Health Leaders | Nursing

JULY 10, 2024

The Supreme Court's decision will impact patients receiving care through Medicare, Medicaid, and CHIP. According to the brief, approximately 65 million Americans receive healthcare coverage through Medicare, while Medicaid and CHIP cover 90 million low-income children and adults and seniors with disabilities.

Medicaid 118

Medicaid Medicare Health Insurance Healthcare Laws 118

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

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.

Nurse Practitioner 144

Nurse Practitioner APRN Medicare Medicaid 144

Health Leaders | Nursing

FEBRUARY 6, 2023

The hospital association says it is focusing advocacy on workplace violence, Medicare residency slots, the nursing shortage, and workforce diversity. Strengthening the healthcare workforce is one of the top priorities of the American Hospital Association's advocacy agenda for 2023.

Medicare 105

Medicare Nurse Shortage Retirement Education 105

Health Leaders | Nursing

FEBRUARY 24, 2023

The recent bipartisan Save America’s Rural Hospitals Act includes a provision to permanently remove physician supervision of Certified Registered Nurse Anesthetists (CRNAs), under Medicare Part A conditions of participation. This legislation would permanently end Medicare cuts that have devastated small-town hospitals,” said U.S.

Medicaid 105

Medicaid Medicare 105

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.

Long Term Care 52

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

Health Leaders | Nursing

JANUARY 27, 2023

more Black Medicare beneficiaries than Black NPs in non-FPA states. That’s significant because a nursing workforce that reflects its patient demographic makes healthcare more comfortable for every patient, several studies, including a Joint Commission report on cultural diversity, have shown.

Nurse Practitioner 119

Nurse Practitioner Medicare Business 119

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)

APRN 101

APRN Medicaid Medicare Resume 101

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

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

IntelyCare

DECEMBER 27, 2022

In 2023, you expect deeper conversations and more guidance on the legality of gig worker classification. Staffing Minimums Will Test Strategic Planning Regulations around staffing minimums are shifting, and post-acute leaders will feel the pressure ramp up in 2023. These models have cut costs from benefits, payroll taxes, etc.,

Leadership 52

Leadership Medicare Travel Nursing Education 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

Medicare 111

Medicare Medicaid Senior Living Long Term Care 111

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

Amercan Journal of Nursing

JUNE 14, 2024

In 2023, there were 1,977 full-time faculty vacancies that were unfilled, or 7.8% 2815 (the Nurse Faculty Shortage Reduction Act of 2023), which if enacted will better define the scope of the problem. of the faculty workforce. Federal policymakers have also addressed the salary gap and have proposed solutions, including H.R.

Nurse Practitioner 111

Nurse Practitioner Medicare Self-Care Retirement 111

Healthcare Law Insights blog

DECEMBER 28, 2023

Ron Elfenbein, a physician, billed Medicare and private payors a Level 4 E/M for patients receiving COVID-19 tests. But on December 21, 2023, the federal judge who presided over that trial granted Dr. Why Was This Physician Acquitted Following Conviction at Trial? 21, 2023), at 81. [2] 1] United States v.

Medicare 64

Medicare 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.

Business 98

Business Medicare Medicaid 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.

HIPAA 52

HIPAA Medicare Medicaid Telemedicine 52

Healthcare Law Insights blog

JUNE 22, 2023

On June 14, 2023, a federal jury found that a Georgia physician knowingly violated the False Claims Act following a two-week trial on allegations that he made false claims to the Medicare Program. The false diagnosis codes submitted to Medicare likely took this case from an instance of mere overpayment to knowing false claims.

Medicare 52

Medicare 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.

Medicaid 98

Medicaid Medicare Nurse Shortage 98

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

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

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

Nursing Review

DECEMBER 9, 2024

The Australian Institute of Health and Welfare (AIHW) has revealed that Australia's public hospitals admitted the highest number of elective surgery patients on record during the 2023-24 year. million in 2023-24). million in 2019-20 to 8.8

Medicare 52

Medicare 52

Healthcare Law Insights blog

AUGUST 15, 2023

Large managed care plans have been squarely in DOJ’s crosshairs for years, but a late July 2023 Justice Department settlement agreement with one regional healthcare provider’s Medicare Advantage Plan offers a glimpse into an issue health systems and providers with their own managed care plans need to track. million for her share. [3]

Medicare 52

Medicare 52

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

Healthcare Law Insights blog

MAY 4, 2022

In the Federal omnibus spending bill signed in March 2022, Congress extended current Medicare reimbursement waivers applicable to telehealth services for five months beyond the end of the PHE. Medicare will continue to cover certain audio-only telehealth services. Bipartisan bills (i.e.

Medicare 52

Medicare Mental Health 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.

Medicaid 88

Medicaid Medicare Education 88

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. decrease in pay for 2023 is the net effect.

Medicare 52

Medicare Medicaid 52

Health Leaders | Nursing

FEBRUARY 8, 2023

Under the Medicare program, NPs are authorized to be reimbursed for the treatment of patients with diabetes, yet they are not authorized to certify their patients’ need for diabetic shoes. Current federal law imposes an additional burden on federal employees who may have to travel great distances to receive care from an approved provider.”

Nurse Practitioner 59

Nurse Practitioner Medicare APRN Licensing 59

Scrubs

JUNE 29, 2023

The authors of the report estimate that there will be 66,750 ER visits and 366,186 outpatient visits from pickleball in 2023. Lacerations or dislocations make up less than 10% of related injuries.

Medicare 75

Medicare Health Outcomes 75

Healthcare Law Insights blog

JUNE 5, 2023

In the 25 years since, the OIG has issued multiple and specific CPGs that apply to particular segments of the healthcare industry including Medicare Advantage organizations, hospitals, home health agencies, nursing homes, and clinical laboratories. The OIG intends to publish the GCPG by December 31, 2023.

Medicare 52

Medicare Federal healthcare Communication 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

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

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

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 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.

Medicaid 93

Medicaid Continuing Education Medicare Communication 93