

Medicaid 59

Medicaid Medicaid Medicare Medicare 59

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

Medisys Compliance

JANUARY 23, 2025

As we step into 2025, mental health providers must stay informed about evolving telehealth billing regulations to ensure compliance and optimize reimbursement. Will Medicare Stop Paying for Telehealth in 2025? What Is the CPT Code for Telehealth in 2025? CPT codes are essential for billing telehealth services accurately.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicare Medicare Medical Billing 59

HIT Consultant

APRIL 3, 2025

This liquidity cushion is crucial for navigating ongoing headwinds and macro uncertainties, including potential changes to Medicaid. Median Medicaid reimbursement The median Medicaid reimbursement as a percentage of gross patient revenue marginally increased to 16.6% from 170.2%. in 2023 from 15.9% in 2023 from 2.8%

Hospitals 66

Hospitals Medicaid Medicaid ACA 66

Healthcare Dive

SEPTEMBER 9, 2024

The insurer’s Wellpoint subsidiary is expanding its ACA footprint for the 2025 coverage year, likely in a bid to capture enrollees who recently lost Medicaid coverage.

ACA 258

ACA Medicaid Medicaid 258

Healthcare Dive

MARCH 13, 2024

The budget request includes proposals for “Medicaid-like” coverage in non-expansion states and future penalties for hospitals that don’t implement cybersecurity standards.

ACA 253

ACA Medicaid Medicaid Hospitals 253

Fierce Healthcare

NOVEMBER 2, 2024

The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups. | The Centers for Medicare and Medicaid Services (CMS) is moving forward with a 2.9% cut to physician payments in 2025 despite protest from major industry groups.

Medicare 132

Medicare Medicare Doctors Medicaid 132

Fierce Healthcare

OCTOBER 10, 2024

Just 40% of Medicare Advantage prescription drug plans offered in 2025 achieved a score of four stars or higher, the Centers for Medicare & Medicaid Services (CMS) revealed Oct. Here's how they performed for 2025. It's harder than ever for Medicare Advantage plans to score well on star ratings.

Medicare 126

Medicare Medicare Medicaid Medicaid 126

Healthcare IT Today

JANUARY 19, 2025

Two-thirds of healthcare organizations are considering bringing workloads from the public cloud back to private or on-premise clouds, according to the 2025 State of the Cloud report form Rackspace. Products At CES 2025, Asahi Kasei Microdevices unveiled sensors to power fall detection and wristband-based thermometers.

Medicaid 89

Medicaid Medicaid Telemedicine Hospitals 89

HIT Consultant

NOVEMBER 22, 2024

Key recommendations include: Extend Enhanced Tax Credits: Make permanent the enhanced marketplace premium tax credits, which are set to expire in 2025, to prevent premium increases and coverage losses. Expand Medicaid: Establish a federal fallback option to cover the millions of uninsured individuals in states that have not expanded Medicaid.

ACA 98

ACA Health Insurance Medicaid Medicaid 98

Mobi Health News

JULY 12, 2024

The proposed 2025 physician fee schedule from the Centers for Medicare & Medicaid Services includes payment and coding for digital health tools for behavioral health.

Medicaid 118

Medicaid Medicaid Medicare Medicare 118

Jane Sarashon

DECEMBER 30, 2024

The 2025 convening of CES (once known as the Consumer Electronics Show) in Las Vegas officially kicks off on 7 January 2025. More granularly, Ill be looking into Sleep-tech: The square footage of CES convention floor space devoted to sleep has been significant and visible, with 2025 growing new products and sleep-tech flavors.

FDA 52

FDA Medicare Medicare Medical Billing 52

HIT Consultant

DECEMBER 11, 2024

Food as Medicine: This trend has emerged from its niche, driven by increased funding and partnerships, particularly within Medicare Advantage and Medicaid programs. Looking Ahead to 2025 The digital health landscape is constantly evolving.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare Dive

FEBRUARY 6, 2025

Medicaid and dual-eligible contracts fuel growth for the California-based insurer, but also come with upfront implementation costs that will lower its earnings this year, executives said.

Medicaid 152

Medicaid Medicaid 152

Healthcare IT News - Telehealth

APRIL 22, 2024

Currently, it also is covered in some form by about 32 state Medicaid programs. If AMA makes these changes to RPM codes, coverage changes would most likely go into effect in 2025 or later. These have been the four most common general RPM codes for a few years now. Medicare was the first to cover RPM.

Medicare 194

Medicare Medicare Medicaid Medicaid 194

Bill of Health

APRIL 4, 2025

Published April 4, 2025 Author James Lytle Share Share on LinkedIn Share on X Share on Facebook Share on Reddit Concerns over ultra-processed foods (UPFs) and their responsibility for rising rates of chronic disease and obesity have been highlighted in the medical literature and in the popular press. territories, and the District of Columbia.

Public Health 147

Public Health FDA World Health Medicaid 147

Verisys

FEBRUARY 10, 2025

What You Need to Know: The National Committee for Quality Assurance (NCQA) has announced significant updates to its credentialing and monitoring requirements, effective July 1, 2025. Key NCQA 2025 Compliance Changes 1. The post Navigating NCQAs 2025 Credentialing & Monitoring Requirements appeared first on Verisys.

Licensing 40

Licensing Compliance Medicaid Medicaid 40

HIPAA Journal

MARCH 28, 2025

Two breach notices have been added to the Beacon Health System website, the first on March 24, 2025, involving a business associate called CPS Solutions, a provider of services to support pharmacy operations. Notification letters were mailed to the affected individuals on February 10, 2025.

Licensing 63

Licensing Health Insurance HIPAA Medicaid 63

Healthcare IT Today

JANUARY 22, 2025

Here’s a quick look at some of the health IT jobs we found: Systems Analyst 1- EMR and Clinical Workflows – Oracle Manager Data Health Informatics – MLK Community Healthcare Director, Software Engineering – Midi Health Business Office Representative Clerk – Owensboro Surgery Center – SCA Health Behavioral Health (..)

Due Diligence 69

Due Diligence Medicaid Medicaid Medicare 69

Hall Render

MARCH 10, 2025

On March 7, 2025, the Centers for Medicare & Medicaid Services (CMS) posted a memo dated March 10, 2025, that gives nursing homes and surveyors more time to prepare for implementation of new rules and updates to allow surveyors to add extra attention and increase oversight in nursing homes. New Surveyor Guidance Memo).

Nursing Homes 52

Nursing Homes Nurses Medicaid Medicaid 52

Bill of Health

OCTOBER 17, 2024

This aligns with recent guidance from the Centers for Medicare and Medicaid Services that Medicare Advantage plans may not make a determination of medical necessity solely based on algorithms using broad data sets. 2025) research interests are focused on the intersection of health and the law. Rebekah Ninan’s (J.D.

Medicare 150

Medicare Medicare Health Insurance Licensing 150

Bill of Health

MARCH 14, 2025

Published March 14, 2025 Author Rebekah Ninan Share Share on LinkedIn Share on X Share on Bluesky Share on Facebook Between Feb. Approximately 14 states Medicaid programs cover any form of a GLP-1 drug to treat obesity. 2025) is a student fellow with the Petrie-Flom Center. The reason for the sudden drop in its stock price?

FDA 130

FDA Governance Medicaid Medicaid 130

Fierce Healthcare

SEPTEMBER 27, 2024

Medicare's open enrollment window opens in a few weeks, and the Centers for Medicare & Medicaid Services is offering a broad look at the landscape around Medicare Advantage and Part D before si | Medicare's open enrollment window opens in a few weeks, and the Centers for Medicare & Medicaid Services is offering a broad look at the (..)

Medicare 121

Medicare Medicare Medicaid Medicaid 121

Healthcare IT Today

JANUARY 23, 2025

The HEI Reward Factor will assess how well plans serve beneficiaries with social risk factors such as low income, disability, or dual eligibility for Medicaid. Data from measurement years 2024 and 2025 will impact Star ratings in 2027.

Medicare 97

Medicare Medicare Medicaid Medicaid 97

Hall Render

MARCH 27, 2025

The Centers for Medicare & Medicaid Services (CMS) has given surveyors additional rules and updates to allow surveyors to assess and cite violations of the regulations on nursing homes with admission agreements that create prohibited third-party guarantee of resident payments. a)(3) Third Party Guarantee of Payment Under 42 CFR 483.15(a)(3),

Nursing Homes 52

Nursing Homes Nurses Medicaid Medicaid 52

Fierce Healthcare

OCTOBER 21, 2024

Humana, one the country’s largest Medicare Advantage organizations, is suing the Centers for Medicare & Medicaid Services over its 2025 star | Humana, one the country’s largest Medicare Advantage organizations, is suing the Centers for Medicare & Medicaid Services over its 2025 star ratings results.

Medicaid 116

Medicaid Medicaid Medicare Medicare 116

Fierce Healthcare

NOVEMBER 25, 2024

UnitedHealthcare successfully won its lawsuit over the Centers for Medicare and Medicaid Services, a federal judge determined Nov. UnitedHealthcare will get to claim victory over CMS for its star ratings lawsuit win.

Medicaid 119

Medicaid Medicaid Medicare Medicare 119

Fierce Healthcare

DECEMBER 17, 2024

The Centers for Medicare & Medicaid Services (CMS) is discontinuing the Medicare Advantage (MA) Value-Based Insurance Design model at the end of 2025. | The Value-Based Insurance Design model for Medicare Advantage plans will be terminated at the end of next year.

Medicare 126

Medicare Medicare Medicaid Medicaid 126

Fierce Healthcare

APRIL 1, 2024

Insurers will feel resentful Monday as the feds opted to not reverse its decision to decrease Medicare Advantage benchmark payments by 0.16%, the Centers for Medicare and Medicaid announced. | Benchmark payments will still decrease 0.16% but the feds expect it will still pay up to $600 billion in payments to plans in 2025.

Medicare 143

Medicare Medicare Medicaid Medicaid 143

Fierce Healthcare

JULY 11, 2024

The Centers for Medicare & Medicaid Services' (CMS') proposed calendar year 2025 physician fee schedule rule, out Wednesday, proposed an assortment of new payments and coverage for digital heal | CMS' proposed changes to digital health payment for physicians includes new codes for mental health-related digital therapeutics, an assortment (..)

Medicaid 129

Medicaid Medicaid Medicare Medicare 129

Fierce Healthcare

JULY 10, 2024

A proposed rule outlining the Centers for Medicare & Medicaid Services’ (CMS’) intended Medicare payment rates and policy updates for outpatient and ambulatory surgical centers (ASCs) in the co | The administration's CY 2025 OPPS and ASC Payment Systems proposed rule looks to improve obstetrical services, quality reporting and care access. (..)

Payment Systems 124

Payment Systems Medicare Medicare Medicaid 124

HealthIT Answers

JANUARY 16, 2025

The Centers for Medicare & Medicaid Services has posted new 2025 Merit-based Incentive Payment System (MIPS) resources to the QPP Resource Library. The post Now Available: 2025 MIPS Resources appeared first on Health IT Answers.

Payment Systems 59

Payment Systems Medicaid Medicaid Medicare 59

Healthcare IT Today

DECEMBER 22, 2024

DUOS updated its digital health platform for seniors to enable end-to-end applications for federal and state assistance programs such as SNAP and Medicaid. O’Kane will retire at the end of 2025 ; she has led the organization for 35 years. We’ll publish again on January 5, 2025.

Medicare 88

Medicare Medicare FDA Telemedicine 88

Healthcare IT Today

MARCH 27, 2025

The capital will be used to expand Millies technology platform, offerings, and market footprint, with new clinics slated to open in 2025, starting with an upcoming launch in California in collaboration with Good Samaritan Hospital, part of HCA Healthcare. Millie accepts all major insurance plans, both Commercial and Medicaid.

Patient Satisfaction 64

Patient Satisfaction Hospitals Medicaid Medicaid 64

Fierce Healthcare

FEBRUARY 7, 2025

Molina Healthcare CEO Joe Zubretsky predicted future Medicaid reform in Congress will be minimal. The insurer missed its quarterly earnings target and previewed its 2025 guidance.

Medicaid 99

Medicaid Medicaid 99