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. How will the 2023 final rule affect your business? While this seems like a treat, William A.

Medicare 52

Medicare Medicaid Business 52

Nurse Practitioners in Business

JULY 5, 2023

Heads up, though… If you are listening to this before July 20th, 2023 , you’ll have time to get on a webinar with NPBO and Susan Montana , who, among other things, is a Certified Medical Practice auditor. On July 20, 2023, Susan Montana will discuss what to expect in an audit. Would you rather listen?

Business 370

Business Medicaid Medicare Self-Care 370

Capitol Beat

APRIL 4, 2022

Recently, the Biden Administration released its Fiscal Year (FY) 2023 budget proposal. Title VIII Nursing Workforce Development Programs received $294.972 million for FY 2023. billion in discretionary funding for Centers for Medicare and Medicaid Services, a 8% increase from FY 22 $9.9 decrease from FY 22 $4.3

Medicaid 40

Medicaid Medicare Mental Health Nurse Educator 40

American Nurse

FEBRUARY 22, 2024

Missouri’s maternal mortality rates are double the national average, placing the state 38th in the United States (Nickelson, 2023). Additionally, rates of chronic conditions such as obesity, diabetes, and hypertension continue to rise among women of childbearing age (Health in Rural Missouri Biennial Report, 2022-2023). Margiotta, C.,

Medicaid 52

Medicaid Mental Health Health Insurance Promotion 52

Health Leaders | Nursing

FEBRUARY 24, 2023

That provision, along with another to include non-medically directed CRNA services as a mandatory benefit under the Medicaid program, is being cheered by the American Association of Nurse Anesthesiology (AANA).

Medicaid 105

Medicaid Medicare 105

Health Leaders | Nursing

JULY 17, 2024

An amicus brief , published in September 2023, warned that "overruling Chevron would have enormous impact on the administration of federal programs, including Medicare, Medicaid, and CHIP, that are critical to public health."

Medicaid 64

Medicaid Medicare Mental Health 64

Capitol Beat

FEBRUARY 28, 2023

The COVID-19 Public Health Emergency (PHE) that was declared in March 2020 is set to end on May 11, 2023, as the President has announced there will be no more extensions to the PHE. The end of the PHE will also have an effect on the Medicaid program. That means that this will end on December 31 of this year. Anesthesia Services.

APRN 101

APRN Medicaid Medicare Resume 101

Healthcare Law Insights blog

APRIL 28, 2023

The Department of Health and Human Services (HHS) has announced its plan to end the Federal Public Health Emergency (PHE) for COVID-19 on May 11, 2023. Some of these changes have become permanent or extended beyond the end of the PHE due to Congressional action, while some waivers will expire on May 11, 2023. Reimbursement A.

HIPAA 52

HIPAA Medicare Medicaid Telemedicine 52

Health Leaders | Nursing

SEPTEMBER 11, 2023

Editor’s note: This article appeared in the July-September 2023 edition of HealthLeaders magazine. of full-time NPs seeing Medicare patients and 82% seeing Medicaid patients. Senate in April and would allow NPs, physician assistants, and other APRNs to provide particular services under Medicare and Medicaid.

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Nurse Practitioner APRN Medicare Medicaid 144

Healthcare Law Insights blog

JULY 7, 2023

A handful of FCA circuit court decisions issued in 2023 are noteworthy as well. The Sixth Circuit further agreed the amended complained faced another problem: neither the hospital nor the eye care center’s owner submitted claims for Medicare or Medicaid reimbursement for items or services “resulting from” the AKS violation.

Pharmaceutical 52

Pharmaceutical Medicare Medicaid Communication 52

American Nurse

SEPTEMBER 9, 2024

Change this 100-year-old policy (2023) thefreelibrary.com – Nursing is the room rate (2012) HISTORY “Want to Fix the Nursing Shortage?” Medicare, Medicaid, and many private insurers require the use of the National Provider Identifier (NPI) which is administered by the Centers for Medicare and Medicaid Services (CMS).

Medicare 52

Medicare Medicaid APRN Nurse Shortage 52

Minority Nurse

NOVEMBER 13, 2024

That includes advocating for legislation to improve federal employees’ timely access to healthcare for workplace injuries and removing Medicare and Medicaid barriers on NPs and other advanced practice registered nurses. A new study from the AANP supports granting greater access to NPs for patient care.

Nurse Practitioner 59

Nurse Practitioner Medicaid Medicare Licensing 59

American Nurse

APRIL 30, 2024

In this role, she leads projects and advises within the agency aimed at improving care for Medicaid beneficiaries in Texas. Rocha and her team translate that clinical language into policy, determining needs for Medicaid recipients and bringing in specialty clinicians when necessary. Learn more at nursingworld.org/ancc/.

Medicaid 116

Medicaid APRN Health Literacy Nurse Practitioner 116

Scrubs

JUNE 22, 2023

In all cases, the majority were Medicaid enrollees. States across the rural Southeast have not expanded Medicaid coverage to larger numbers of lower-income residents, which often means lower shares of patients have health coverage. South Dakota voters adopted Medicaid expansion in late 2022 and will implement it this summer.

Medicaid 69

Medicaid Education 69

Council of Public Health Nursing Organizations

MARCH 8, 2024

CMS (2022) created rural emergency hospitals (REH) as a separate provider designation effective January 1, 2023. Hospitals within a rural area with not more than 50 beds or that closed after December 27, 2020, can seek designation as a REH as long as they meet the conditions of participation to participate in Medicare and Medicaid programs.

Medicaid 52

Medicaid Medicare Emergency Care Promotion 52

American Nurse

MAY 8, 2023

Takeaways: To help patients and their families make informed decisions about choosing health care, the Centers for Medicare and Medicaid Services (CMS) publicly reports quality performance measures. 2023; 18(5). ahrq.gov/cahps/surveys-guidance/index.html Centers for Medicare & Medicaid Services. March 8, 2023.

Medicare 52

Medicare Medicaid Patient Experience Home Healthcare 52

American Nurse

MARCH 5, 2024

Recently, I had the privilege of meeting with Governor Kelly and several healthcare organizations in Kansas to discuss strategies for passing legislation on Medicaid expansion for the state. We delved into the impact of neighboring states expanding Medicaid, drawing Kansas residents for healthcare services, leading to revenue loss.

Medicaid 52

Medicaid Leadership Business 52

American Nurse

JUNE 13, 2024

Change this 100-year-old policy (2023) thefreelibrary.com – Nursing is the room rate (2012) HISTORY “Want to Fix the Nursing Shortage?” Medicare, Medicaid, and many private insurers require the use of the National Provider Identifier (NPI) which is administered by the Centers for Medicare and Medicaid Services (CMS).

Medicare 52

Medicare Medicaid APRN Nurse Shortage 52

Health Leaders | Nursing

SEPTEMBER 5, 2023

Editor’s note: This article appears in the July-September 2023 edition of HealthLeaders magazine. of full-time NPs seeing Medicare patients and 82% seeing Medicaid patients. Senate in April and would allow NPs, physician assistants, and other APRNs to provide particular services under Medicare and Medicaid. What will it take?

Medicare 116

Medicare Medicaid Telemedicine Nurse Practitioner 116

American Nurse

SEPTEMBER 27, 2023

Despite the evils of the pandemic, one important change was the expansion of private insurance reimbursement for telehealth services as well as Medicare and Medicaid expansion to reduce previously prohibitive barriers of telehealth services. References Centers for Medicare & Medicaid Services. March 17, 2020. link] Zemlak, J.

Medicare 116

Medicare Telemedicine Medicaid Communication 116

American Nurse

SEPTEMBER 5, 2024

among the Black population (March of Dimes, 2023). As reported in the March of Dimes 2023 Report Card, the preterm birth rate in Kansas in 2022 was 10.5 March of Dimes, 2023). According to The State of Babies Yearbook, the percentages of Kansas mothers reporting less that optimal mental health in 2021, 2022, and 2023 were 26.5,

Mental Health 52

Mental Health Medicaid Health Outcomes Education 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 receive Medi­care and Medicaid funding. Hospitals that accept patients with Medicare or Medicaid insurance (approximately 61.4 2023; 18(7). March 2023. 2023 Comprehensive Accreditation Manual.

Medicaid 52

Medicaid Medicare Promotion Leadership 52

American Nurse

MARCH 13, 2024

In fact, the drug is still free for those who are uninsured or enrolled in Medicare, Medicaid, or other federal health programs, including those for veterans. billion in Paxlovid and covid vaccine sales in 2023, after a $57 billion peak in 2022. Pfizer reported $12.5

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Medicare Medicaid Senior Living Long Term Care 111

Healthcare Law Insights blog

NOVEMBER 22, 2022

The Affordable Care Act mandated that the Centers for Medicare and Medicaid Services (“CMS”) establish risk categories for Medicare enrollment, which are used by CMS to determine what level of scrutiny to give provider enrollment applications, which includes initial enrollment, change of ownership (“CHOW”) applications, and revalidations.

Medicare 52

Medicare Medicaid Mental Health 52

Healthcare Law Insights blog

DECEMBER 11, 2023

A hospital that receives what it suspects to be an improper transfer must report their suspicions to the Centers for Medicare and Medicaid Services or the relevant state survey agency within 72 hours of when the hospital suspects they have received an improperly transferred individual. Ass’n, AMA Principles of Med. Ethics: II: 9.4.2

Medicaid 59

Medicaid Medicare Licensing 59

Daily Nurse

JULY 31, 2023

The American Nurses Association (ANA) underscores the urgency for Congressional leaders, the Centers for Medicare & Medicaid Services (CMS), and other key stakeholders to advance efforts in implementing safe staffing standards , including minimum nurse-to-patient ratios.

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Medicaid Medicare Nurse Shortage 98

American Nurse

SEPTEMBER 20, 2024

Roles and responsibilities as a Chief of Staff for Maryland Department of Health I was appointed Chief of Staff at the Maryland Department of Health (MDH) in February 2023. In this role, I bring nearly 15 years of combined state and federal health policy experience to my role.

Medicaid 52

Medicaid Health Insurance Professional Development Communication 52

American Medical Compliance

FEBRUARY 13, 2023

Interoperability of Telehealth The Centers for Medicare and Medicaid Services (CMS) is coming up with a process for improving the exchange of electronic healthcare information and interoperability. Reference Health IT News (2023, January 23). What’s ahead for health IT policy and legislation in 2023. course today.

Medicaid 52

Medicaid Medicare 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 behavioral adjustment proposed for 2023 would permanently reduce the 30-day payment rate by 7.69%. decrease in pay for 2023 is the net effect. The proposed 4.2% Mandatory Telehealth Reporting.

Medicare 52

Medicare Medicaid 52

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. In Ohio, Medicaid recently started covering CGM for all people with diabetes, regardless of what medications they take.

Medicaid 88

Medicaid Medicare Education 88

IntelyCare

MAY 1, 2024

Nearly eight months have passed since The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule to set minimum staffing standards for nursing homes. At the time, the proposed CMS staffing mandate was met with criticism from all sides. The dust has settled — for now.

Long Term Care 101

Long Term Care Licensing Medicaid Medicare 101

American Nurse

JUNE 13, 2024

South Carolina is one of the few states that has not expanded Medicaid. This bill was signed into law in March 2023. SCNA has joined Cover SC, which seeks to strengthen the health and economy of our state through affordable, sustainable healthcare coverage. This bill went into proviso and is awaiting passage of the Senate budget.

Telemedicine 52

Telemedicine Medicaid Promotion Nurse Practitioner 52

American Medical Compliance

FEBRUARY 15, 2023

The Centers for Medicare and Medicaid Services (CMS) require FWA training. CMS FWA Training 2023 The CMS requires both Part D plan sponsors and MA organizations to annually communicate certain compliance and FWA requirements to FDRs or first-tier, downstream, and related entities. Prescription Drug Plans (PDP) provides such coverage.

Medicare 52

Medicare Medicaid Pharmaceutical Federal healthcare 52

American Medical Compliance

FEBRUARY 15, 2023

The Centers for Medicare and Medicaid Services (CMS) require FWA training. CMS EMS Fraud Waste and Abuse Training 2023 The CMS requires both Part D plan sponsors and MA organizations to annually communicate certain compliance and FWA requirements to FDRs or first-tier, downstream, and related entities.

Medicare 52

Medicare Medicaid Pharmaceutical Federal healthcare 52

American Medical Compliance

JUNE 21, 2024

The Department of Health and Human Services (HHS) estimated that improper payments in the Medicare and Medicaid programs exceeded $100 billion from 2016 to 2023. Moreover, as frontline defenders of the healthcare system, healthcare providers play a crucial role in preventing these issues.

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Medicaid Continuing Education Medicare Communication 99

American Nurse

FEBRUARY 16, 2024

Forward to 2023, Nurse’s now utilize the SDOH (Social Determinants of Health) to assess areas that can be affecting the patient’s safety and overall health, such as housing, safe environments free from abuse, access to transportation, and money to afford food and medications. link] Association of Rehabilitation Nurses (n.d.) Karmarkar, A.,

Medicaid 52

Medicaid Medicare Long Term Care Self-Care 52

American Nurse

JUNE 13, 2024

The American Nurses Association (ANA) has done a lot of work to achieve equitable reimbursement of nursing care (McClendon, 2023). Use of NPIs allows advanced practice nurses to bill Medicare and Medicaid for services provided to patients. 2023) Driving the economic value in nursing through equity in nursing care reimbursement.

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Health Outcomes Medicaid Medicare Nurse Educator 52