American Medical Compliance

AUGUST 7, 2024

CMS (Centers for Medicare & Medicaid Services) These regulations provide essential guidelines for healthcare providers participating in Medicare and Medicaid programs. For example, CMS requires accurate and timely documentation of patient care to ensure proper billing and reimbursement.

HIPAA 81

HIPAA Medicaid Medicare Legal Issues 81

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. Through accurate documentation, ethical billing practices, continuous education, and robust internal controls, providers can significantly lessen FWA risks.

Medicaid 93

Medicaid Continuing Education Medicare Communication 93

Relias

MAY 1, 2022

Keeping accurate documentation. Because the Centers for Medicare and Medicaid Services will not reimburse healthcare organizations for costs associated with hospital- or facility-acquired pressure injuries, appropriate assessment at the time of admission is vital. Deliberate Wound Documentation. Carefully assessing on admission.

Education 98

Education Communication Long Term Care Medicaid 98

American Nurse

JUNE 3, 2024

Create a care plan based on the patient’s ASD assessment, communicate it to all care team members, and document it in the patient health record. Admission history document. If the patient is ever re-admitted, the care team can retrieve and update the document as needed. 3W3aHFM Centers for Medicare & Medicaid Services.

Communication 111

Communication Medicare Self-Care Mental Health 111

Consult QD

FEBRUARY 17, 2023

There are also documented misconceptions in the medical community around the ability of people experiencing homelessness to adhere to treatment plans. One common myth is that people who are homeless may be more aggressive, despite research showing that they are more likely to be victims of violence than perpetrators.

Medicaid 114

Medicaid Mental Health Health Outcomes Education 114

Hospital Recruiting | Nursing

APRIL 1, 2020

The emergency decision by the Center for Medicare and Medicaid Services (CMS) on March 17, 2020 (and retroactively in effect beginning March 6, 2020) to pay for telehealth visits outside of rural areas has eased physician concern.

Telemedicine 73

Telemedicine Medicaid Medicare Licensing 73

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. Comprehensive documentation of any dysfunction in skin integrity aids early diagnosis and prompt treatment to improve overall outcomes.

Clinical Nurse Specialist 98

Clinical Nurse Specialist Medicaid Medicare Communication 98

American Nurse

FEBRUARY 29, 2024

Takeaways: The 1990 Federal Patient Self Determination Act requires that Medicare- and Medicaid-funded healthcare organizations follow state laws related to advance directives. Advance directives are legal documents that allow adults to record their wishes related to serious illness or end-of-life care. See Patient self-determination.

Self-Care 59

Self-Care Medicaid Medicare Nurse Practitioner 59

Minority Nurse

NOVEMBER 13, 2024

Those technologies, he said, use a microphone that’s set up in the exam room that is picking up the conversation between the NP and the patient and is not just transcribing the conversation but also putting it into an exam note format would be used for documentation purposes.

Nurse Practitioner 59

Nurse Practitioner Medicaid Medicare Licensing 59

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. Providing documentation of its financial commitment to staffing. At the time, the proposed CMS staffing mandate was met with criticism from all sides.

Long Term Care 101

Long Term Care Licensing Medicaid Medicare 101

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. Frequently, providers report measures using standardized documentation required by CMS. Data transparency aids care quality improvement.

Medicare 52

Medicare Medicaid Patient Experience Home Healthcare 52

Healthcare Law Insights blog

OCTOBER 17, 2023

To best position the nursing home for the most successful outcome at the appeal hearing, the facility must follow specific rules and requirements as it discharges or transfers the resident and the facility must ensure it documents all necessary facts along the way. What documentation is required before sending the notice of discharge?

Long Term Care 59

Long Term Care Medicaid Medicare Communication 59

American Medical Compliance

OCTOBER 25, 2024

The healthcare industry is highly regulated, with various laws such as the Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health Act (HITECH), and the Medicare and Medicaid Services (CMS) regulations shaping operations.

HIPAA 85

HIPAA Medicaid Health Insurance Best Practices 85

American Nurse

JULY 2, 2024

Yes, it affirms that cannabis has medicinal value, but it doesn’t make it more affordable for Medicaid patients, for instance.” The product of extensive thought by many cannabis nurses, this new scope and standards document provides 18 national standards of practice and professional performance. It needs to go further,” she said.

Education 105

Education Business Nurse Practitioner Self-Care 105

IntelyCare

JANUARY 10, 2023

The RAI process is also a federal requirement from the Centers of Medicare and Medicaid Services (CMS) as outlined in section §483. Compliance The most recent ‘comprehensive’ assessment (initial or periodic assessment) is often referred to as the primary resident document and is the representation of the resident’s overall health status.

Medicaid 52

Medicaid Medicare Mental Health Licensing 52

Relias

APRIL 28, 2023

The Centers for Medicare and Medicaid Services (CMS) requires all health facilities in the Medicare program to track and report data reflecting pressure injury development on all clients. All such checks should be documented as well.

Medicare 98

Medicare Long Term Care Medicaid Promotion 98

American Medical Compliance

MARCH 15, 2024

Furthermore, it prohibits knowingly submitting false or false claims to Medicare, Medicaid, or other federally funded healthcare programs. While EHRs offer numerous benefits, including improved documentation and care coordination, they also introduce complexities and potential vulnerabilities.

HIPAA 88

HIPAA Self-Care Health Insurance Best Practices 88

American Medical Compliance

DECEMBER 26, 2023

What you will learn: Situations where the No Surprises Act applies Specific requirements for compliance with the No Surprises Act Billing and payment processes under the No Surprises Act The importance of accurate documentation Details Course length: 45 minutes.

Health Insurance 52

Health Insurance Medicaid Medicare 52

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). ANA’s regulatory engagements, though sometimes overlooked, are an important part of our advocacy on behalf of more than 5 million nurses in the U.S.

APRN 73

APRN Medicare Long Term Care Medicaid 73

Consult QD

OCTOBER 24, 2023

Patients with planned TAVR and documented AF who were tolerant of oral anticoagulants were eligible. We are reaching out to the Centers for Medicare & Medicaid Services (CMS) to encourage reimbursement of the combined procedures,” Dr. Kapadia says. All patients in the TAVR+LAAO group received the Watchman 2.5

Medicaid 97

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. You can provide consistent care if you have accurate documentation of your patient’s care at the hospital. Manage wounds better. Build clinical excellence.

Education 10

Education Medicare Medicaid Business 10

Nurse.com

OCTOBER 12, 2023

Be sure to take pertinent documents with you to the consultation, including copies of the old policies and procedures. In addition, Medicare and Medicaid certification may be threatened if the policies are not managed correctly.

Medicaid 52

Medicaid Medicare 52

IntelyCare

MARCH 2, 2023

It shouldn’t be a huge surprise that many senior living communities have told McKnight’s that they will have to increase agency use this year , especially in light of the Centers for Medicare and Medicaid Services (CMS) potentially moving forward with a new minimum staffing standard in 2023.

HIPAA 52

HIPAA Senior Living Best Practices Medicaid 52

American Medical Compliance

FEBRUARY 15, 2023

The Centers for Medicare and Medicaid Services (CMS) require FWA training. Documentation of this distribution is required. Abuses create a variety of issues, including: Wasteful Medicaid and Medicare program expenses. Medicare Advantage and Part D sponsors have to provide FWA training.

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. Documentation of this distribution is required. Abuses create a variety of issues, including: Wasteful Medicaid and Medicare program expenses. Medicare Advantage and Part D sponsors have to provide FWA training.

Medicare 52

Medicare Medicaid Pharmaceutical Federal healthcare 52

Celayix

FEBRUARY 7, 2023

There is also the patient family, and the patient insurance provider, or the government in the case of Medicare or Medicaid. It can help to document everything so that you can review this with your patient later. This helps to ensure that the complaint is properly addressed, and that the resolution is documented for future reference.

Home Healthcare 52

Home Healthcare Medicaid Business Medicare 52

American Nurse

FEBRUARY 16, 2024

To address patients’ needs, Bayhealth Hospital has started sending a box of food home on discharge with patients who have food insecurities per their SDOH documentation and a referral to the Delaware Food Bank. In 2012, the Centers for Medicare and Medicaid Services implemented the Hospital Readmissions Reduction Program (HRRP).

Medicaid 52

Medicaid Medicare Long Term Care Self-Care 52

Relias

OCTOBER 28, 2022

The Centers for Medicare and Medicaid Services (CMS) is ramping up survey scrutiny for hospice this year, training surveyors to focus on interdisciplinary group care planning and coordination of care as part of an emphasis on meeting four core Conditions of Participation. Documentation in the medical record.

Care coordination 52

Care coordination Communication Medicaid Medicare 52

American Nurse

SEPTEMBER 18, 2024

Outdated language in Medicare and Medicaid regulations were written in 1965 before APRNs were providers in the U.S. Improving Care and Access to Nurses (ICAN) (H.R. 2418): This bill does NOT change any APRN scope of practice but allows APRNs to be reimbursed for many services they already provide. Nurse Faculty Reduction Act (H.R.

APRN 52

APRN Long Term Care Medicaid Medicare 52

Relias

APRIL 18, 2022

Providing consistent, evidence-based care and thorough documentation. Avoiding penalties and legal risks that go along with inaccurate assessments, incomplete documentation, and preventable pressure injuries. Knowing how to correctly document wound care assessments and actions taken will protect the clinician and the organization.

Education 52

Education Medicare Promotion Medicaid 52

American Nurse

SEPTEMBER 11, 2024

The value of these interactions was seen and now many insurance companies continue to provide reimbursement for complex or lengthy management of a patient through telephone triage (Centers for Medicare & Medicaid Services, 2023). After the call, it is essential to document the conversation. Child is a 3-year-old male with no PMH.

Medicaid 52

Medicaid Medicare Retirement Nurse Shortage 52

Relias

JUNE 1, 2023

5 – Educate clinicians on required documentation Clinicians sometimes omit important documentation. Missing documentation can cause rework for revenue cycle staff. If this isn’t documented in the record, it delays the authorization — and therefore, delays patient care,” said Budri.

Medicaid 52

Medicaid Education 52

Relias

JUNE 1, 2023

5 – Educate clinicians on required documentation Clinicians sometimes omit important documentation. Missing documentation can cause rework for revenue cycle staff. If this isn’t documented in the record, it delays the authorization — and therefore, delays patient care,” said Budri.

Medicaid 52

Medicaid Education 52

Board Vitals - Nursing

AUGUST 30, 2016

Quick links are posted at the bottom of this document for your convenience. Teen pregnancy Increase access to contraceptive counseling by expanding the age and income eligibility levels for Medicaid coverage of family planning services to increase teens’ access to healthcare services, including contraception and other preventive services.

Medicaid 52

Medicaid Promotion Licensing Health Outcomes 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 Doi: 10.51256/ANJ072339 Reference Centers for Medicare and Medicaid Services.

Medicaid 52

Medicaid Medicare Promotion Leadership 52

Capitol Beat

DECEMBER 6, 2022

Recently, the Centers for Medicare & Medicaid Services (CMS) issued a Request for Information (RFI) entitled Make Your Voice Heard: Promoting Efficiency and Equity Within CMS Programs. These recommendations also support ANA’s legislative advocacy as we encourage lawmakers to support H.R.

APRN 52

APRN Medicaid Medicare Licensing 52

Relias

FEBRUARY 26, 2024

” The Centers for Medicare and Medicaid Services (CMS) defines care coordination more holistically as “the process of ensuring that the patient’s health needs and preferences for health information and services are met across the continuum of care.”

Care coordination 52

Care coordination Patient Satisfaction Self-Care Emergency Care 52