Relias

OCTOBER 6, 2021

Individual states determine provider rates and must include these rates in their state’s Medicaid Plan, which is ultimately reviewed by the Centers for Medicaid and Medicare Services (CMS). Sadly, in our 2021 DSP Survey Report, we found that these sentiments continued to resonate with DSPs. In our 2021 survey, 65.8%

Medicaid 105

Medicaid Leadership Health Insurance Medicare 105

Consult QD

MAY 16, 2023

A new policy from the Centers for Medicare & Medicaid Services (CMS) vastly expands coverage for continuous glucose monitoring (CGM), putting better type 2 diabetes management within reach for millions more patients. 2021; 325 (22):2262-2272) Previously, CGM was covered only for those who required mealtime insulin. Martens et al.

Medicaid 88

Medicaid Medicare Education 88

Scrubs

JUNE 29, 2023

UBS, a global financial services company, decided to investigate the issue when UnitedHealth Group, whose stock is analyzed by the firm, reported that healthcare utilization rates have skyrocketed among Medicare beneficiaries. The injury rate among this age group will likely continue to grow as more seniors discover the sport.

Medicare 75

Medicare Health Outcomes 75

Relias

FEBRUARY 2, 2023

The 2023 Home Health Final Payment Rule , which the Centers for Medicare and Medicaid Services (CMS) released in October, increases Medicare payments for home health agencies by 0.7%, or $125 million, compared to 2022. While this seems like a treat, William A. The final rule includes a 4.1% net inflation rate update.

Medicare 52

Medicare Medicaid Business 52

American Nurse

JUNE 3, 2024

3W3aHFM Centers for Medicare & Medicaid Services. cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalHCAHPS. Indianapolis, IN: Sigma Theta Tau International; 2021. J Autism Dev Disord. 2017;47(5):1510-29. doi:10.1007/s10803-017-3040-5 Center for Autism Related Disabilities.

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Communication Medicare Self-Care Mental Health 111

Daily Nurse

AUGUST 7, 2023

“For example, an analysis by McKinsey & Co found that telehealth accounted for less than 1% of Medicare services before the onset of the pandemic, but by July of 2021, telehealth services accounted for about 13-17% of claims submitted to Medicare.

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APRN Licensing Medicare HIPAA 98

Healthcare Law Insights blog

MAY 17, 2023

One study of cosmetic surgery data found that body procedures like tummy tucks, buttock augmentation, and liposuction increased by 63 percent from 2020 to 2021. [1] billion on aesthetic procedures in 2021 with surgical revenues increasing by 63 percent. [4] 12, 2021, available at [link]. 12, 2021, available at [link].

Medicare 52

Medicare Medicaid 52

Relias

JANUARY 11, 2023

For example, less than 20% of Medicare spending is currently value-based. But momentum will continue, since the Centers for Medicare and Medicaid Services (CMS) announced in 2021 that it plans to transition fully to value-based reimbursement by 2030. Here’s what you need to know about value-based payments.

Medicare 52

Medicare Medicaid Patient Satisfaction Business 52

Relias

AUGUST 15, 2022

Centers for Medicare and Medicaid Services (CMS) proposes a decrease in Medicare reimbursement for home health agencies by 4.2% The act mandates a six-year monitoring period for the Patient-Driven Groupings Model ( PDGM), the home health payment model implemented for Medicare in 2020. Cap on Negative Wage Index.

Medicare 52

Medicare Medicaid 52

Council of Public Health Nursing Organizations

MARCH 8, 2024

To increase access to healthcare in rural areas and to respond to the hospital closures, in 2021 congress passed the Consolidated Appropriations Act ( Public Law 116-260 ). Centers for Medicare & Medicaid Services. CMS (2022) created rural emergency hospitals (REH) as a separate provider designation effective January 1, 2023.

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Medicaid Medicare Emergency Care Promotion 52

Healthcare Law Insights blog

APRIL 25, 2022

Prior to the pandemic a Centers for Medicare and Medicaid pilot study yielded positive results with respect to hospital readmission rates and follow-up emergency department visits. A survey in September 2021 showed that patients who received ACHAH care were highly satisfied (88%) and were likely to recommend it to friends and family (85%).

Medicaid 52

Medicaid Medicare Patient Satisfaction Business 52

Nurse.com

APRIL 14, 2022

In August 2021, Delaware Governor John Carney signed legislation that grants the state’s nurse practitioners full practice authority (FPA) , making Delaware the 24th state to adopt FPA legislation — and not a moment too soon. “This is a major milestone in health care for Kansas and for our nation,” said Kapu in a news release.

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Nurse Practitioner APRN Medicare Patient Satisfaction 98

Relias

DECEMBER 8, 2022

Every year, the Centers for Medicare and Medicaid Services (CMS) releases the Program for Evaluating Payment Patterns Electronic Report (PEPPER). Utilizing data from the most recent three calendar years, the PEPPER offers providers specific Medicare data statistics for discharges or services that may be vulnerable to improper payments.

Medicare 52

Medicare Medicaid Self-Care Education 52

Relias

SEPTEMBER 1, 2022

With the successes reaped during the pilot of the Home Health Value-Based Purchasing (HHVBP) program, the Centers for Medicare and Medicaid Services (CMS) aims to accelerate the results nationwide. The program started in 2016 as a pilot to determine the impact of financial incentives on home health agencies in nine states. million decrease.

Medicare 52

Medicare Self-Care Medicaid Communication 52

Healthcare Law Insights blog

MARCH 25, 2022

The Emergency Temporary Standard (ETS) for Occupational Exposure to COVID-19 for healthcare and healthcare support service workers (OSHA Healthcare ETS) was originally published on June 21, 2021. Potential changes in the OSHA Healthcare ETS. OSHA is not considering mandating vaccines for employees.

Medicaid 52

Medicaid Medicare Business 52

Capitol Beat

NOVEMBER 4, 2022

The ICAN Act would remove unnecessary and outdated barriers to providing care for APRNs across the country so they can better care for their patients who are enrolled in Medicare and Medicaid programs. ANA will continue working with federal policy makers to expand access to APRN care and advance the nursing profession.

APRN 52

APRN Medicaid Medicare Mental Health 52

American Nurse

JULY 5, 2023

The Centers for Medicare and Medicaid Services (CMS) provides federal oversight of care quality in all U.S. Hospitals that accept patients with Medicare or Medicaid insurance (approximately 61.4 million have Medicare, Parts A and B, and 75.8 Doi: 10.51256/ANJ072339 Reference Centers for Medicare and Medicaid Services.

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Medicaid Medicare Promotion Leadership 52

Capitol Beat

AUGUST 24, 2022

As we know, there are many issues nurses care about, but for this year’s Hill Day, we focused on three key topics: Improving Seniors’ Timely Access to Care Act of 2021 (S.3018/H.R. The goal of this legislation is to remove burdensome administrative barriers for all four APRN roles to deliver care to their patients.

APRN 52

APRN Medicare Communication Education 52

American Medical Compliance

DECEMBER 26, 2023

On December 27, 2020, the United States Congress adopted the No Surprises Act (NSA) as part of the Consolidated Appropriations Act of 2021, which has various provisions to assist in protecting customers against unexpected costs beginning January 1, 2022. The following course highlights the NSA and how it impacts healthcare.

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Health Insurance Medicaid Medicare 52

American Medical Compliance

NOVEMBER 3, 2022

The end of 2021 to early 2022, approximately 21 months into the COVID-19 pandemic, saw the addition of a second electronic survey that was exclusive to physicians. The AMA released a statement indicating that in 2021, the prevalence of burnout among U.S. This study would take place over three-year intervals. doctors was 62.8%.

Telemedicine 52

Telemedicine Mental Health Medicare Promotion 52

American Nurse

MARCH 6, 2024

Silver Spring, MD: American Nurses Association ; 2021. doi:10.1136/bmj.m865 Centers for Medicare and Medicaid Services. 2021; 16(5):e0252151. August 24, 2021. Br J Clin Pharmacol. 2020; 86(1):29-38. doi:10.1111/bcp.14164 14164 American Nurses Association. Nursing: Scope and Standards of Practice. Backhouse A, Ogunlayi F.

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Telemedicine Health Insurance Health Literacy Promotion 98

Relias

APRIL 18, 2022

Medicare payment models in skilled nursing and home health provide incentives for clinicians to be well versed in specialty areas such as skin and wound care. Chronic wounds affect about 15% of Medicare beneficiaries each year. Editor’s note: This post was originally published in January 2021 and updated.

Education 52

Education Medicare Promotion Medicaid 52

American Nurse

FEBRUARY 16, 2024

In 2012, the Centers for Medicare and Medicaid Services implemented the Hospital Readmissions Reduction Program (HRRP). Prescription Opiates [link] Centers for Medicare and Medicaid Services (n.d) [link] Li, C. Education can be formal or informal, depending on the complexity of the patient’s needs. Karmarkar, A.,

Medicaid 52

Medicaid Medicare Long Term Care Self-Care 52

Capitol Beat

JANUARY 2, 2023

7666, the Restoring Hope for Mental Health and Well-Being Act of 2021 was included. Annual Medicare Payment Changes Medicare providers were faced with 8.5% We are pleased to report that H.R. Specifically, ANA supported the inclusion of H.R. 1384, the Mainstreaming Addiction Treatment (MAT) Act.

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Clinical Nurse Specialist Chief Nursing Officer Medicare APRN 40

Consult QD

MAY 22, 2023

It is the number one cause of hospitalizations in the Medicare population and accounts for approximately 1 million hospitalizations annually. Treatment options for end-stage heart failure include heart transplant and LVAD therapy.

Medicare 52

Medicare Promotion 52

Capitol Beat

MARCH 15, 2022

Nursing Title VIII Nursing Workforce Development programs received $280.472 million, which is a $16 million increase over Fiscal Year 2021. The Committee requests a report within 180 days of enactment of this Act addressing the role of Medicare funding in supporting the training of nursing and allied health professionals.

Medicare 40

Medicare Mental Health APRN Telemedicine 40

Consult QD

MAY 1, 2023

Ballroom B (Hynes) Laryngology/Bronchoesophagology TRIO Session Trends in Medicare Reimbursement for Laryngology Procedures between 2000-2021 Author List: Nicole Maronian, MD; Todd Otteson, MD, MPH; Robert Lorenz, MD, MBA ; Michael Lerner, MD; Paul Bryson, MD, MBA 4:05-4:20 P.M. Byrne, MD, MBA – Presenter 9:00-9:40 A.M.

Medicare 40

Medicare 40

Nursing Review

MARCH 31, 2023

ChatGPT, a chatbot that makes predictions based on a vast dataset of words and natural human dialogues, gained over 100 million users in the first two months after its launch in November 2021. It can produce discharge papers a person could use for Medicare or insurance claims and create transcripts of conversations.

Communication 52

Communication Medicare Education 52

American Nurse

FEBRUARY 21, 2024

found that failure to document or falsifying documentation increased in frequency and severity in 2020, compared to 2015 and 2021. Finally, deliberately falsifying documentation (such as submitting false claim to Medicare) can subject nurses to sanctions under the federal False Claims Act. References American Nurses Association.

Licensing 52

Licensing Legal Issues Medicare Promotion 52

The Nurse Break

NOVEMBER 30, 2022

The following article was written March 28, 2021. In Australia, more than 30 million Medicare eligible telehealth consultations have occurred since March 2020, and patients overwhelmingly want the format to continue. Kate Renzenbrink | Director of Nursing & Midwifery Informatics (CNMIO).

Pharmaceutical 52

Pharmaceutical Medicare Health Outcomes Business 52

Celayix

FEBRUARY 7, 2023

billion in health care fraud settlements and judgments in 2021. There is also the patient family, and the patient insurance provider, or the government in the case of Medicare or Medicaid. Fraud is unfortunately, very common in home healthcare. In fact, the federal government saw a return of nearly $1.9 There is of course, the patient.

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Home Healthcare Medicaid Business Medicare 52

The Nurse Break

DECEMBER 20, 2022

I am currently based in Melbourne working as a Clinical Nurse Specialist within a metropolitan ICU, I joined this unit in 2021 as a Critical Care Registered Nurse and was promoted to CNS in 2022. Where in Australia/clinical area are you now working? How did you get a job initially in Australia?

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Clinical Nurse Specialist Medicare Promotion 52

Relias

DECEMBER 13, 2021

The increased pressure of the COVID-19 pandemic has presented never-before-seen growth opportunities for home health agencies and their workforce, as Bill Dombi, President of the National Association of Home Care and Hospice (NAHC), noted in a December 2021 webinar titled The State of Home Health.

Professional Development 52

Professional Development Medicaid Health Insurance Medicare 52

Nursing Review

SEPTEMBER 30, 2024

billion (in premium rebates) in 2021–22. Medicare also subsidised fees for medical services delivered for private patients in private and public hospitals to the tune of $3.81 Taxpayers subsidise the private health system Australian taxpayers subsidised private health insurance premiums by A$6.3 billion in 2023–24.

Health Insurance 52

Health Insurance Medicare Licensing Business 52

Relias

JUNE 1, 2022

Another case alleged that a health system defrauded the Centers for Medicare and Medicaid Services of $1 billion because doctors were pressured to add diagnosis codes to medical records that were nonexistent or unrelated to the visit. Many providers were noncompliant with 2021 E/M coding documentation guidelines.

Outpatient Clinic 52

Outpatient Clinic Retirement Legal Issues Medicaid 52

Relias

JUNE 1, 2022

Another case alleged that a health system defrauded the Centers for Medicare and Medicaid Services of $1 billion because doctors were pressured to add diagnosis codes to medical records that were nonexistent or unrelated to the visit. Many providers were noncompliant with 2021 E/M coding documentation guidelines.

Outpatient Clinic 52

Outpatient Clinic Retirement Legal Issues Medicaid 52

American Nurse

SEPTEMBER 5, 2024

According to Chaffee (2021), the evidence connects cannabis use to poor oral health. Missouri skilled nursing facility residents (N=253) reported that 49% of residents rely on staff to clean their mouth, many have no Medicare dental coverage, and Medicaid covers a limited number of dental services (The Oral Health of Adults, 2022).

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Medicare Self-Care Promotion Communication 52