Healthcare IT News - Telehealth

APRIL 21, 2021

Cavanaugh previously has served as the deputy administrator and director of the Center for Medicare at the Centers for Medicare & Medicaid Services and as deputy director for programs and policy in the Center for Medicare & Medicaid Innovation. Figuring out the best use cases will take good data and analysis.

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COVID-19 Medicare Medicare Telemedicine 213

Compliancy Group

FEBRUARY 12, 2025

Using the ICPG to Maintain an Effective Compliance Program The Centers for Medicare & Medicaid Services (CMS) has issued participation requirements for nursing facilities in the Medicare and Medicaid programs (Requirements of Participation or ROPs). The ICP covers the areas listed below.

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Nurses Compliance Medicare Medicare 52

Healthcare IT News - Telehealth

DECEMBER 14, 2021

This is why, as the new year approaches, Healthcare IT News has sat down with an expert in value-based care to get his views on what 2022 will hold for the payment system. Caravan Health is a privately held company formed to create sustainable methodologies for health systems to excel in value-based care.

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COVID-19 Medicare Medicare Telemedicine 200

Hall Render

JULY 7, 2022

The Consolidated Appropriations Act, 2021 (the “Act”) signed into law on December 27, 2020, created a new Medicare provider type called a Rural Emergency Hospital (“REH”). Critical access hospitals (“CAHs”) and rural hospitals with 50 beds or fewer could transition to REH status starting January 1, 2023.

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Hospitals Payment Systems Medicare Medicare 70

HIT Consultant

APRIL 21, 2022

What You Should Know: – Centers for Medicare & Medicaid Services’ (CMS) payment adjustments did not adequately address hospitals increased costs for FY 2021, according to new data from Premier. – The data reveals this discrepancy has resulted in hospitals receiving only a 2.4 PINC AI™ Data Analysis.

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Hospitals COVID-19 Payment Systems Medicaid 52

HIT Consultant

OCTOBER 30, 2023

The impact on eligible hospitals would be the loss of 75 percent of the annual market basket increase; for CAHs, payment would be reduced to 100 percent of reasonable costs instead of 101 percent.

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Medicare Medicare Payment Systems Hospitals 98

The Health Law Firm

AUGUST 30, 2013

Board Certified by The Florida Bar in Health Law On August 2, 2013, the Centers for Medicare and Medicaid Services (CMS) released the 2014 Inpatient Prospective Payment System (IPPS) Final Rule (the 2014 IPPS Final Rule). Indest III, J.D.,

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Hospitals Payment Systems Medicaid Medicaid 40

Electronic Health Reporter

JANUARY 15, 2019

The 340B Drug Pricing Program was created in 1992 to give safety net providers — those that deliver a significant level of both healthcare and other health-related services to the uninsured, Medicaid, and other vulnerable populations — discounts on outpatient drugs to “stretch scare federal resources as […].

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Medicaid Medicaid Payment Systems Medicare 107

Medisys Compliance

MARCH 14, 2023

Wound care is provided in various healthcare settings like inpatient hospital, outpatient clinics, long-term care facilities, home health settings, hospice and skilled nursing facilities. For example, patients who require ongoing wound care but do not need to be hospitalized can receive treatment in outpatient clinics.

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Payment Systems Medical Billing Medicare Medicare 52

Hall Render

AUGUST 1, 2022

REHs are intended to help address barriers in access to health care, particularly emergency services and other outpatient services that result from rural hospital closures. Hospitals may only convert to REHs if they were a CAH or rural hospital with not more than 50 beds participating in Medicare as of December 27, 2020.

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Hospitals Payment Systems Medicare Medicare 40

AIHC

NOVEMBER 15, 2022

Written by Joanne Byron , BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, COCAS, CORCM, OHCC, ICDCT-CM/PCS The Federal Hospital Price Transparency Rule helps Americans know the cost of a hospital item or service before receiving it. The regulation aims to improve the affordability of hospital care by promoting price competition.

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Hospitals US Department of Health and Human Services Compliance Governance 52

Healthcare IT Today

NOVEMBER 15, 2023

The technique involves finding data from public sources such as Centers for Medicare & Medicaid Services (CMS). Resilient Healthcare Employs Extensive Data Analytics Resilient Healthcare provides in-home care for conditions that have traditionally required a hospital stay. offering in-home treatment.

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Medicare Medicare Hospitals Compliance 124

AIHC

JANUARY 28, 2022

Medicare Uncompensated Care Payments & DSH Hospitals' charity care and bad debt, together known as uncompensated care, is used to calculate disproportionate-share hospital payments. This is calculated based on the hospital’s relative share of uncompensated care nationally.

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Hall Render

MARCH 4, 2025

SNF services covered by the Medicare Part A Skilled Nursing Prospective Payment System (PPS) payment are not designated health services (DHS) for purposes of the PSL. Nursing Facility ICPG and Physician Self-Referral Law The federal physician self-referral law (PSL) at Section 1877 of the Social Security Act , 42 U.S.C.

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Compliance Nursing Homes Nurses Medicare 52

Medisys Compliance

FEBRUARY 9, 2024

Hospital Outpatient Prospective Payment System (OPPS) Updates OPPS is a payment system used by Medicare to reimburse hospitals for outpatient services, including some wound care procedures. These updates reflect changes in healthcare costs and utilization patterns.

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Medical Billing Outsourcing Payment Systems Medical Billing Medicare 59

Healthcare IT Today

DECEMBER 31, 2020

To further support clinicians during the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services (CMS) has extended the deadline for COVID-19 related 2020 Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances Exception applications to February 1, 2021.

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COVID-19 Payment Systems Medicaid Medicaid 52

Hall Render

MARCH 1, 2023

Following this reporting, impacted providers and teaching hospitals will have until May 15, 2023, to review reported payments and investments and to dispute any incorrect reports. During the Dispute Period, Covered Recipients may use CMS’ Open Payments system to formally dispute any information they believe is incorrect.

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Hospitals Payment Systems Nurses Medical Device Industry 40

Medisys Compliance

AUGUST 4, 2022

Proposed ESRD Payment System. This rule also proposes an update to the Acute Kidney Injury (AKI) dialysis payment rate for renal dialysis services furnished by ESRD facilities for calendar year (CY) 2023. Direct nursing services include registered nurses, licensed practical nurses, technicians, social workers, and dietitian.

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Medical Billing Medical Billing Outsourcing Payment Systems Medicare 59

YouCompli

FEBRUARY 22, 2023

Price increases can sometimes result in inappropriate outlier payments. Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. It is “prospective” because hospitals and other providers know ahead of time what they will be reimbursed.

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Compliance US Department of Health and Human Services Overpayment Overpayments 52

Medisys Compliance

APRIL 11, 2024

You can bill for services provided in various settings, including your private practice office, hospitals, outpatient clinics, and even some telehealth platforms. Telehealth Considerations Telehealth has become an increasingly important aspect of mental healthcare delivery.

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Medicare Medicare Medical Billing Outsourcing Medical Billing 59

HIT Consultant

JULY 25, 2024

What You Should Know: – Avenda Health , a pioneer in AI-powered prostate cancer care, announced today that the Centers for Medicare & Medicaid Services (CMS) has assigned a national payment rate for its prostate cancer mapping technology, Unfold AI.

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Medicare Medicare Payment Systems Medicaid 52

Hall Render

SEPTEMBER 5, 2024

On August 1, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released the Fiscal Year 2025 Hospital Inpatient Prospective Payment System Final Rule (“Final Rule”), finalizing the proposed Transforming Episode Accountability Model (“TEAM”). A list of the mandatory CBSAs can be found here.

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Payment Systems Hospitals Medicare Medicare 40

C&M Health Law

DECEMBER 23, 2022

The regulations impact CMS-regulated payers and provide incentives for providers and hospitals that participate in the Medicare Promoting Interoperability Program and the Merit-based Incentive Payment System (MIPS). Most of the Proposed Rule’s provisions will be effective on January 1, 2026. Patient Access API. (i)

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Medicare Medicare Medicaid Medicaid 59

HIT Consultant

AUGUST 28, 2023

.” The standard playbook for success in the medical facility industry focuses on factors like identifying and delivering in-demand services, establishing a strong brand and building relationships with local hospitals and physicians to create a referral network. But mergers and acquisitions can lead to major headaches for AP processes.

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Payment Systems Compliance Medicaid Medicaid 103

Health Law Attorney

DECEMBER 18, 2020

The Centers for Medicaid & Medicare Services ( CMS ) recently released the 2021 Outpatient Prospective Payment System ( OPPS ) and Ambulatory Surgical Center ( ASC ) Final Rule, which may be accessed here. CMS will be phasing the IPO list out over the next three years, with the IPO being completely phased out by CY 2024.

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Medicare Medicare COVID-19 Payment Systems 40

Hall Render

AUGUST 10, 2023

On August 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its Final Hospital Inpatient Prospective Payment System (“IPPS”) and Long-Term Care Hospital (“LTCH”) PPS rule for fiscal year (“FY”) 2024 (“Final Rule”). The Final Rule increases the rate for IPPS payments by 3.3%

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Hospitals Medicare Medicare Medicaid 40

Compliancy Group

JUNE 28, 2024

HHS OIG determines whether a provider information blocking violation has occurred, and then notifies the Centers for Medicare and Medicaid Services (CMS) of its determination. For CAHs, payment will be reduced to 100 percent of reasonable costs instead of 101 percent. CMS may then apply the disincentive.

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Medicare Medicare Hospitals HIPAA 59

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. RFI on additional payment policies recognizing advanced primary care services.

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Medicare Medicare Payment Systems Medicaid 52

AIHC

NOVEMBER 29, 2023

Hospital reimbursement also changed. In 1983 Medicare shifted to the inpatient Prospective Payment System (PPS) and DRGs (Diagnostic Related Groups) and only paying a limited number of days to the hospital regardless of the actual length of stay. healthcare system were exorbitant.

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Medicare Medicare Medicaid Medicaid 59

Hall Render

AUGUST 6, 2024

The Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) on August 1, 2024. Background on Rural and Urban Delineations Medicare classifies hospitals by rural and urban status for a variety of payment purposes.

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Medicare Medicare Payment Systems Hospitals 40

Hall Render

AUGUST 6, 2024

The Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) on August 1, 2024. Background on Rural and Urban Delineations Medicare classifies hospitals by rural and urban status for a variety of payment purposes.

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Medicare Medicare Payment Systems Hospitals 40

Hall Render

APRIL 12, 2024

On April 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Proposed Rule (“Proposed Rule”). Background Medicare classifies hospitals by rural and urban status for a variety of payment purposes.

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Medicare Medicare Payment Systems Hospitals 40

Verisys

JUNE 13, 2023

Centers for Medicare & Medicaid Services : The US Department of Health and Human Services has issued a final rule update concerning guidelines for COVID-19 vaccination requirements for Long-Term Care Facilities (LTC) and Intermediate Care for Individuals with Intellectual Disabilities (ICFs-IID). All are effective July 5, 2023.

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COVID-19 Vaccine US Department of Health and Human Services COVID-19 Licensing 52

Hall Render

SEPTEMBER 2, 2022

On July 26, 2022, the Centers for Medicaid and Medicare (“CMS”) published the 2023 Hospital Outpatient Prospective Payment System (OOPS) and Ambulatory Surgery Center Payment System Proposed Rule. Background. Once a facility converts to an REH, it cannot provide inpatient services. New Stark Exception.

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Payment Systems Hospitals Medicare Medicare 40

CMS.gov

NOVEMBER 15, 2018

Administrator, Centers for Medicare & Medicaid Services. Approximately 60 million people live in rural areas – including millions of Medicare and Medicaid beneficiaries. We know that accurate and appropriate Medicare payment rates are essential to all hospitals, especially rural ones. Jeremy.Booth@c…. Seema Verma.

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Hall Render

AUGUST 27, 2024

The Centers for Medicare & Medicaid Services (“CMS”) will publish the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) in the Federal Register on August 28 with an effective date of October 1, 2024. reduction to their inpatient payments. reduction to their inpatient payments.

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Hospitals Payment Systems Medicare Medicare 40

AIHC

NOVEMBER 29, 2023

Hospital reimbursement also changed. In 1983 Medicare shifted to the inpatient Prospective Payment System (PPS) and DRGs (Diagnostic Related Groups) and only paying a limited number of days to the hospital regardless of the actual length of stay. healthcare system were exorbitant.

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Medicare Medicare Medicaid Medicaid 52