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. Much of Medicare is in statute, and as a result the Administration has limited authority to expand telehealth absent Congressional action. 42 CFR §482.12(c)(1)–(2)

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APRN Medicaid Medicare Resume 101

Capitol Beat

JANUARY 4, 2024

Not surprisingly, the main focus of advocacy is the federal Department of Health and Human Services (HHS) and its subagency, the Centers for Medicare and Medicaid Services (CMS). CMS is strengthening the Medicare Diabetes Prevention Program (MDPP) , which ANA supports.

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APRN Medicare Long Term Care Medicaid 73

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

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.

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Medicare Telemedicine Medicaid Communication 116

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.

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Medicare Medicaid Telemedicine Nurse Practitioner 116

American Nurse

NOVEMBER 5, 2023

Minimum staffing standards proposed for LTC facilities On September 1, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that, if finalized, would establish minimum staffing standards for long-term care (LTC) facilities. The post ANA Enterprise News, November 2023 appeared first on American Nurse.

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Long Term Care Medicaid Medicare 52

American Nurse

MAY 5, 2023

NPIs provide a means for 
advanced practice RNs to 
bill most insurance providers, including Medicare and Medicaid. The post ANA Enterprise News, May 2023 appeared first on American Nurse. This content is for Digital Access and Print Plus subscribers only. Visit the site and log in/register to read.

Medicaid 52

Medicaid Medicare Professional Development 52

American Nurse

MARCH 13, 2024

A recent JAMA Network study found that sick people 85 and older were less likely than younger Medicare patients to get covid therapies like Paxlovid. 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. Pfizer reported $12.5

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Medicare Medicaid Senior Living Long Term Care 111

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.

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Medicare Medicaid Business 52

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

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. Medicare 1.

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HIPAA Medicare Medicaid Telemedicine 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. The policy update is the latest in a series of moves that have made CGM more accessible.

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Medicaid Medicare Education 88

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

American Nurse

JULY 18, 2024

According to the Center for Medicare Advocacy and Lu and Lu, ownership and sponsorship type have been shown to significantly impact the quality of care in nursing homes, with for-profits generally having lower staffing levels and poorer patient outcomes. It saves money for Medicare and Medicaid, and it’s exactly what the people want.

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Business Medicare Medicaid 98

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 105

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

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

American Medical Compliance

FEBRUARY 15, 2023

The impact of these losses and risks magnifies as Medicare continues to serve a growing number of beneficiaries. Even organized crime groups infiltrate the Medicare Program and operate as Medicare providers and suppliers. The Centers for Medicare and Medicaid Services (CMS) require FWA training.

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Medicare Medicaid Pharmaceutical Federal healthcare 52

American Medical Compliance

FEBRUARY 15, 2023

The impact of these losses and risks magnifies as Medicare continues to serve a growing number of beneficiaries. Even organized crime groups infiltrate the Medicare Program and operate as Medicare providers and suppliers. The Centers for Medicare and Medicaid Services (CMS) require FWA training.

Medicare 52

Medicare Medicaid Pharmaceutical Federal healthcare 52

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

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. The proposed 4.2%

Medicare 52

Medicare Medicaid 52

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.

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Medicaid Medicare Emergency Care Promotion 52

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.

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Pharmaceutical Medicare Medicaid Communication 52

Health Leaders | Nursing

MARCH 5, 2023

Care models had not wavered much since hospitals became medicalized in the early 20 th century, and particularly since the Centers for Medicare & Medicaid Services (CMS) were created in 1965, says Jason Gilbert, PhD MBA RN NEA-BC , executive vice president and chief nurse executive, Indiana University Health.

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Retirement Nurse Shortage Leadership Medicaid 116

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 million have Medicare, Parts A and B, and 75.8 2023; 18(7).

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Medicaid Medicare Promotion Leadership 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

American Nurse

JUNE 5, 2023

2023; 18(6). doi:10.1186/s12913-019-4760-3 Centers for Medicare and Medicaid Services. cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/HospitalHCAHPS Family Caregiver Alliance. The authors work at Houston Methodist West Hospital in Houston, Texas. American Nurse Journal.

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Medicare Patient Satisfaction Patient Experience Medicaid 98

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.

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Medicaid Medicare 52

Consult QD

OCTOBER 24, 2023

So concludes the randomized controlled WATCH-TAVR trial, which was presented by Samir Kapadia, MD , in a late-breaking clinical trials session at the TCT 2023 conference in San Francisco and published simultaneously in Circulation. device is noninferior to TAVR plus medical therapy with anticoagulation.

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Medicaid Medicare 97

Relias

NOVEMBER 16, 2022

In April, the Centers for Medicare and Medicaid Services proposed a $320 million decrease in Medicare payments to skilled nursing facilities for fiscal year 2023. A study published in Value in Health on the cost of chronic wound care for Medicare beneficiaries revealed that nearly 15% of the patients (8.2

Education 10

Education Medicare Medicaid Business 10

Relias

NOVEMBER 4, 2021

Keeping an eye on your case mix is important with Medicare reimbursement shifting to value-based purchasing. The Centers for Medicare and Medicaid Services is planning to implement the Home Health Value-Based Purchasing (HHVBP) model nationwide in 2023. Why Focus on Enhancing Home Health Specializations.

Medicare 52

Medicare Business Medicaid Professional Development 52

Relias

DECEMBER 8, 2022

Every year, the Centers for Medicare and Medicaid Services (CMS) releases the Program for Evaluating Payment Patterns Electronic Report (PEPPER). This free resource is accessible online and can play an essential part in your internal compliance program in 2023, a year of increased oversight by CMS. Average case mix.

Medicare 52

Medicare Medicaid Self-Care Education 52

American Nurse

DECEMBER 8, 2023

The Centers for Medicare & Medicaid Services won’t reimburse hospitals for the care of this condition and may apply a value-based penalty fee. 2023; 18(12). Frequent turning, placing the patient on their side at 30 degrees using foam wedges, and applying skin barriers, such as foam dressings, can help prevent DTI.

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Clinical Nurse Specialist Medicaid Medicare Communication 98

Healthcare Law Insights blog

MAY 17, 2023

DOJ’s Latest False Claims Act Complaint On May 9, 2023, the U.S. 6] Specifically, the government’s complaint gives examples of giving patients “tummy tucks” following the patients’ “interest in body contouring,” but billing Medicaid for “hernia repairs.” [7] May 9, 2023) (government’s complaint in intervention). [7]

Medicare 52

Medicare Medicaid 52

Consult QD

MAY 8, 2023

3 Who to enroll in a lung cancer screening program : Guidance from the United States Preventive Services Task Force (USPSTF) has contributed to policy from Centers for Medicare & Medicaid Services and other payors for who should be screened. Accessed March 22, 2023. 2021;4(4):e218559. Lung-RADS® v2022.

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Best Practices Medicaid Medicare Communication 87

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. As nationwide expansion begins in 2023, the program is expected to save $3.376 billion in the next five years (2023-2027).

Medicare 52

Medicare Self-Care Medicaid Communication 52

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.,

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Medicaid Medicare Long Term Care Self-Care 52