HIT Consultant

NOVEMBER 10, 2021

Centers for Medicare and Medicaid Service (CMS) approved dozens of new telehealth services last year, and payers are beginning to offer virtual-first health plans, where patients first see a virtual provider before making an in-person appointment. . – Finally, estimates say U.S. The insurance side is jumping on board, too.

COVID-19 105

COVID-19 Telemedicine Medicaid Medicaid 105

Healthcare IT Today

SEPTEMBER 26, 2024

The rollout of the Centers for Medicare & Medicaid Services (CMS) Health Equity Index (HEI) further underscores this shift by integrating several Star measures and Social Determinants of Health (SDOH) into its evaluation criteria. Investing in AI and analytics gives health plans insights beyond traditional claims and medical data.

Health Outcomes 78

Health Outcomes Medicare Medicare Medicaid 78

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

Hall Render

MARCH 20, 2024

The improved information requirements apply to the following payers, including: Medicare Advantage plans; Medicaid and Children’s Health Insurance Program (“CHIP”) managed care plans; State Medicaid and CHIP fee-for-service payers; and Qualified Health Plans only in the Federally Facilitated Exchanges.

Medicare 40

Medicare Medicare Health Insurance Medicaid 40

HIT Consultant

AUGUST 12, 2024

The firm’s investment thesis is supported by the significant growth in the payer market, with projected revenues reaching $75B by 2027. – Advocatia : Simplifies the financial assistance experience and helps more patients enroll in Medicaid and other programs such as nutrition assistance and home energy assistance.

Pharmaceutical Industry 52

Pharmaceutical Industry Medicaid Medicaid Health Outcomes 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 90

Compliance Doctors Medicaid Medicaid 90

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. Workforce: Workforce investments with a goal of equitable and sustainable access to care in Medicaid.

Medicaid 52

Medicaid Medicaid Nurses Medicare 52

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% Even if the GLP-1 agents are selected for price negotiation, negotiated price will not come to fruition until 2027. The cost to Medicare Part D would be $26.8

Medicare 59

Medicare Medicare COVID-19 Medicaid 59

Medisys Compliance

JULY 27, 2022

For dates of service calendar years 2027-2029, the reduced coinsurance is 10%. In the CY 2017 PFS Final Rule, the Centers for Medicare & Medicaid Services (CMS) modified coding and reporting of procedural services that include moderate sedation as an inherent part of the service, including for screening colonoscopies.

Medical Billing 52

Medical Billing Medical Billing Outsourcing ACA 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.

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

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% Even if the GLP-1 agents are selected for price negotiation, negotiated price will not come to fruition until 2027. The cost to Medicare Part D would be $26.8

Medicare 52

Medicare Medicare COVID-19 Medicaid 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. By FY 2027, these changes will increase IPPS spending by $459 million. billion.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

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

Innovaare Compliance

APRIL 6, 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% Even if the GLP-1 agents are selected for price negotiation, negotiated price will not come to fruition until 2027. The cost to Medicare Part D would be $26.8

Medicare 52

Medicare Medicare COVID-19 Medicaid 52

Jane Sarashon

JUNE 5, 2023

Just in time for #ASCO2023, the IQVIA Institute published their annual report on Global Oncology Trends 2023 – Outlook to 2027 , an update featuring pipelines, therapy approvals, research updates, costs of oncology products, and patients. in 2023, and millions of more people worldwide.

COVID-19 52

COVID-19 Medicaid Medicaid Health Insurance 52

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. By looking back over the history of this phenomenon, healthcare organizations have the opportunity to take a more reasoned, long-term approach to technology investment and shorten the time to realize the value.

Hospitals 64

Hospitals Medicaid Medicaid Medicare 64

Health Populi

OCTOBER 8, 2019

The Centers for Medicare and Medicaid Services (CMS) forecasts that prescription drug spending will be the fastest-growing cause of rising health spending by 2027. Pricing failure, the second big waste factor, is predominantly challenged by pharmaceutical/prescription drug pricing based on this research.

Prescription Drug Pricing 108

Prescription Drug Pricing Medicare Medicare ACA 108

Healthcare Law Blog

AUGUST 25, 2022

Fifteen more Part D drugs are set to be published in 2027, followed by 15 Part D and Part B drugs, collectively, in 2028. Improvement of Access to Adult Vaccines under Medicaid and CHIP. Certain vaccines must be covered under Medicaid and certain cost-sharing is eliminated. Negotiation-Eligible Drugs.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

MARCH 30, 2023

California Governor Gavin Newsom has asked President Joe Biden to authorize a program called “transitional rent,” which would provide up to six months of rent or temporary housing for low-income enrollees in California’s state Medicaid program. The project is expected to be completed in 2027.

Hospitals 40

Hospitals Medicaid Medicaid Health Outcomes 40

Hall Render

SEPTEMBER 20, 2024

Federal Grant to Study Eye Disease UAMS Study to Address Maternal, Infant Deaths with $2.4M Vincent, Indianapolis Colts announce new partnership Franciscan Health launches 24/7 ambulance to help patients in rural counties Lilly to make $1.8B

US Department of Health and Human Services 40

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

Health Populi

FEBRUARY 21, 2019

every year from 2020 to 2027, the actuaries at the Centers for Medicare and Medicaid Services forecast in their report, National Health Expenditure Projections, 2018-2927: Economic And Demographic Trends Drive Spending And Enrollment Growth , published yesterday by Health Affairs. GDP By 2027 appeared first on HealthPopuli.com.

Medicare 91

Medicare Medicare Medicaid Medicaid 91

Healthcare Law Blog

JANUARY 5, 2023

Just in time for the holidays, the Centers for Medicare and Medicaid Services (“CMS”) issued the Contract Year 2024 Proposed Rule for Medicare Advantage organizations (“MAOs”) and Part D sponsors (the “Proposed Rule”). We’ve summarized some of the key changes in the Proposed Rule. Comments on due February 13, 2023. Star Ratings.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

AUGUST 9, 2024

increases Medicaid rates, expands coverage NEW JERSEY Brigham and Women’s Faulkner exec heads to RWJBarnabas Health Capital Health 1st in region to offer minimally invasive option for complex aortic repair Court denies nursing home’s effort to withhold privileged safety records, citing dual uses Is your nursing home on the list?

US Department of Health and Human Services 40

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

Hall Render

NOVEMBER 17, 2023

Million Individuals Affected by MOVEit Hack MARYLAND Adventist HealthCare, Montgomery College form partnership to address need for qualified nursing workforce Harford Memorial Hospital closing set for Feb. million patients stolen during ransomware attack MINNESOTA CFO of the Year 2023: Penny Cermak, HealthPartners Inc.

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

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.

Compliance 81

Compliance Medicaid Medicaid Public Health 81

Hall Render

SEPTEMBER 27, 2024

million to help others replicate Kentucky’s lung cancer screening success SUN Behavioral will provide Clark County schools mental health $5.7 headcount among top 10 biopharma employers shrinks New Mass. million to help others replicate Kentucky’s lung cancer screening success SUN Behavioral will provide Clark County schools mental health $5.7

Nurses 40

Nurses Hospitals Nursing Homes Medicare 40

Hall Render

AUGUST 23, 2024

hospital, university working to fight ambulance staff shortage Purchase of Wadley Regional Medical Center in Hope, Ark., Vincent Heart Center ranked No. 1 in Indiana, No. million impact on local economy Proposal: Nursing home would have 10-plus years to pay $1 million owed to the state of Iowa This Des Moines hospital was rated 5 stars by CMS.

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., Vincent Heart Center ranked No. 1 in Indiana, No. million impact on local economy Proposal: Nursing home would have 10-plus years to pay $1 million owed to the state of Iowa This Des Moines hospital was rated 5 stars by CMS.

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

less than MU Health projected Lutheran Family and Children’s Services Expands Services in Kansas City Kansas City groups support designating gun violence as public health crisis Fitch downgrades Missouri hospital MONTANA Organizations request Montana health department investment following Medicaid redetermination Montana offers $15.8M

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 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 Here’s why Grady Health System recognized as health care I.T.

US Department of Health and Human Services 40

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

Hall Render

AUGUST 16, 2024

Medicaid fraud scheme Union leaders say payroll problems persist for home care workers CT universities embrace holistic care as a way to teach the new generation of health care workers Thousands of CT residents to lose HUSKY coverage, health group says. Therapist pleads guilty to $1.6M 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

Medicaid fraud scheme Union leaders say payroll problems persist for home care workers CT universities embrace holistic care as a way to teach the new generation of health care workers Thousands of CT residents to lose HUSKY coverage, health group says. Therapist pleads guilty to $1.6M 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

Bill of Health

MARCH 28, 2023

As bad as this seems, it is worth noting that the patents run through 2027, and the FDA has already given tentative approval to two generic versions of enzalutamide. The money involved is significant. In 2021, the Medicare program spent nearly $7 million per day on Xtandi, or $2.4 all of which would be impacted by a successful march in.

Licensing 264

Licensing Governance Medicare Medicare 264

Hall Render

DECEMBER 6, 2024

to settle Medicaid fraud allegations Cone Health operating margin rises to 5.3% operating income in Q3 Northwell’s Huntington Hospital nurses voteto change union representation to NYSNA Police Hunt for Gunman After UnitedHealthcare C.E.O. Q3 operating loss, improves margin to -1.4%

Nursing Homes 40

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

Hall Render

JANUARY 12, 2024

NYU Langone Health taps CFO Northwell inches closer to Epic launch New York looks to strengthen healthcare cybersecurity New York Medicaid waiver opens door for $7.5B to settle improper billing allegations COVID-19 variant JN.1 1 ‘more transmissible’?

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? case of emerging mpox strain; risk to public ‘very low’ California medical office building sells for $14.4M

US Department of Health and Human Services 40

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