Healthcare IT Today

JANUARY 20, 2025

My career spans over three decades in health information technology, health policy and public health, including roles at the Centers for Medicare and Medicaid Innovation and in state government. Definitely. My name is Vatsala Kapur, and I’m the Vice President of External Affairs at Bamboo Health.

Governance 72

Governance Medicaid Medicaid Health Outcomes 72

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 305

Governance Public Health Local Policy Medicaid 305

Healthcare IT News - Telehealth

JUNE 26, 2020

"It is definitely helpful to have someone there who understands technology who can troubleshoot with you," said A. " McBride and other panelists noted that before the COVID-prompted changes from the Centers for Medicare and Medicaid Services, Northwell was not seeking reimbursement for MTT services.

COVID-19 202

COVID-19 Telemedicine Medicaid Medicaid 202

Healthcare IT News - Telehealth

SEPTEMBER 3, 2020

Centers for Medicare and Medicaid Services to extend administrative flexibility around greater portability of licensure for telehealth service providers. "States and the federal government should work to harmonize definitions and regulations (e.g.,

Licensing 190

Licensing Medicare Medicare Governance 190

Healthcare IT News - Telehealth

OCTOBER 27, 2020

The Centers for Medicare and Medicaid Services announced earlier this month , for example, that it would add 11 virtual services to its reimbursement list during the COVID-19 public health emergency – following in the footsteps of its earlier flexibilities for virtual care. " Kat Jercich is senior editor of Healthcare IT News.

COVID-19 202

COVID-19 Governance Medicare Medicare 202

Healthcare IT News - Telehealth

APRIL 24, 2020

The Alliance for Integrated Care of New York (AICNY) oversees the healthcare needs of roughly 6,200 dually eligible Medicare and Medicaid beneficiaries with intellectual and developmental disabilities (IDD). Many AICNY beneficiaries reside in group homes and use Federally Qualified Community Health Centers. THE PROBLEM. ” PROPOSAL.

Telemedicine 198

Telemedicine COVID-19 Medicaid Medicaid 198

AIHC

DECEMBER 27, 2024

This provides a straightforward definition of consent as it applies specifically to intimate areas of the body defined by the policy as breasts, buttock, groin, or genitals. [14] In order to address concerns about these unauthorized practices, an increasing number of states have passed laws protecting the bodily autonomy of patients.

Informed Consent 98

Informed Consent Bioethics ADA Medical Personnel 98

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. This shift places greater emphasis on tangible risks rather than hypothetical possibilities.

Medicaid 40

Medicaid Medicaid Nursing Homes Medicare 40

Healthcare Law Blog

JANUARY 20, 2023

To add uniformity to this practice, CMS codified this flexibility in the 2016 Medicaid and Children’s Health Insurance Plan (CHIP) managed care final rule by authorizing coverage for “In Lieu of Service or Settings” (ILOS). [i] ILOSs must advance the objectives of the Medicaid program. ILOSs must be medically appropriate.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare IT News - Telehealth

APRIL 30, 2021

Although some of those original provisions have been enacted into law or adopted by the Centers for Medicare and Medicaid Services since then, others remain – namely, the broadly popular move to expand the definition of originating site.

COVID-19 218

COVID-19 Medicare Medicare Public Health 218

Healthcare IT News - Telehealth

OCTOBER 14, 2021

" Key to moving forward will be a delivery model through the Centers for Medicare and Medicaid Services Innovation Center that will enable testing and implementation of a long-term advanced care at home framework. "We're going to need to have a few different ways of measuring this." "There's no vanity here.

Hospitals 183

Hospitals Public Health COVID-19 Patient Satisfaction 183

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

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). Note that there is no formal definition of the term maximum feasible efforts beyond its plain meaning because every factual situation will be different.

Nurses 52

Nurses Medicaid Medicaid Medicare 52

American Medical Compliance

FEBRUARY 19, 2025

The CMS Interim Final Rule The Centers for Medicare & Medicaid Services (CMS) issued an interim final rule with comment period (IFC) to implement section 6052 of the Deficit Reduction Act of 2005 (DRA). As a result, this rule guides how Medicaid will reimburse for case management services.

Nurses 52

Nurses Compliance Medicaid Medicaid 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 58

Medicaid Medicaid Hospitals 58

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

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

FEBRUARY 3, 2022

The highest rates of telehealth visits were among Medicaid and Medicare users, along with Black patients and those earning less than $25,000 a year. For instance, lawmakers in New Hampshire this past year sought to exclude audio-only care from the definition of telemedicine.

Telemedicine 166

Telemedicine COVID-19 Health Insurance Medicaid 166

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 106

Governance HIPAA Compliance Nursing Homes 106

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

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

Hall Render

DECEMBER 20, 2023

For NFs, the data would be reported via means prescribed by the applicable state Medicaid agency. The Final Rule finalized its proposed definition of PEC but did not finalize its proposed definition of REIT to provide a definition consistent with the commentor’s concerns to be more consistent with current federal law and industry practice.

Nurses 40

Nurses Medicaid Medicaid Medicare 40

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 93

Medicare Medicare Compliance Medicaid 93

Healthcare IT News - Telehealth

AUGUST 30, 2021

In doing so, Trinity also hoped to receive readmission incentives from the Centers for Medicare and Medicaid Services, avoid penalties, and reduce costs as it transitioned to value-based care reimbursement. There is definite value with continuing to monitor patients after a home care episode, Joyce noted.

Patient Satisfaction 195

Patient Satisfaction Nurses Medicare Medicare 195

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

Healthcare IT News - Telehealth

JUNE 14, 2024

RPM was initially recognized in 2019 by the Centers for Medicare and Medicaid Services through a small set of codes for remote physiologic monitoring services, enabling clinicians to seek reimbursement for gathering data from patients through certain medical devices outside the hospital setting.

Medicare 172

Medicare Medicare Nursing Homes Hospitals 172

Healthcare IT News - Telehealth

JUNE 17, 2020

advocated for two particular policy changes to be made permanent: the originating site rule, allowing physicians to be reimbursed for telehealth appointments wherever a patient is located, including a patient's home, and the expansion of Medicare- and Medicaid-reimbursable telehealth services. Lamar Alexander, R-Tenn.,

US Department of Health and Human Services 203

US Department of Health and Human Services Telemedicine COVID-19 Doctors 203

Healthcare IT News - Telehealth

OCTOBER 3, 2022

The Rural Health Information Hub breaks down various definitions of frontier designations, but a common one is six or fewer people per square mile. All but one of One Health's clinic locations serve communities that meet the frontier definition. THE PROBLEM.

Telemedicine 146

Telemedicine Medicaid Medicaid 146

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.

COVID-19 132

COVID-19 Medicaid Medicaid Doctors 132

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]

Overpayment 98

Overpayment Overpayments Medicare Medicare 98

HIT Consultant

AUGUST 25, 2021

What You Should Know: – Headspace , a global leader in mindfulness and meditation, and Ginger , a leader in on-demand mental healthcare, today announced they have entered into a definitive agreement to merge. states and in 190+ countries worldwide.

World Health 98

World Health Medicaid Medicaid 98

Healthcare IT News - Telehealth

SEPTEMBER 9, 2024

Meanwhile, the American Telemedicine Association is pleading with the Centers for Medicare and Medicaid Services for expanded flexibilities and further guidance on payment and coverage. counties have internet speeds below the FCC's definition of "broadband." One recent study reported on telehealth trends in U.S.

Telemedicine 188

Telemedicine Licensing Health Outcomes Governance 188

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 Today

MARCH 1, 2023

Reporting), paying close attention to data quality Perform custom analysis of disparate healthcare and information systems data, interpret results, and make recommendations about data collection methods, metrics definitions and evaluation methods to pertinent decision makers, based on analytic findings Create and maintain high-quality documentation (..)

Healthcare information Technology 142

Healthcare information Technology Medicaid Medicaid Health Outcomes 142

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

Health Populi

JANUARY 16, 2020

The definition of that “modern house call” is largely based on the model of care delivered by CareMore Health — a team-based approach that serves the whole person beyond their diagnosis. adults 23 years of age and over in September and October 2019.

Doctors 159

Doctors Hospitals Nurses Medicaid 159

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