Innovaare Compliance

APRIL 7, 2024

The Centers for Medicare & Medicaid Services (CMS) officially announced capitation rates for Medicare Advantage (MA) plans for CY 2025 – average increase of 3.7% In total, gross spending under Medicare Part D was $240 billion in 2022; Ozempic accounted for 2% of this amount, before rebates [5]. billion [4].

Medicare 59

Medicare Medicare COVID-19 Medicaid 59

Healthcare Law Blog

JANUARY 26, 2024

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Medicaid 52

Health Care Law Brief

FEBRUARY 2, 2024

The Waiver Amendment was approved on January 9, 2024, by the Centers for Medicare & Medicaid Services (“CMS”) under Section 1115(a) of the Social Security Act and will expire on March 31, 2027. billion in Medicaid investments over the next three years. Instead, such costs will be covered by the state. CMS has authorized up to $2.2

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Hall Render

AUGUST 27, 2024

The Centers for Medicare & Medicaid Services (“CMS”) will publish the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) in the Federal Register on August 28 with an effective date of October 1, 2024. In FY 2025, acute care hospitals are estimated to experience a $3.2 for a total increase of 2.9%.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

Hall Render

MARCH 20, 2024

The Final Rule also imposes additional reporting requirements under the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals and for eligible clinicians reporting under the Promoting Interoperability performance category of the Merit-Based Incentive Payment System.

Medicare 40

Medicare Medicare Health Insurance Medicaid 40

Innovaare Compliance

APRIL 7, 2024

The Centers for Medicare & Medicaid Services (CMS) officially announced capitation rates for Medicare Advantage (MA) plans for CY 2025 – average increase of 3.7% In total, gross spending under Medicare Part D was $240 billion in 2022; Ozempic accounted for 2% of this amount, before rebates [5]. billion [4].

Medicare 52

Medicare Medicare COVID-19 Medicaid 52

Healthcare IT Today

DECEMBER 12, 2023

The latest policy update from The Centers for Medicare and Medicaid Services (CMS) adds key provisions to the December 2022 proposed rule requiring adoption of a new NCPDP SCRIPT standard version. The proposed deadline for adopting the new CMS SCRIPT standards is January 1, 2027.

Compliance 89

Compliance Doctors Medicaid Medicaid 89

Healthcare Law Blog

FEBRUARY 12, 2024

CMS indicates in the Demonstration Amendment that, effective in April 2024, HRSN benefits will be put into action through non-risk arrangements in managed care, with the intent to integrate such benefits in full risk managed care programs by March 2027. Medicaid Hospital Global Budget Initiative CMS authorized up to $2.2

Medicaid 52

Medicaid Medicaid Hospitals Nurses 52

Matt Kinley

OCTOBER 22, 2024

Other health facilities will start at $21 per hour in 2024, reaching $25 per hour by 2027 for community clinics and by 2028 for other facilities. Facilities with a large percentage of Medicare and Medicaid patients, rural independent hospitals, and small county facilities will start at $18 per hour in 2024, with a 3.5%

Compliance 40

Compliance Hospitals Medicaid Medicaid 40

Hall Render

JANUARY 12, 2022

This client alert is Part 5 of our series providing insight into Medicare graduate medical education (“GME”) reimbursement changes that occurred in 2021. Part 2, which addressed billing requirements for physicians at teaching hospitals (the “PATH” rules) and the rules regarding cap transfers, is available here.

Medicare 40

Medicare Medicare Hospitals 40

Healthcare IT Today

JANUARY 5, 2023

I’ve been talking with hospitals all over the country this year, and in recent conversations I’ve heard more and more about virtual nursing. Labor shortages and financial pressures are even shuttering some hospitals, leading to gaps in access for entire communities and piling on the pressure for remaining systems.

Nurses 82

Nurses Hospitals Licensing Health Outcomes 82

HIT Consultant

OCTOBER 23, 2023

Significant swings in recent years One key example in healthcare is outsourcing, a market expected to be worth $488 billion by 2027. As of 2021, nearly 78% of office-based physicians and 96% of non-federal, acute care hospitals had adopted certified EHRs. And then these organizations found out they missed the mark in many areas.

Hospitals 64

Hospitals Medicaid Medicaid Medicare 64

HIT Consultant

NOVEMBER 20, 2024

Challenges in Employer-Provided Healthcare Employers face significant barriers in healthcare, including: – Cost: US employers spend over $800 billion annually, often paying hospitals nearly three times Medicare rates. – Cost Efficiency: Prices within the network are at or below Medicare levels. In Europe, 4.1

Doctors 97

Doctors Nurses Medicare Medicare 97

HIT Consultant

SEPTEMBER 18, 2024

That’s when the Biden administration announced its new mandate — the CMS Interoperability and Prior Authorization Final Rule — designed to effectively speed up the process for Medicare Advantage patients, providers and health plans. Speed is only one of many inefficiencies surrounding prior authorization.

Hospitals 59

Hospitals Medicare Medicare Health Insurance 59

NY Health Law

FEBRUARY 13, 2024

On January 9, 2024, the federal Centers for Medicare and Medicaid Services (CMS) finally approved New York State’s 1115 waiver amendment to establish the New York Health Equity Reform (NYHER) Program. The actual Medicaid Hospital Global Budget Model to be used remains to be approved by CMS. Each will be examined in turn.

Medicaid 52

Medicaid Medicaid Nurses Medicare 52

Hall Render

MAY 30, 2023

On April 4, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“Proposed Rule”) that would update Medicare payment policies and rates for skilled nursing facilities (“SNFs”) under the Skilled Nursing Facility Prospective Payment System (“SNF PPS”) for fiscal year 2024. CMS sees this as a 3.7%

Nurses 40

Nurses COVID-19 Vaccine COVID-19 Medicare 40

Hall Render

AUGUST 11, 2023

On August 7, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released a final rule (“Final Rule”) that updated Medicare payment policies and rates for skilled nursing facilities (“SNFs”) under the Skilled Nursing Facility Prospective Payment System (“SNF PPS”) for fiscal year (“FY”) 2024.

Nurses 40

Nurses COVID-19 Vaccine COVID-19 Payment Systems 40

Health Populi

OCTOBER 8, 2019

This challenge covers hospital-acquired conditions and adverse events, clinician-related inefficiency, and lack of adoption of preventive care practices like administering vaccines and addressing obesity and hypertension. Pricing failure as a waste-factor accounted for nearly another third of total waste in U.S. health care. patients).

Prescription Drug Pricing 109

Prescription Drug Pricing Medicare Medicare ACA 109

Healthcare IT Today

DECEMBER 9, 2024

Earlier in 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Interoperability and Patient Access Final Rule (CMS-0057-F)requiring impacted payers to implement and maintain an ePA-specific API to automate the process for providers. In other words, you are going to need that much time.

Compliance 78

Compliance Medicaid Medicaid Public Health 78

Hall Render

SEPTEMBER 20, 2024

Mesa hospital Phoenix bioscience boom poised to improve health care and local economy, proponents say What’s next for Steward hospitals in Arizona? Federal Grant to Study Eye Disease UAMS Study to Address Maternal, Infant Deaths with $2.4M Federal Grant to Study Eye Disease UAMS Study to Address Maternal, Infant Deaths with $2.4M

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Hospitals Nursing Homes 40

Hall Render

AUGUST 9, 2024

NATIONAL 10 multimillion-dollar Stark law cases in 2 years 40 hospital ownership changes made in 1 day 15 Areas That Would Change Under Health Data Rule Proposal 5 states cracking down on noncompetes New DOJ whistleblower program not ‘easy money’: legal expert CMS’ inpatient rule adds ‘insult to injury,’ say hospital groups CMS drops (..)

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

JUNE 28, 2024

NATIONAL 50% of physicians are thinking of leaving the field due to shortage AHA backs bid to repeal nursing home staffing rule AHA wins lawsuit against HHS over third-party web tracking AHA responds to study blaming hospital prices for societal issues AHA slams study tying unemployment to hospital price increases Behind the battle against corporate (..)

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

AUGUST 23, 2024

hospital, university working to fight ambulance staff shortage Purchase of Wadley Regional Medical Center in Hope, Ark., hospital, university working to fight ambulance staff shortage Purchase of Wadley Regional Medical Center in Hope, Ark.,

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

AUGUST 26, 2024

hospital, university working to fight ambulance staff shortage Purchase of Wadley Regional Medical Center in Hope, Ark., hospital, university working to fight ambulance staff shortage Purchase of Wadley Regional Medical Center in Hope, Ark.,

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

AUGUST 16, 2024

Luke’s Behavioral Health ARKANSAS LaDonna Johnston Named CEO of Unity Health Update: Hearing to Approve Sale of Wadley Regional Medical Center Rescheduled How Arkansas Children’s is diversifying its workforce Sale hearing for Steward Health, Debtors’ Hospitals in Louisiana and Arkansas moved to Aug. Therapist pleads guilty to $1.6M

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Hospitals Nurses 40

Hall Render

AUGUST 16, 2024

Luke’s Behavioral Health ARKANSAS LaDonna Johnston Named CEO of Unity Health Update: Hearing to Approve Sale of Wadley Regional Medical Center Rescheduled How Arkansas Children’s is diversifying its workforce Sale hearing for Steward Health, Debtors’ Hospitals in Louisiana and Arkansas moved to Aug. Therapist pleads guilty to $1.6M

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Hospitals Nurses 40

Hall Render

NOVEMBER 17, 2023

Jill Biden will lead new initiative to boost federal government research into women’s health Joint Commission says acute, critical access hospitals must join safety network Lawsuit claims UnitedHealth AI wrongfully denies elderly extended care Most Rural U.S.

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Hall Render

SEPTEMBER 27, 2024

Vincent’s to get $380 million medical records platform Jackson Hospital named Alabama’s first dementia-friendly hospital Biden-Harris admin. to distribute RSV infant immunizations to 21 villages ARIZONA After exhaustive negotiations, St. Million Settlement with L.A.

Nurses 40

Nurses Hospitals Nursing Homes Medicare 40

Hall Render

OCTOBER 27, 2023

Ransomware attacks against hospitals put patients’ lives at risk, researchers say States, FTC continue to target noncompetes: 3 updates The best hospital in each state, per Newsweek What to know about Stark law’s $9.2M

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Nursing Homes COVID-19 40

Hall Render

DECEMBER 6, 2024

health center receives funding to help people leaving prison CARTIs Festival of Trees Breaks Fundraising Record, Raises Nearly $870K Pediatrics Plus Draws $8.7M health center receives funding to help people leaving prison CARTIs Festival of Trees Breaks Fundraising Record, Raises Nearly $870K Pediatrics Plus Draws $8.7M

Nursing Homes 40

Nursing Homes US Department of Health and Human Services Hospitals Nurses 40

Hall Render

JANUARY 12, 2024

NATIONAL 60% of health systems considering ASC joint ventures 9% of hospitals had ‘vulnerable’ cash on hand levels in 2022 $3.7B

Nursing Homes 40

Nursing Homes US Department of Health and Human Services COVID-19 Nurses 40

Hall Render

NOVEMBER 22, 2024

million grant to tackle physician shortage CBRE: Folsom sale shows resilience of medical office building values Cedars-Sinai COO reflects on healthcare tech failures Dignity California hospital CEO retires How safe is your hospital?

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40