Healthcare IT News - Telehealth

FEBRUARY 17, 2021

There has definitely been a change at Helio Health. We have a large network that is predominantly Medicaid. Healthcare IT News recently compiled a comprehensive list of these vendors with detailed descriptions. To read this special report, click here. MEETING THE CHALLENGE. A big change in culture. "Transportation is huge.

Medicaid 210

Medicaid Medicaid COVID-19 Telemedicine 210

Health Law RX

SEPTEMBER 16, 2022

AHCA is sending out postcards to existing Florida Medicaid providers (Providers) alerting them to upcoming changes in the Florida Medicaid program. Providers are urged to sign into their account on the Florida Medicaid portal immediately. Direct care employees falling within this definition also include 1099 employees.

Medicaid 52

Medicaid Medicaid Nursing Homes Nurses 52

C&M Health Law

JANUARY 18, 2023

On January 4, in its most recent effort to expand federal support for addressing health-related social needs (HRSNs), the Centers for Medicare & Medicaid Services (CMS) issued guidance to clarify an existing option for states to address HRSNs through the use of “in lieu of” services and settings policies in Medicaid managed care.

Medicaid 52

Medicaid Medicaid Federal Policy Health Outcomes 52

Bill of Health

SEPTEMBER 25, 2024

In short, the conflict hinges on the definition of what it means to be “entitled to supplemental security income (SSI) benefits.” DSH payments have become a lifeline for many rural and urban hospitals, especially in states that have not expanded their Medicaid programs under the Affordable Care Act.

Medicare 100

Medicare Medicare Medicaid Medicaid 100

Hall Render

OCTOBER 22, 2024

Effective October 1, 2024, the Centers for Medicare & Medicaid Services (“CMS”) introduced significant updates to the CMS-855A form , specifically requiring a new Skilled Nursing Facility (“SNF”) Attachment for every SNF. Accompanying guidance to the revised form may be found here.

Medicare 40

Medicare Medicare Nurses Medicaid 40

HIT Consultant

JUNE 26, 2024

What You Should Know: – The Rise Fund, the multi-sector strategy of TPG’s global impact investing platform, today announced it has signed definitive documentation to lead an investment of over $200 million in Foodsmart, the leading telenutrition provider and food benefits management platform in the US.

Health Outcomes 105

Health Outcomes Medicaid Medicaid Medicare 105

Healthcare IT News - Telehealth

JUNE 8, 2020

"Regrettably, minority groups are being left behind by the telehealth revolution," said David Smith, executive director for the Medicaid Transformation Project, in an interview with Healthcare IT News. " David Smith, Medicaid Transformation Project Executive Director. Since the pandemic began its spread across the U.S.

COVID-19 191

COVID-19 Medicaid Medicaid Telemedicine 191

Bill of Health

FEBRUARY 6, 2024

Congress can enhance the federal Earned Income Tax Credit (EITC) (26 U.S. Code § 32) by making the tax credit monthly. State Government Opportunities: States can increase expungement rates by amending laws to apply automatic expungement to minor drug possession convictions and seal the records.

Governance 306

Governance Public Health Local Policy Medicaid 306

Innovaare Compliance

JUNE 30, 2024

The Centers for Medicare & Medicaid Services (CMS) provides standardized model materials to facilitate the process. Chapter 5 and under Definitions in Chapter 12, EOC) Lengthy explanation for requesting exceptions to the formulary (Sections 6.2, Section 2.1 Chapter 9, EOC) A monthly cap of $35.00 and Section 3.2, Section 2.1

Medicare 52

Medicare Medicare Compliance Medicaid 52

HIT Consultant

APRIL 19, 2024

Medicare providers in hospitals and skilled nursing facilities (SNFs) are adjusting to new split/shared services documentation and billing regulations rolled out by the Centers for Medicare and Medicaid Services (CMS) as part of the 2024 Medicare Physician Fee Schedule (MPFS) final rule.

Nurses 102

Nurses Medicare Medicare Medicaid 102

Healthcare It News

JUNE 3, 2022

Since California expanded health coverage under the Affordable Care Act, a large number of people have been mistakenly bounced between Covered California, the state’s marketplace for those who buy their own insurance, and Medi-Cal, the state’s Medicaid program for low-income residents. “This shouldn’t be happening.

Public Health 254

Public Health Health Insurance Professionals ACA Medicaid 254

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

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.

Patient Satisfaction 147

Patient Satisfaction Medicare Medicare Medicaid 147

MedTrainer

AUGUST 8, 2024

In FY2021, the Centers for Medicare and Medicaid Services ( CMS ) reported that Medicare processed more than 1.1 Key aspects of this training include: Content: The training covers definitions of fraud, waste, and abuse, examples of FWA in healthcare, relevant laws and regulations, and methods to identify and report suspicious activities.

Medicare 52

Medicare Medicare Compliance Medicaid 52

Healthcare Law Blog

MAY 16, 2022

On April 29, 2022 , the Centers for Medicare and Medicaid Services (“CMS”), issued the final rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Final Rule”). Refining Definition for Fully Integrated and Highly Integrated D-SNPs (§§ 422.2 and 422.107).

Medicare 52

Medicare Medicare Medicaid Medicaid 52

HIPAA Journal

NOVEMBER 17, 2022

I’m currently on contract to a State Medicaid Agency’s Privacy Office. Medicaid modularity, health information exchange, patient access APIs and apps. I definitely learned on the job. HIPAA, specifically the Privacy Rule, has very little definitive provisions. What is your current position?

Governance 98

Governance HIPAA Compliance Nursing Homes 98

HIT Consultant

NOVEMBER 22, 2021

What You Should Know: – Today, global health IT company, Edifecs announced it has entered a definitive agreement to acquire Health Fidelity, a San Francisco-based tech provider. Together, the companies will offer health plans and provider customers with the most complete risk adjustment solution in healthcare. Edifecs , Inc.,

ACA 52

ACA Medicaid Medicaid Medicare 52

Verisys

JULY 12, 2023

Updates include requirements for credentialing providers in state Medicaid services, state employee medical programs, health maintenance organization contracts, hospital quality assessments, and health plan and insurer requirements. Major changes to Medicaid credentialing are effective July 1, 2024.

Licensing 52

Licensing COVID-19 Medicaid Medicaid 52

Healthcare Law Blog

JANUARY 10, 2022

On January 6, 2022 , the Centers for Medicare and Medicaid Services (“CMS”) issued the proposed rule on Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs (the “Proposed Rule”). Refining Definitions for Fully Integrated and Highly Integrated D-SNPs (§§ 422.2

Medicare 98

Medicare Medicare COVID-19 Medicaid 98

AIHC

FEBRUARY 7, 2024

Medicaid policies on this issue vary from state to state. Centers for Medicare & Medicaid Services (CMS) offers a 17-page PDF: “ Telehealth for Providers: What You Need to Know ”. Centers for Medicare & Medicaid Services (CMS) offers a 17-page PDF: “ Telehealth for Providers: What You Need to Know ”.

HIPAA 59

HIPAA Medicaid Medicaid Telemedicine 59

Healthcare Law Blog

MARCH 2, 2023

Effective March 1 st , certain providers choosing to self-disclose Stark Law violations must use forms updated by the Centers for Medicare & Medicaid Services (“CMS”). 411.352 it failed to satisfy.

Overpayments 52

Overpayments Overpayment Medicare Medicare 52

Hall Render

APRIL 6, 2022

Second, the relator pointed out that Pharmacy Benefit Managers (“PBMs”) adopted and incorporated this definition of the “usually and customary” pricing into their agreements with pharmacies. Regarding the PBM’s adoption of this definition, the Court stated that this may not serve as the basis of a fraud claim under the FCA.

Medicare 72

Medicare Medicare Medicaid Medicaid 72

Innovaare Compliance

FEBRUARY 14, 2022

This includes CMS regulations for Medicare Plans, regulations for Commercial Plans and Medicaid regulations for state plans. With this in mind, much as possible, find a way to standardize grievance categories so that they can equally apply to CMS reporting, Medicaid reporting and Commercial reporting.

Compliance 52

Compliance Regulatory Compliance Medicaid Medicaid 52

Healthcare Law Blog

DECEMBER 27, 2022

The Centers for Medicare and Medicaid Services (“CMS”) has issued a proposed rule which would amend the existing regulations for reporting and returning identified overpayments (the “Proposed Rule”). UnitedHealthcare Litigation. UnitedHealthcare challenged the current Overpayment Rule in litigation. [1]

Overpayments 98

Overpayments Overpayment Medicare Medicare 98

AIHC

FEBRUARY 7, 2024

Medicaid policies on this issue vary from state to state. Centers for Medicare & Medicaid Services (CMS) offers a 17-page PDF: “ Telehealth for Providers: What You Need to Know ”. Centers for Medicare & Medicaid Services (CMS) offers a 17-page PDF: “ Telehealth for Providers: What You Need to Know ”.

HIPAA 52

HIPAA Medicaid Medicaid Telemedicine 52

HIT Consultant

OCTOBER 7, 2021

The Welltok acquisition will accelerate Virgin Pulse’s ability to serve substantially more clients, consumers, patients and members across the full healthcare continuum – employer, health plans (commercial, Medicare Advantage, Managed Medicaid), pharmacies/pharmacy benefits managers (PBMs) and health systems.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare IT Today

NOVEMBER 16, 2024

Read more… Tackling Out-of-State Medicaid Claims and Credentialing Challenges. Read more… Funding and M&A Activity: Definition Health secured about $7.5 Lack of credentialing, misunderstanding of benefits, and unverified eligibility can all impact reimbursement.

Medicaid 66

Medicaid Medicaid Hospitals 66

Jane Sarashon

MARCH 29, 2023

” Start with the definition set forth in the report: that techquity is the “intentional design and deployment of technology both to advance health equity and to avoid depending existing systemic inequities and health disparities.”

Medicaid 103

Medicaid Medicaid Health Outcomes Medicare 103

Healthcare IT News - Telehealth

NOVEMBER 11, 2024

While there are privacy, security and regulatory expectations (for example, the Joint Commission, Centers for Medicare and Medicaid Services , private insurance) for telemedicine programs, there is not yet an official group evaluating or designating maturity levels for these programs.

Telemedicine 186

Telemedicine Nurses Regulatory Compliance COVID-19 186

HIPAA Journal

MAY 12, 2023

The term “continuity of care” has various definitions. Some definitions imply care is continuous within the same healthcare organization (or Organized Health Care Arrangement), while others extend the definition to multiple healthcare settings.

HIPAA 68

HIPAA Compliance Health Services Administration Medicare 68

Healthcare IT Today

JUNE 7, 2023

In the comments that we will submit to ONC on HTI-1, we’ll also be encouraging ONC and the Centers for Medicare and Medicaid Services (CMS) to work more closely together to address the misalignments that frequently occur between when ONC tells software developers to deploy new certified versions and when CMS requires providers to be using them.

FDA 97

FDA Compliance Regulatory Compliance Medicaid 97

HIT Consultant

JULY 15, 2024

– The Centers for Medicare & Medicaid Services (CMS) released a proposed rule outlining changes to Medicare payments under the Physician Fee Schedule (PFS) for services furnished and other Medicare Part B issues on or after January 1, 2025. Allowing audio-only communication for home telehealth visits when video is not possible.

Medicare 52

Medicare Medicare Payment Systems Medicaid 52

Healthcare Law Blog

NOVEMBER 2, 2023

According to the Congressional Research Service, which analyzed data from the Centers for Medicare & Medicaid Services (“CMS”) National Health Expenditure Accounts (“NHEA”) on the personal health expenditures for LTSS by payer, in 2021, an estimated $467.4 billion was spent on LTSS. This represents 13.2% of LTSS spending. [5]

Nursing Homes 52

Nursing Homes Medicaid Medicaid Medicare 52

Healthcare IT Today

OCTOBER 20, 2023

Previous articles covered the definition, collection, sharing, and use of SDoH. Another source of fresh foods for low-income people is FarmboxRx , often available through Medicaid and Medicare Advantage programs as part of SNAP or Healthy Food Card benefits. I’ll finish with a look at some specific areas of intervention.

Medicaid 125

Medicaid Medicaid COVID-19 Doctors 125

C&M Health Law

OCTOBER 18, 2023

Section 504 covers all health care and human services programs and activities funded by HHS, from providers, like hospitals and doctors that accept Medicare or Medicare, to state child welfare programs, as well as Medicare Advantage Plans, and Medicaid Managed Care Plans.

ADA 98

ADA COVID-19 Medicare Medicare 98

CMS.gov

SEPTEMBER 13, 2021

The Centers for Medicare & Medicaid Services (CMS) is committed to ensuring people on Medicare have quicker access to innovative medical technologies for life-threatening or irreversibly debilitating diseases – like cancer and heart disease.

Medicare 37

Medicare Medicare FDA Medicaid 37

Hall Render

SEPTEMBER 10, 2024

On July 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) issued its calendar year 2025 Medicare Physician Fee Schedule (“MPFS”) proposed rule (“Proposed Rule”), to implement certain payment updates effective January 1, 2025.

Medicare 40

Medicare Medicare Medicaid Medicaid 40