Fierce Healthcare

NOVEMBER 3, 2024

Under a final rule issued by the Centers for Medicare and Medicaid Services, outpatient hospital facilities and ambulatory surgical centers will get a 2.9% Medicare pay increase next year, up from | Under a final rule issued by CMS, outpatient hospital facilities and ambulatory surgical centers will get a 2.9%

Medicare 122

Medicare Medicare Medicaid Medicaid 122

Healthcare It News

APRIL 29, 2024

One way hospitals dealt with staffing shortages and the need for beds during COVID-19 was to use flexibilities allowed by the Centers for Medicare and Medicaid Services to treat acute care patients at

COVID-19 264

COVID-19 Medicaid Medicaid Nurses 264

MRO Compliance

FEBRUARY 3, 2025

Below are three key steps health systems, hospitals, and physician practices should take to effectively prepare for the upcoming HEDIS season. 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.

Patient Satisfaction 147

Patient Satisfaction Compliance Medicare Medicare 147

Healthcare IT News - Telehealth

MARCH 4, 2021

Retain important “Hospital without Walls” site of care flexibility to support home-based hospital services. Encourage greater flexibility for home-based care services to meet commercial and Medicare Advantage network adequacy standards. Advocate for a bundled-payment model for extended care in the home.

Hospitals 216

Hospitals Medicare Medicare COVID-19 216

Bill of Health

OCTOBER 17, 2024

This aligns with recent guidance from the Centers for Medicare and Medicaid Services that Medicare Advantage plans may not make a determination of medical necessity solely based on algorithms using broad data sets. Furthermore, AI cannot be used in isolation to deny admission or downgrade hospital stays.

Medicare 150

Medicare Medicare Health Insurance Licensing 150

Healthcare IT News - Telehealth

APRIL 3, 2024

Hospital patients with conditions like pneumonia, dehydration and heart failure have been shown to experience shorter recovery times with fewer complications when they receive more cost-effective healthcare at home – and many health systems have been preparing for this future.

Hospitals 189

Hospitals Medicaid Medicaid Medicare 189

Healthcare It News

JUNE 13, 2023

WHY IT MATTERS Food as medicine programs, designed for patients with complex health and social needs, may reduce avoidable hospitalizations and emergency room visits. KFF's online Medicaid Waiver Tracker has information on which state Medicaid programs are granted 1115 waivers.

Medicaid 286

Medicaid Medicaid HIPAA Hospitals 286

Healthcare Dive

OCTOBER 1, 2024

Threatened with steep sanctions and loss of its agreement with Medicare and Medicaid, Johnson & Johnson is rolling back a plan to give hospitals after-the-fact rebates for drugs in the 340B drug discount program.

Governance 201

Governance Medicaid Medicaid Medicare 201

Healthcare IT News - Telehealth

MAY 14, 2021

Mayo Clinic and Kaiser Permanente announced this week that they will collaborate to build capacity for hospital-at-home care. Technology aimed at blurring the lines between at-home care and in-hospital services has taken on a renewed spotlight amidst the COVID-19 pandemic, when patients and providers have sought to avoid potential spread.

Hospitals 214

Hospitals COVID-19 Medicaid Medicaid 214

Kaiser Health News

FEBRUARY 8, 2022

The federal government has penalized 764 hospitals — including more than three dozen it simultaneously rates as among the best in the country — for having the highest numbers of patient infections and potentially avoidable complications.

Medicare 127

Medicare Medicare Hospitals COVID-19 127

Fierce Healthcare

FEBRUARY 21, 2024

Medicaid disproportionate share hospital (DSH) payments are being cut by $8 billion annually during the current and next four federal fiscal years under a new Centers for Medicare and Medicaid Serv | Published Tuesday and set to go into effect in two months, the final rule limits the calculation of a hospitals Medicaid shortfall to beneficiaries with (..)

Medicaid 102

Medicaid Medicaid Hospitals Medicare 102

Healthcare IT News - Telehealth

MARCH 23, 2021

Now more hospitals and health systems are looking to expand their efforts beyond video visit-based virtual care, and push for expanded remote patient monitoring programs – up to and including the provision of acute care at home. Telehealth proved its mettle this past year. And then the big one being the waiver that came out in November.

Hospitals 217

Hospitals COVID-19 Medicare Medicare 217

Bill of Health

OCTOBER 19, 2023

The traditional model for post-graduate education for medical students, called residency, is regulated by the Accreditation Council for Graduate Medical Education ( ACGME ) and largely funded by the Center for Medicare Services (CMS). While this may have some merit, both students and hospitals also benefit.

Nurses 279

Nurses Medicare Medicare Medicaid 279

Healthcare IT Today

OCTOBER 25, 2024

The recent ransomware attack on OneBlood , a blood center that serves hundreds of hospitals in the south, is just the latest example of a cyberattack having a real-world impact. taxpayer dollars, such as Medicaid and Medicare, if the requisite cybersecurity baseline is not met. medical claims.

Ransomware 121

Ransomware Hospitals Medicaid Medicaid 121

MRO Compliance

NOVEMBER 21, 2024

The Centers for Medicare & Medicaid Services (CMS) 2025 Physician Fee Schedule (PFS) Final Rule brings notable updates to the Quality Payment Program (QPP), which will impact eligible clinicians, groups, virtual groups, subgroups, and APM entities.

Compliance 147

Compliance Medicare Medicare Medicaid 147

Compliancy Group

JANUARY 23, 2025

A classic example is Medicare fraud. Providers who bill Medicare for services they did not actually provide and who present the bill with the knowledge that the service was not performed have committed Medicare fraud. Medicare Advantage Matters Medicare Part C is the largest part of Medicare. While the $1.67

Fraud 98

Fraud Medicare Medicare Regulatory Compliance 98

Healthcare IT News - Telehealth

MARCH 25, 2024

The Centers for Medicare and Medicaid Services just released data on its Acute Hospital Care at Home initiative , which thus far has admitted 11,159 patients suffering from respiratory infections, heart failure and severe sepsis. You contend CMS's Acute Hospital Care at Home program needs scalability to survive.

Hospitals 195

Hospitals Health Outcomes Medicaid Medicaid 195

Healthcare Blog

JANUARY 19, 2025

CMS Medicare Swing Bed Rules and Regulations for Critical Access Hospitals (CAHs) Critical Access Hospitals (CAHs) are the backbone of rural healthcare, providing essential services to underserved communities. This flexibility benefits both the hospital and the patient. Prevent fraud and abuse of Medicare funds.

Medicare 52

Medicare Medicare Compliance Nurses 52

Fierce Healthcare

JULY 30, 2024

As artificial intelligence rapidly makes inroads in healthcare, federal agencies already have the authority to regulator AI at the hospital bedside, according to some healthcare researche | An article published in JAMA Health Forum argues that through the conditions of participation in Medicare and Medicaid, CMS has the authority to oversee how hospitals (..)

Hospitals 131

Hospitals Medicaid Medicaid Medicare 131

Healthcare IT Today

JANUARY 23, 2025

Shah, Co-Founder and CEO at Dina Payers Lean on Technology to Coordinate New Innovative Supplemental Benefits to Improve Quality, Outcomes, and Costs for Seniors Non-medical supplemental benefits like in-home support services, meal delivery, home modifications, and transportation have skyrocketed with Medicare Advantage (MA) plans.

Medicare 97

Medicare Medicare Medicaid Medicaid 97

Healthcare IT News - Telehealth

NOVEMBER 25, 2020

The Centers for Medicare & Medicaid Services on Wednesday took several new steps to help U.S. hospitals manage the crush of new patients as the COVID-19 crisis worsens. Among them are new allowances for telehealth and remote monitoring, for what CMS is calling the Acute Hospital Care at Home program. WHY IT MATTERS.

COVID-19 206

COVID-19 Hospitals Nurses Medicaid 206

Bill of Health

JUNE 15, 2023

By Laura Dolbow Merck recently filed a lawsuit that challenges the constitutionality of the Medicare price negotiation program created by the Inflation Reduction Act. Merck argues that this form of price regulation charts a “ radical new course ” for Medicare that violates the Takings Clause of the Fifth Amendment.

Medicare 195

Medicare Medicare Medicaid Medicaid 195

Healthcare It News

JANUARY 10, 2023

The virtual care services will be delivered without copays, out-of-pocket costs or deductibles for families with active insurance or Medicaid coverage. Before the pandemic, patients had to be in a rural area in a hospital or clinical setting to receive reimbursement for telehealth. WHY IT MATTERS. THE LARGER TREND.

COVID-19 331

COVID-19 Hospitals Telemedicine Medicaid 331

Healthcare IT News - Telehealth

JANUARY 11, 2021

In November, the Centers for Medicare and Medicaid Services took several new steps to help U.S. hospitals manage the crush of new patients as the COVID-19 crisis worsens. Among them were new allowances for telehealth and remote monitoring, for what CMS is calling the Acute Hospital Care at Home program. They like it more.

Hospitals 177

Hospitals Medicare Medicare COVID-19 177

Fierce Healthcare

NOVEMBER 26, 2024

The Centers for Medicare & Medicaid Services (CMS) finalized a six-year mandatory model to increase access to kidney transplants, the agency announced Nov. CMS made some concessions to hospitals who strongly criticized the kidney transplant model proposed rule in May.

Hospitals 124

Hospitals Medicaid Medicaid Medicare 124

HIT Consultant

OCTOBER 22, 2024

Making HPH-CPGs a Condition of Participation (CoP) for CMS : The Centers for Medicare & Medicaid Services (CMS) could require adherence to HPH-CPGs as a condition for participating in Medicare and Medicaid programs.

HIPAA 139

HIPAA Compliance Public Health Medicaid 139

HealthIT Answers

MARCH 11, 2025

This is notification that eligible hospitals and critical access hospitals participating in the Centers for Medicare & Medicaid Services Promoting Interoperability Program that there is an upcoming data submission deadline on March 14, 2025, at 11:59 p.m. Pacific Time.

Medicaid 59

Medicaid Medicaid Medicare Medicare 59

Healthcare IT News - Telehealth

APRIL 10, 2020

The Centers for Medicare and Medicaid Services has temporarily suspended several regulations to enable hospitals, clinics and other providers to boost their front-line medical staff during the coronavirus pandemic.

Nurses 216

Nurses Medicare Medicare Licensing 216

Healthcare IT News - Telehealth

AUGUST 6, 2021

Intermountain Healthcare announced this week that it is expanding the scope and services of its hospital at home program, more than a year since it was first launched in May 2020. The initiative now serves patients at 12 hospitals across Utah, with new locations soon to come. WHY IT MATTERS. Other value-based payers will be added.

Hospitals 172

Hospitals Nurses COVID-19 Medicaid 172

Healthcare It News

OCTOBER 31, 2022

With the Centers for Medicare & Medicaid Services mandating hospitals be ready to report on SDOH screening quality in 2024, a multi-stakeholder effort to advance an FHIR-based approach is needed to help providers meet CMS requirements, according to HL7 CEO Dr.

Licensing 342

Licensing Medicaid Medicaid Health Outcomes 342

Healthcare It News

APRIL 5, 2024

Dell and Northwestern drive AI further into hospital workflows Dell Technologies and Northwestern Northwestern University Feinberg School of Medicine aim to develop and integrate generative multimodal large language models into hospital workflows to improve patient care and reduce physician burnout, according to an announcement Friday from Dell.

US Department of Health and Human Services 312

US Department of Health and Human Services Medicaid Medicaid Hospitals 312

Fierce Healthcare

NOVEMBER 2, 2023

The Centers for Medicare & Medicaid Services has dropped the final rule to remedy the invalidated 340B-acquired drug payment policy for calendar years 2018 to 2022. |

Hospitals 114

Hospitals Medicare Medicare Medicaid 114

AIHC

NOVEMBER 12, 2024

Written by Gabriella Neff, RHIA, CHA, CHC, CHRC, CHPC This past year, in 2024, revisions were made to clarify hospital guidelines related to informed consent specifically addressing UIEs (unconsented intimate exams) to patients while under anesthesia. b)(2); The Medical Record Services CoP at 482.24(c)(4)(v);

Informed Consent 98

Informed Consent HIPAA Compliance Hospitals 98

Healthcare IT News - Telehealth

OCTOBER 14, 2021

A group of healthcare organizations announced this week the launch of the Advanced Care at Home Coalition, an advocacy effort aimed at creating a pathway toward safeguarding access to hospital-level services. "We're going to need to have a few different ways of measuring this." "There's no vanity here.

Hospitals 184

Hospitals Public Health COVID-19 Patient Satisfaction 184

Healthcare IT News - Telehealth

FEBRUARY 5, 2020

The Center for Connected Health Policy has published a 21-page guide intended to help providers with telehealth-based Medicare and Medicaid reimbursements. WHY IT MATTERS. THE LARGER TREND.

Medicare 201

Medicare Medicaid Medicaid Medicare 201

Healthcare IT News - Telehealth

NOVEMBER 8, 2022

Orlando Health on Monday announced that it's been approved by Florida's Agency for Health Care Administration to start delivering hospital-level acute care in adult patients’ homes. " Here are some tips for how health systems should be preparing now for the future of hospital-at-home. WHY IT MATTERS. ON THE RECORD.

Hospitals 147

Hospitals Nurses COVID-19 Medicaid 147

Fierce Healthcare

MARCH 21, 2024

More than 100 provider organizations want the Centers for Medicare & Medicaid Services (CMS) to take a tougher stance on Medicare Advantage (MA) plans’ practices following an industry survey es | Providers spent nearly $20 billion in 2022 pursuing delays and denials across all payer types, yet those efforts are substantially more costly on average (..)

Medicare 144

Medicare Medicare Medicaid Medicaid 144