Healthcare IT News - Telehealth

FEBRUARY 18, 2021

million commercially insured and Medicare Advantage enrollees from January through June 2020. In a separate Health Affairs blog, health policy experts noted that Medicaid users have had "less consistent" access to telemedicine. THE LARGER TREND.

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COVID-19 Telemedicine Medicaid Medicaid 217

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.

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Compliance Officers Medicare Medicare Compliance 130

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.

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Medicaid Medicaid Medicare Medicare 97

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.

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Medicare Medicare Medicaid Medicaid 100

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.)

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Nursing Homes Nurses Medicaid Medicaid 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.

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COVID-19 Compliance Regulatory Compliance Medicaid 97

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.

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Nursing Homes Medicaid Medicaid Nurses 96

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.

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COVID-19 ADA Medicaid Medicaid 246

MedTrainer

AUGUST 8, 2024

As of March 2024, over 67 million in the United States are Medicare beneficiaries. Medicare is the single largest payer for healthcare services in the United States. In FY2021, the Centers for Medicare and Medicaid Services ( CMS ) reported that Medicare processed more than 1.1 Here’s what you need to know.

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Medicare Medicare Compliance Medicaid 52

The Health Law Firm Blog

JUNE 14, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule [.] Indest III, J.D.,

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Medicare Medicare Medicaid Medicaid 52

The Health Law Firm Blog

MARCH 25, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule [.] Indest III, J.D.,

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Medicare Medicare Medicaid Medicaid 52

The Health Law Firm Blog

MARCH 4, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule [.] Indest III, J.D.,

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Medicare Medicare Medicaid Medicaid 52

The Health Law Firm Blog

APRIL 15, 2024

Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule that decreased overall payment rates for services provided under the Physician Fee Schedule [.] Indest III, J.D.,

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Medicare Medicare Medicaid Medicaid 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. The reimbursement landscape has changed since the start of the pandemic.

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COVID-19 Medicare Medicare Medicaid 105

MRO Compliance

JUNE 1, 2022

HEDIS (Healthcare Effectiveness and Data Information Set) is part of a review process for Medicare Advantage plan quality measures. Depending on the score of a health plan, payers may receive considerable Medicare financial incentives if a score exceeds a certain level. HEDIS audits are important for Medicare and Medicaid health plans.

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Medicare Medicare Compliance Medicaid 130

MedTrainer

APRIL 18, 2024

Behavioral health credentialing exploded in 2023 and 2024 as providers could enroll in Medicare for the first time. In this blog post, we’ll explore these and how behavioral health practices are adopting technology to prepare for the future. Behavioral health credentialing certainly has a unique and challenging credentialing process.

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Medicare Medicare Licensing Compliance 52

Innovaare Compliance

FEBRUARY 19, 2024

On January 31, 2024, the Centers for Medicare & Medicaid Services (CMS) released a draft of the 2025 Advance Notice describing the Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ahead of the final notice to be published on April 1, 2024.

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Medicare Medicare Medicaid Medicaid 52

Innovaare Compliance

FEBRUARY 19, 2024

On January 31, 2024, the Centers for Medicare & Medicaid Services (CMS) released a draft of the 2025 Advance Notice describing the Methodological Changes for Calendar Year (CY) 2025 for Medicare Advantage (MA) Capitation Rates and Part C and Part D Payment Policies ahead of the final notice to be published on April 1, 2024.

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Medicare Medicare Medicaid Medicaid 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

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Medicaid Medicaid Hospitals Nurses 52

MRO Compliance

AUGUST 8, 2024

The Role of Clinical Data Registries According to the latest information from the Centers for Medicare and Medicaid Services (CMS), 90% of payments are now linked to value, with 40% flowing through alternative payment models (APMs), showing the shift towards more cost-effective care driven by data from registries.

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Patient Satisfaction Medicare Medicare Medicaid 147

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.

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COVID-19 Medicaid Medicaid Medicare 90

Hall Render

MAY 23, 2023

The Centers for Medicare & Medicaid Services (“CMS”) is now accepting applications from ACOs to participate in the Medicare Shared Savings Program (“MSSP” or “Program”) for the agreement period beginning January 1, 2024. Hall Render blog posts and articles are intended for informational purposes only.

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Medicare Medicare Medicaid Medicaid 64

Healthcare Law Blog

AUGUST 25, 2023

On August 21, 2023, the New York State Office of the Medicaid Inspector General (OMIG) announced updates to the Medicaid overpayment self-disclosure program, which now includes an abbreviated process for reporting and explaining overpayments that are considered routine or transactional in nature and have been already voided and adjusted.

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Overpayments Overpayment Medicaid Medicaid 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 [.]

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Medicaid Medicaid Overpayment Overpayments 52

Wyatt Law Blog

FEBRUARY 22, 2024

On February 8, 2024, the Centers for Medicare and Medicaid Services (CMS) issued a memorandum entitled Texting of Patient Information and Orders for Hospitals and CAHs (the 2024 Memo), which provides updated guidance to State Survey Agency Directors.

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Medicaid Medicaid Medicare Medicare 80

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.

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Medicare Medicare Compliance Medicaid 52

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.

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Fraud Medicaid Medicaid Licensing 52

MedTrainer

DECEMBER 15, 2023

The Centers for Medicare and Medicaid (CMS) is bringing an approximate 400,000 behavioral health providers into their network. CMS 2024 Behavioral Health Changes Explained Effective January 1, 2024 , behavioral health providers will officially — and finally — be able to enroll with Medicare.

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Medicare Medicare Hospitals Medicaid 98

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 [.]

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Medicaid Medicaid Fraud Medicare 52

Healthcare Law Blog

AUGUST 11, 2023

On July 13, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed rule (the “Proposed Rule”) for the 2024 Medicare Physician Fee Schedule (“PFS”). CMS projects that the Proposed Rule will lead to growth in the Medicare Shared Savings Program (“MSSP”).

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Medicare Medicare Nurses Medicaid 52

MRO Compliance

JUNE 23, 2022

Audit document delivery instantly transmits charts, discussions, and appeal filings to Medicare, Medicaid and commercial auditors, preventing file loss and delivery delay. You can log and track all audits in a single system that simplifies information sharing and collaboration among authorized users. Save time through automation.

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Medicaid Medicaid Medicare Medicare 130

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 [.]

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Medicaid Medicaid Fraud Medicare 52

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 [.]

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Medicaid Medicaid Fraud Medicare 52

MedTrainer

JULY 28, 2023

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. Medicare/Medicaid Compliance Reviews. The OIG performs regular compliance reviews of Medicare and Medicaid providers.

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Fraud Compliance Medicaid Medicaid 98

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 [.]

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Medicaid Medicaid Fraud Medicare 52

Hall Render

FEBRUARY 22, 2024

In the FY 2024 IPPS Final Rule (the “Final Rule”), the Centers for Medicare & Medicaid Services (“CMS”) incorporated certain social risk factors into the Hospital Value-Based Purchasing (“VBP”) Program (“the Program”). Hall Render blog posts and articles are intended for informational purposes only.

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Hospitals Medicare Medicare Medicaid 66

Bill of Health

FEBRUARY 23, 2023

On August 19, 2022 the Centers for Medicare and Medicaid Services announced plans to require nursing facilities to vaccinate most employees to continue to receive federal reimbursements. States that sought to inhibit vaccine mandates faced alternative arguments framed in federal conditional spending powers and preemption.

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COVID-19 Public Health COVID-19 Vaccine Governance 182