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"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.
In just the first three quarters of 2024, 155 providers have been added to the Texas Health and Human Services Commission Medicaid exclusion list. Over 4 million people in Texas are covered by Medicaid, and the Texas OIG exclusion list provides protection for each of them, as well as for healthcare facilities.
Chris Oskuie, VP, State & Local Government &Education Sales at Software AG Government Solutions As a result of the Families First Coronavirus Response Act (FFCRA), Medicaid programs were required to keep citizens continuously enrolled through the COVID-19 public health emergency (PHE).
With the temporary flexibilities from HHS and the Centers for Medicare and Medicaid Services, as well as the impact of the pandemic on telehealth use, we really wanted to kind of do a deep dive and to see, "OK, how many beneficiaries are using telehealth? Was there anything that surprised you in the report?
The federal False Claims Act prohibits someone from knowingly presenting or causing a false claim for payment if the federal government will pay for that claim. 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.
In previous years, the USDA has funded food equity programs through Medicare and Medicaid. She reported positive results for diabetes sufferers from a study involving Instacart delivery of curated boxes of produce prescriptions to Medicaid population diabetic or pre-diabetic individuals for six months.
More > Tags: Audit , Centers for Medicare & Medicaid Services , CMS , COVID-19 , Healthcare Compliance Issues , Medicaid , Medicare , regulatory compliance. Just as the pandemic may finally be easing, federal focus on use of COVID-19 resources promises to increase healthcare providers’ stress.
The Iowa Department of Health and Human Services has announced there have been three separate breaches of the protected health information of Iowa Medicaid recipients in the past two months – two hacking incidents and an impermissible disclosure, all three of which involved third-party contractors.
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.
Social determinants of health are major contributors to health inequity and rising healthcare costs in vulnerable populations such as Medicaid beneficiaries. For example, training a predictive model on the general population may be inaccurate when used in a Medicare or Medicaid population. Twitter: @SiwickiHealthIT.
Unlike chronic hypertension, HDP requires more immediate and precise monitoring to address the sudden and acute risks it presents. Reimbursement challenges exist While RPM could provide immense benefits, some State Medicaid funding falls short. Addressing this oversight in reimbursement could enable RPM to reach its full potential.
The settlement compelled the tobacco companies to pay billions of dollars to the states to compensate them for Medicaid costs incurred by smokers, placed limits on tobacco advertising, and funded public information efforts. territories, and the District of Columbia.
The Centers for Medicare and Medicaid Services recently opened the much-anticipated federal Independent Dispute Resolution (IDR) Portal , a component of the No Surprises Act section of the Consolidated Appropriations Act of 2021 (the Act). By: Jessica Waltman, Principal, Forward Health Consulting.
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.
" VanLandingham, who is senior counselor, Medicaid Policy/Acting Health IT at the agency, will be presenting at HIMSS21 this summer, HHS-OIG colleague, Assistant Inspector General for Legal Affairs Lisa Re. Overall, she says she hopes attendees leave their presentation with a sense of what compliance requires.
However, COVID has presented a new and more formidable challenge. The highest scores on the Index tended to cluster in states in the South and West that have not accepted the Medicaid expansion under the Affordable Care Act. For patients in poorer rural areas, the risk of hospital closures presents an especially serious threat.
Director of Healthcare Strategy, LexisNexis Risk Solutions During the peak of the Covid-19 pandemic, over 10 million Americans enrolled in Medicaid – nearly a 14% increase from the beginning of 2020. A month before the public health emergency ended on May 11, 2023, 87 million individuals were enrolled in Medicaid.
The Centers for Medicare and Medicaid Services also has temporarily suspended rules around telehealth , allowing care across state lines, and also allowing physicians to care for patients at rural hospitals “via phone, radio or online communication, without having to be physically present.” ” ON THE RECORD.
Meanwhile, the Centers for Medicare and Medicaid Services recently issued a final rule making permanent some changes to telehealth , although Administrator Seema Verma said it would be up to Congress to ensure virtual care would not return to a wholly rural benefit. ON THE RECORD.
history, which is now killing more than 100,000 people a year, the country’s outdated and restrictive federal regulatory schemes that pertain to methadone and buprenorphine present a pernicious and persistent barrier to accessing OUD medications. However, during the worst drug poisoning crisis in U.S.
"We found that patients covered by Medicaid and Medicare had the highest in-person follow-up rates," they said. High rates of in-person follow-up were present only in specialties that require hands-on care, such as obstetrics and surgery.
The Centers for Medicare & Medicaid Services (CMS) is reinforcing its emphasis on hospice quality of care and identifying fraud. Services should not be curtailed due to staffing shortages, lack of supplies or inability to provide any service the hospice presents as part of its program.
Last month, the Centers for Medicare & Medicaid Services (CMS) held the first ever CMS Health Equity Conference. CHIR members who attended the inaugural conference provide an overview of the meeting—including a presentation by CHIR’s Christine Monahan—and its implications for current and future health equity initiatives.
Advocacy efforts could include sharing patient stories, presenting evidence-based recommendations, and emphasizing how certain policy decisionsor the lack thereofaffect patient care and health outcomes. Health equity, beyond being an ethical imperative, should be viewed as a long-term investment.
SkinCure Oncology has notified 13,434 patients about an email attack that occurred in June 2023, and the Wisconsin Department of Health Services has announced a breach of the personal information of 19,150 Medicaid recipients. SkinCure Oncology believes files in those email accounts were viewed and potentially obtained in the attack.
This past week, a bipartisan group of House representatives – all of whom were present on the call – introduced the Protecting Access to Post-COVID-19 Telehealth Act.
"I like that I can touch 10 patients instead of five in one day, and I can see them on my own rather than relying on someone else's assessment," said one provider quoted in the panel presentation. "I know their baseline and when they call, I send the [mobile telemedicine technicians] there."
The Medicaid population, who typically benefits from progress last, still grapples with harmful biases within the healthcare system that pose extreme barriers to care. Research lays the foundation for equitable healthcare and where there is a lack of research, notable biases are present. The CDC found that in 2020, 18.4%
With so many providers falling onto the OMIG list and the need for hiring picking up speed, the traditional manual approach to managing these lists isnt just time-consuming but also presents a variety of risks. Simply put, the manual method isnt cutting it for healthcare businesses anymore, regardless of the organizations size.
Gallup and West Health presented their study in a webinar earlier this week; in today’s post, I feature a few key data points that particularly resonate as I celebrate/appreciate yesterday’s U.S. Compared with people enrolled in Medicaid, members of private insurance plans were more likely to have medical debt. households.
This past week, Centers for Medicare and Medicaid Services Administrator Seema Verma said she "can't imagine going back" to making beneficiaries return to in-person visits after the agency's relaxation of telehealth regulations in response to the coronavirus pandemic.
In their presentation Hasselberg and Richman describe how they developed the new telehealth model, which capitalized on the psychiatric skills of their colleagues in Rochester while extending their reach into rural communities. " Michael Hasselberg, Rochester University Medical Center.
More than 100 physician groups, led by the American Medical Association, told the Centers for Medicare and Medicaid Services in no uncertain terms this past week that, while they supported temporary regulatory relaxations in response to COVID-19, they were strongly opposed to certain rules changes being made permanent. WHY IT MATTERS.
Meanwhile, the Centers for Medicare and Medicaid Services' final rule , "Modernizing and Clarifying the Physician Self-Referral Regulations," notes that the existing framework is tailored to a fee-for-service model.
Meanwhile, the Centers for Medicare and Medicaid Services' Center for Program Integrity also announced that it has taken administrative actions against more than 50 healthcare providers alleged to be involved in similar schemes. healthcare system at the expense of patients."
The Centers for Medicare and Medicaid Services included phone-based services in its temporary expansion of telehealth benefits earlier this spring, but some lawmakers have pushed back against reimbursement parity for telehealth services compared to in-person care.
With a shortage of physicians to address the growing need for care, a lack of providers who accept Medicaid, and access issues due to transportation or office hour challenges, healthcare organizations are looking to technology to help bridge the gap. Addressing the increasing need for behavioral health services is a nationwide challenge.
This code is often used when patients present with some chronic condition or disease with complex symptoms. Detailed Medical History On patient presentation, the medical history of the patient is taken to make a probable diagnosis. History has many parts, and it starts with presenting complaints. When to use CPT code 99204?
What is a Medicaid Fraud Control Unit (MFCU)? But these programs cannot be controlled by Medicaid and Medicare alone. But these programs cannot be controlled by Medicaid and Medicare alone. With this legislation, Medicaid Fraud Control Units (MFCUs) were born.
The partnership brings yet another level of important care services into the home for health plans using MedArrive, especially those that serve Medicaid beneficiaries. More than one in four Medicaid beneficiaries have some form of CVD, rates that are often much higher than in other populations.
So the driving factors that might encourage that type of platform weren't present to allow for it," he continued. Centers for Medicare and Medicaid Services make permanent. "Traditionally, telehealth visits are not reimbursed by private payers, or, when they are, it's at a fraction of the cost.
IKC Inova Health System has relied on evidence-based solutions and standardized approaches to treat patients, earning recognition for excellence in healthcare from the Centers for Medicare and Medicaid Services (CMS), U.S. News & World Report Best Hospitals, and Leapfrog Hospital Safety Grades. THE PROBLEM.
"Of those patients, 84 (20%) were readmitted to inpatient care and 35 (8%) presented at the emergency department as a recurrent visit but were stabilized and sent home." "All 417 patients in the study had been admitted to the hospital with a diagnosis of CHF," he continued.
Jeff Geier, Cyber Security Leader at Pivotalogic California’s bold new CalAIM Medicaid transformation program is restructuring what partnership for health looks like across the state. This initiative presents a great opportunity for CBOs, which often lack the resources and expertise to undertake such comprehensive initiatives on their own.
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