Medisys Compliance

AUGUST 20, 2024

Psychologists: Licensed psychologists can provide psychotherapy, psychological testing, and assessments but cannot prescribe medications. Licensed Clinical Social Workers (LCSWs): LCSWs provide therapy, counseling, and support for patients dealing with mental health issues, particularly in community settings.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Licensing Medical Billing Informed Consent 59

MedTrainer

MAY 10, 2024

1, 2024 , mental health counselors can enroll with Medicare as part of The Centers for Medicare and Medicaid Services ( CMS ) plan to bring approximately 400,000 marriage and family therapists (MFT) and mental health counselors (MHC) into their network. Effective Jan. This is where it gets complex.

Licensing 52

Licensing ACA Medicare Medicare 52

Verisys

FEBRUARY 8, 2024

Upon moving to another compact state, a nurse holding a compact license must apply for a new license in their new primary state of residence within 60 days of relocating. NLC Relocation Rule Explanation NLC Relocation FAQ Arizona: The Arizona Board of Nursing has issued a reminder for nursing licenses expiring in 2024.

Regulatory Compliance 52

Regulatory Compliance Compliance Licensing Nurses 52

Healthcare It News

OCTOBER 31, 2022

Through the secure collection, documentation, reporting, access and use of data across provider types, ONC aims to address health inequities that have their root causes in poverty and racism. They're not limited to using the SDOH standards in ONC's guide in their work, according to the post. THE LARGER TREND.

Licensing 273

Licensing Medicaid Medicaid Health Outcomes 273

MedTrainer

DECEMBER 20, 2023

Both licensing and credentialing processes are pivotal in upholding the integrity and safety of healthcare delivery in the state of New Jersey. The New Jersey State Board of Medical Examiners oversees medical credentialing and licensing within the state. Primary Source Verification. Payers in New Jersey have specific requirements.

Licensing 52

Licensing Medicaid Medicaid Malpractice 52

Physician Credentialing Company

OCTOBER 26, 2024

This PCC guide will give better clarity on CPT Code 85025, How it can be utilized and how to document this procedure along with billing guidelines. Documentation Requirements For CPT 85025 Proper documentation is always important while billing for CPT 85025. There are a few things which should be documented properly.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

MedTrainer

DECEMBER 4, 2023

The Kentucky Cabinet for Health and Family Services (CHFS), Department for Medicaid Services administers the state’s Medicaid program, ensuring access to essential health care services for eligible low-income individuals and families in Kentucky.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

MAY 29, 2024

One of the newest changes that impacts medical credentialing services in Oklahoma is a major change to SoonerCare, the state’s Medicaid program. Controlled Dangerous Substance (CDS) Required The Oklahoma State Bureau of Narcotics and Dangerous Drugs Control requires registration as well as a controlled dangerous substance (CDS) license.

Licensing 52

Licensing Medicaid Medicaid Malpractice 52

MedTrainer

NOVEMBER 27, 2023

The Division of Health Benefits administers the state’s Medicaid program, which provides essential healthcare coverage to eligible individuals and families. Providers must be licensed in North Carolina, except under certain conditions, and must ensure that services align with their scope of practice. Medicaid expansion under H.B.

Compliance 52

Compliance Licensing Telemedicine Medicaid 52

MedTrainer

NOVEMBER 27, 2023

The Ohio Department of Medicaid is responsible for administering the state’s Medicaid, a comprehensive healthcare program that provides medical coverage to low-income individuals and families in Ohio. This department focuses on ensuring access to quality healthcare services while managing the state’s Medicaid budget and policies.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 27, 2023

The Department of Community Health (DCH) serves as the lead agency for Medicaid and PeachCare for Kids® , and also oversees the State Health Benefit Plan , Healthcare Facility Regulation Division and State Office of Rural Health. The Medical Assistance Plans Division oversees Georgia’s Medicaid and PeachCare for Kids® programs.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

MAY 15, 2024

Florida Medicaid Portal The Florida Medicaid Web Portal is very specific and if you aren’t familiar with submitting the documentation, it is easy to make a wrong turn. Providers must first submit their Medicaid enrollment application and receive the Application Tracking Number (ATN) before they can access the clearinghouse.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Verisys

OCTOBER 23, 2023

Alabama : License renewals for pharmacy technicians, pharmacy interns, and facilities are open as of 9/15/2023. The board urges that nurses who were practicing under an EMSA license should apply for licensure by endorsement to continue to practice in California. These documents will no longer be accepted if submitted via mail.

Licensing 52

Licensing Nurses Compliance Medicaid 52

Med-Net Compliance

SEPTEMBER 7, 2022

A 49-year-old Texas physician assistant was arrested and charged for his role in a scheme to defraud Medicaid by working with a suspended medical license. On July 20, 2021, the Texas Medical Board allegedly ordered the immediate suspension of his physician assistant license, deeming him to be a “continuing threat to public welfare.”

Medicaid 59

Medicaid Medicaid Licensing Medical Personnel 59

Verisys

JULY 12, 2023

It is the responsibility of the technician, as well as the pharmacy/supervising pharmacist, to ensure that all training is completed within six (6) months of the technician’s registration and documented with the Board of Pharmacy within ten (10) days of the completion of training. The majority of the bill is effective July 1, 2023.

Licensing 52

Licensing COVID-19 Medicaid Medicaid 52

MedTrainer

AUGUST 5, 2024

The extensive administrative workload required to gather, verify, and review all necessary documentation can strain staff and delay bringing new providers on board, directly impacting patient care and revenue. Such lawsuits can threaten a hospital’s ability to participate in federally funded programs like Medicare and Medicaid.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

MAY 7, 2024

We’ll walk you through the steps in enrolling your providers with UnitedHealthcare, the information and documents you need, and the best practices to follow. This blog will highlight how credentialers can navigate UnitedHealthcare provider enrollment. Why Is Payer Enrollment Important for Healthcare Providers?

Malpractice 52

Malpractice Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 29, 2023

The South Carolina Department of Health and Human Services (SCDHHS) administers the state’s Medicaid program and works to enhance the health and well-being of South Carolinians through a range of healthcare services and initiatives. which further ensures that they meet state-mandated health and safety standards.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

DECEMBER 7, 2023

Healthcare compliance in New Mexico mirrors the state’s diverse culture, with unique regulations that differ from other states, such as credentialing documentation requirements for managed care organizations. New Mexico’s parity law requires insurers to cover telemedicine services to the same extent as in-person services.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

NOVEMBER 29, 2023

The Louisiana Department of Health (LDH) Medicaid Program administers the state’s Medicaid services, providing essential health coverage to qualifying residents, including low-income individuals, families, and seniors. If using a learning management system, ensure the vendor offers Louisiana -approved training.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

DECEMBER 7, 2023

The Medicaid and Health program of Idaho provides health coverage to eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities in the state, offering a range of medical and health-related services. If using a learning management system, ensure the vendor offers [STATE] -approved training.

Compliance 52

Compliance Licensing Compliance Officers Informed Consent 52

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. As such, providers should prioritize billing compliance.

Fraud 40

Fraud Compliance Medicaid Medicaid 40

MedTrainer

DECEMBER 7, 2023

MaineCare , operating under the Maine Department of Health and Human Services (DHHS), is the state’s Medicaid program, providing essential health coverage to eligible low-income residents, thereby enhancing access to quality healthcare services in Maine.

Compliance 52

Compliance Licensing Compliance Officers Medicaid 52

MedTrainer

MAY 29, 2024

No Medicaid Identification Numbers As of September 1, 2021 , Texas stopped assigning Medicaid identification numbers, formerly known as a “TPI number.” If the provider will be enrolling with Medicare and the Texas Medicaid program , you’ll also want to set up the Provider Enrollment and Management System (PEMS) profile.

Medicaid 52

Medicaid Medicaid Malpractice Licensing 52

MedTrainer

OCTOBER 29, 2023

The Colorado Medical Board oversees medical credentialing and licensing within the state. Additional Medicaid Requirements Providers who participate in the Child Health Plan Plus (CHP+) and Health First Colorado (Colorado’s Medicaid program) are required to submit the enrollment fee ($688 in 2023) with their application.

Licensing 52

Licensing Malpractice Medicaid Medicaid 52

MedTrainer

NOVEMBER 28, 2023

The State of New Jersey Department of Human Services, Division of Medical Assistance and Health Services oversees the state’s Medicaid enrollments and programming. The New Jersey Division of Consumer Affairs comprises an array of boards for all licenses , ranging from medical and behavioral/mental health to pharmacy and veterinary.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Healthcare Compliance Blog

MARCH 28, 2022

An Illinois licensed practical nurse (LPN) was convicted and sentenced for failing to administer lifesaving measures to a resident in a nursing home in 2017. Additionally, the LPN’s nursing license was suspended for an unspecified period of time. Discussion Points: Review your policies and procedures on CPR. Update as needed.

Nurses 59

Nurses Nursing Homes Licensing Fraud 59

MedTrainer

NOVEMBER 30, 2023

Wisconsin Medicaid is a state-administered program offering comprehensive healthcare coverage to eligible low-income residents, playing a crucial role in ensuring access to essential medical and health services in the state. If using a learning management system, ensure the vendor offers Wisconsin -approved training.

Compliance 52

Compliance Medicaid Medicaid Licensing 52

MedTrainer

NOVEMBER 28, 2023

Under the state’s Department of Health and Human Resources , Michigan Medicaid works with healthcare providers enrolled with Medicaid programs, provides information about billing, and conducts reporting for Medicaid programs. If using a learning management system, ensure the vendor offers Michigan -approved training.

Compliance 52

Compliance Licensing Public Health Compliance Officers 52

Medisys Compliance

MAY 23, 2024

Introduction The Centers for Medicare & Medicaid Services (CMS) establish specific billing guidelines for behavioral health services provided to Medicare beneficiaries. Documentation Requirements: Detailed and accurate documentation is vital for justifying medical necessity and supporting claim submissions.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicare 59

Med-Net Compliance

SEPTEMBER 14, 2022

A Massachusetts home health aide, who was licensed as a Certified Nursing Assistant (CNA), has been indicted in connection with a home surveillance video showing her abusing an elderly patient, Attorney General Maura Healey announced. Document that the training occurred, and record in each employee’s education file.

US Department of Health and Human Services 59

US Department of Health and Human Services Fraud Medicaid Medicaid 59

MedTrainer

DECEMBER 7, 2023

The New Hampshire Medicaid (Medical Assistance) program within DHHS provides medical assistance to eligible low-income residents, offering a range of healthcare services to support their health and well-being. The software helps to keep documents and policies organized, ensures training content is up to date, and makes reporting easy.

Compliance 52

Compliance Licensing Public Health Medicaid 52

MedTrainer

JUNE 10, 2024

You may be required to complete CEU classes as part of employment or to remain licensed or certified within your chosen field. The requirements for CE vary depending on the profession and may be mandated by licensing boards or professional organizations. Many states require a specific number of CMEs for each license renewal cycle.

Licensing 52

Licensing COVID-19 Medicaid Medicaid 52

MedTrainer

NOVEMBER 17, 2023

Regulations unique to Illinois include those around the state’s Medicaid program and also encompass telehealth licensure, reimbursement, and practice standards for healthcare providers delivering care remotely. Medical licensing is provided by the Illinois Department of Financial and Professional Regulation.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Health Care Law Brief

FEBRUARY 8, 2024

billion to fund Medicaid, $4.8 In addition to the 1115 Waiver, which funds the Medicaid Hospital Global Budget for financially distressed safety net hospitals transitioning from volume-based reimbursement models to value-based models, the HMH Bill would also establish the Healthcare Safety Net Transformation Program (“HSNT Program”).

Medicaid 52

Medicaid Medicaid Nurses Licensing 52

MedTrainer

NOVEMBER 20, 2023

Ensuring adherence to licensing requirements, the Florida Agency for Health Care Administration oversees Medicaid, coordinating essential healthcare access to vulnerable populations. The Florida Board of Medicine is responsible for regulating practitioner licenses and provides the guidelines providers must adhere to.

Compliance 52

Compliance Licensing Regulatory Compliance Medicaid 52

MedTrainer

NOVEMBER 28, 2023

The Arizona Health Care Cost Containment System (AHCCCS) is Arizona’s Medicaid agency, providing health care programs to serve Arizona residents through managed care, cost containment, and services aimed at improving the health of those it covers. It is also best practice to include the standard you are meeting for additional clarity.

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Compliance Licensing Public Health Medicaid 52