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.

Nursing Homes 52

Nursing Homes Nurses Medicaid Medicaid 52

MRO Compliance

FEBRUARY 3, 2025

HEDIS audits are important for Medicare and Medicaid health plans because data is used to determine the efficacy of a payer to care for its members. Utilization and Risk Adjusted Utilization. Health Plan Descriptive Information. Measures Collected Using Electronic Clinical Data Systems.

Patient Satisfaction 147

Patient Satisfaction Compliance Medicare Medicare 147

Healthcare IT News - Telehealth

FEBRUARY 18, 2021

In a separate Health Affairs blog, health policy experts noted that Medicaid users have had "less consistent" access to telemedicine. THE LARGER TREND.

COVID-19 218

COVID-19 Telemedicine Medicaid Medicaid 218

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. Hall Render blog posts and articles are intended for informational purposes only.

Medicare 89

Medicare Medicare Nursing Homes Medicaid 89

Hall Render

JANUARY 29, 2025

The Centers for Medicare & Medicaid Services (CMS) is reinforcing its emphasis on hospice quality of care and identifying fraud. Hall Render blog posts and articles are intended for informational purposes only.

Fraud 80

Fraud Medicare Medicare Compliance 80

American Medical Compliance

OCTOBER 25, 2024

In this blog, we will explore how healthcare providers can conduct effective compliance audits, ensuring both thoroughness and efficiency. Why Compliance Audits Matter in Healthcare A compliance audit is a critical process that reviews an organization’s adherence to internal policies and external regulations.

Compliance 105

Compliance Fraud Compliance Framework HIPAA 105

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.

Nursing Homes 52

Nursing Homes Nurses Medicaid Medicaid 52

Hall Render

MARCH 11, 2025

Government fraud enforcement remains aggressive : Despite this ruling, health care providers should continue prioritizing compliance with Medicare and Medicaid billing regulations. Hall Render blog posts and articles are intended for informational purposes only.

Medicare 52

Medicare Medicare Governance Fraud 52

Bill of Health

MARCH 15, 2022

Further, safety net programs, such as Medicaid and Supplemental Security Income (SSI), have stringent rules that prevent people with disabilities from working while simultaneously forcing them to live in poverty. However, expanding safety net programs , such as SSI and Medicaid, would be important as an interim measure.

COVID-19 246

COVID-19 ADA Medicaid Medicaid 246

Hall Render

NOVEMBER 1, 2024

Health care fraud remains a significant focus for federal and state enforcement agencies, with particular attention placed on the integrity of Medicaid and Medicare billing. He was also ordered to pay $557,000 in restitution to Indiana Medicaid and Medicare.

Fraud 40

Fraud Compliance Medicaid Medicaid 40

Center for Health Insurance Reform

APRIL 29, 2022

As many as 16 million people are expected to lose Medicaid once the COVID-19 public health emergency ends. In their latest To the Point blog for the Commonwealth Fund, Sabrina Corlette and Maanasa Kona discuss strategies that marketplaces can deploy to help reduce the potential coverage loss and help consumers make a smooth transition.

Public Health 96

Public Health ACA COVID-19 Health Insurance 96

Bill of Health

NOVEMBER 15, 2023

See e.g., California’s 1115 waiver (pages 1-9 have an overview of prerelease services). “If… w e can reform jails and prisons from places of withdrawal and abstinence to treatment and recovery, we need to better connect their populations with the outside world.

Governance 173

Governance Public Health Telemedicine COVID-19 173

Provider Trust

APRIL 30, 2024

This year, as always, the Medicaid Fraud Control Units (MFCUs) released an annual report dissecting the exclusions, enforcements, and overall takeaways from their work throughout the previous fiscal year (FY). for every $1 spent How ProviderTrust Can Help With nearly 80 million individuals covered by Medicaid, every data point counts.

Fraud 52

Fraud Medicaid Medicaid Licensing 52

Hall Render

MARCH 12, 2025

Background of the Case Relator Rosales filed a qui tam action in June 2020 against a hospice care provider and its subsidiaries, alleging fraudulent conduct aimed at securing payments from Medicare and Medicaid. Hall Render blog posts and articles are intended for informational purposes only.

Fraud 52

Fraud Governance Medicaid Medicaid 52

MRO Compliance

AUGUST 3, 2022

This blog post serves as a summary to increase efficiency and security in the audit process. Consider auditing software that can instantly transmit charts, discussions, and appeal filings to Medicare, Medicaid and commercial auditors, preventing file loss and delivery delay. Audit Software Helps You Work Smarter, Not Harder.

Compliance Officers 130

Compliance Officers Medicare Medicare Compliance 130

Hall Render

MARCH 20, 2025

In December 2024, the Centers for Medicare & Medicaid Services (CMS) made many revisions to its Guidance for SNF Attachment on Form CMS-855A (Guidance). Hall Render blog posts and articles are intended for informational purposes only.

Nurses 52

Nurses Medicaid Medicaid Medicare 52

The Health Law Firm Blog

JANUARY 12, 2024

Board Certified by The Florida Bar in Health Law The nation's largest Medicaid insurer, Centene, has agreed to pay $165.6 million to Texas to resolve claims that it overcharged the state’s Medicaid program for pharmacy services. By George F. Indest III, J.D., The deal was signed on July 11, 2022, but wasn’t publicly [.]

Medicaid 52

Medicaid Medicaid Overpayments Overpayment 52

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

The Health Law Firm Blog

MAY 21, 2024

Board Certified by The Florida Bar in Health Law On October 1, 2021, a former dental office manager was sentenced to 12 months in prison for her role in a Medicaid fraud scheme. Indest III, J.D., Mahsa Azimirad, was the office manager for Universal Smiles, a D.C.-based based dental practice, according [.]

Medicaid 52

Medicaid Medicaid Fraud Medicare 52

The Health Law Firm Blog

APRIL 23, 2024

On October 1, 2021, a former dental office manager was sentenced to 12 months in prison for her role in a Medicaid fraud scheme. By Carole C. Schriefer, J.D. Mahsa Azimirad, was the office manager for Universal Smiles, a D.C.-based based dental practice, according to the U.S. Attorney’s Office for Washington, D.C. She was indicted in [.]

Medicaid 52

Medicaid Medicaid Fraud Medicare 52

MedTrainer

SEPTEMBER 20, 2023

If you want to obtain or retain CMS certification in order to be reimbursed by services provided to patients with a Medicare/Medicaid health plan, you must comply with HIPAA rules and regulations. There are several accrediting organizations that require facilities to meet or exceed Medicaid and Medicare guidelines. Accreditation.

Medicaid 97

Medicaid Medicaid Medicare Medicare 97

The Health Law Firm Blog

MAY 7, 2024

Board Certified by The Florida Bar in Health Law On October 1, 2021, a former dental office manager was sentenced to 12 months in prison for her role in a Medicaid fraud scheme. Indest III, J.D., Mahsa Azimirad, was the office manager for Universal Smiles, a D.C.-based based dental practice, according [.]

Medicaid 52

Medicaid Medicaid Fraud Medicare 52

Healthcare Law Blog

JANUARY 31, 2023

This blog is the second installment of our Digital Health Trends series. vii] “Calendar Year (CY) 2022 Medicare Physician Fee Schedule Final Rule,” Centers for Medicare & Medicaid Services (Nov.

COVID-19 105

COVID-19 Medicare Medicare Medicaid 105

The Health Law Firm Blog

MARCH 26, 2024

Board Certified by The Florida Bar in Health Law On October 1, 2021, a former dental office manager was sentenced to 12 months in prison for her role in a Medicaid fraud scheme. Indest III, J.D., Mahsa Azimirad, was the office manager for Universal Smiles, a D.C.-based based dental practice, according [.]

Medicaid 52

Medicaid Medicaid Fraud Medicare 52

Hall Render

DECEMBER 30, 2024

On November 21, 2024, the Centers for Medicare & Medicaid Services (CMS) issued revised guidance under QSO-25-09-ALL, updating Core Appendix Q of the State Operations Manual regarding findings of immediate jeopardy. Hall Render blog posts and articles are intended for informational purposes only.

Medicaid 40

Medicaid Medicaid Nursing Homes Medicare 40

Healthcare Law Blog

OCTOBER 27, 2022

On October 21, 2022, the Centers for Medicare and Medicaid Services (CMS) announced changes to its Special Focus Facility (SFF) program, including new steps to address nursing home facilities that fail to graduate from the SFF program in a timely manner, or “yo-yo” back into non-compliance after graduating from the SFF program. FOOTNOTES. [1]

Nursing Homes 96

Nursing Homes Medicaid Medicaid Nurses 96

McBrayer Law Blog

FEBRUARY 23, 2022

More > Tags: Audit , Centers for Medicare & Medicaid Services , CMS , COVID-19 , Healthcare Compliance Issues , Medicaid , Medicare , regulatory compliance. Just as the pandemic may finally be easing, federal focus on use of COVID-19 resources promises to increase healthcare providers’ stress.

COVID-19 97

COVID-19 Compliance Regulatory Compliance Medicaid 97

McBrayer Law Blog

OCTOBER 18, 2021

More > Tags: Centers for Medicare & Medicaid Services , Civil Penalties , CMS , Healthcare Providers , Long-Term Care , Long-Term Care Facilities , Medicare. For reference, the 2017 Guidance can be found here. The accompanying CMP Analytic Tool can be found here.)

Nursing Homes 96

Nursing Homes Nurses Medicaid Medicaid 96

Jane Sarashon

JANUARY 19, 2024

Elevance Health, the health plan organization comprising XXX plans serving 117 million members, launched a program to channel mobile phones and data plans into the hands of some Medicaid plan enrollees, explained in the organization’s press release on the program.

Medicaid 75

Medicaid Medicaid COVID-19 Health Outcomes 75

Jane Sarashon

DECEMBER 30, 2024

You can read more at this link to my blog post discussing the company’s program to award washers to schools that help keep kids engaged in attending and engaging in learning. Stay tuned to my daily Health Populi blog postings and LinkedIn messages for #CES2025 updates between 5 and 10 January 2025.

FDA 52

FDA Medicare Medicare Medical Billing 52

Healthcare Blog

FEBRUARY 7, 2023

This blog post will explore the differences between nursing procedures and policy and discuss why both are necessary for healthcare settings. Policies and Procedures – PMC Centers for Medicare & Medicaid Services. Policy, on the other hand, is a statement that guides an organization’s decisions and actions.

Nurses 102

Nurses Hospitals Medicaid Medicaid 102

Bill of Health

SEPTEMBER 25, 2024

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

MedTrainer

AUGUST 8, 2024

In FY2021, the Centers for Medicare and Medicaid Services ( CMS ) reported that Medicare processed more than 1.1 Required Training for Medicaid-Enrolled Providers Though this article discusses Medicare-enrolled provider training requirements, I want to discuss how Medicaid enrollment and training differ. and state regulations.

Medicare 93

Medicare Medicare Compliance Medicaid 93

Bill of Health

NOVEMBER 9, 2023

Despite the important enactment in 2010 of the Patient Protection and Affordable Care Act (ACA), which increases access to care by expanding Medicaid eligibility and protecting insurance coverage of people with pre-existing health conditions and disabilities, more than 25 million people remain uninsured.

COVID-19 162

COVID-19 Public Health ACA Health Insurance 162

McBrayer Law Blog

JANUARY 14, 2022

The Court upheld, however, a similar rule for healthcare employers contracted with the Centers for Medicare and Medicaid Services (“CMS”) as further outlined below.

COVID-19 90

COVID-19 Medicaid Medicaid Medicare 90

Center for Health Insurance Reform

MARCH 25, 2024

While state efforts to provide Medicaid-equivalent benefits to some populations of undocumented residents have helped expand access to coverage, many low- and moderate-income undocumented residents remain without affordable health insurance options.

Health Insurance 52

Health Insurance Medicaid Medicaid State Policy 52

Verisys

MARCH 6, 2025

The Centers for Medicare and Medicaid Services (CMS) Regulates reimbursement policies and ensures healthcare organizations adhere to the standards necessary to participate in federal healthcare programs.

Compliance 52

Compliance HIPAA Licensing Governance 52