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

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 92

Medicaid Continuing Education Medicare Communication 92

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. Costly Pressure Injuries.

Education 98

Education Communication Long Term Care Medicaid 98

Relias

JUNE 1, 2022

Coding and clinical documentation have never been more important in healthcare. “We You’ll need ongoing training for your staff to improve your clinical documentation and avoid the following coding disasters. The documentation and coding are appropriate on our end. Insufficient Clinical Documentation or Underreported codes.

Outpatient Clinic 52

Outpatient Clinic Retirement Legal Issues Medicaid 52

Relias

JUNE 1, 2022

Coding and clinical documentation have never been more important in healthcare. “We You’ll need ongoing training for your staff to improve your clinical documentation and avoid the following coding disasters. The documentation and coding are appropriate on our end. Insufficient Clinical Documentation or Underreported codes.

Outpatient Clinic 52

Outpatient Clinic Retirement Legal Issues Medicaid 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

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

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

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.

Self-Care 59

Self-Care Medicaid Medicare Nurse Practitioner 59

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

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

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.

APRN 73

APRN Medicare Long Term Care Medicaid 73

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 84

HIPAA Medicaid Health Insurance Best Practices 84

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 billion to $96.8

Education 10

Education Medicare Medicaid Business 10

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

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 86

HIPAA Self-Care Health Insurance Best Practices 86

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. Reimbursement The facility’s state Medicaid reimbursement is calculated using the MDS assessments produced from the RAI process. F641 Accuracy of Assessments 483.20(g)

Medicaid 52

Medicaid Medicare Mental Health Licensing 52

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

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. Chronic wounds affect about 15% of Medicare beneficiaries each year. Build Your Reputation as a Specialist.

Education 52

Education Medicare Promotion Medicaid 52

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

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 March 2023.

Medicaid 52

Medicaid Medicare Promotion Leadership 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). 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

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

DECEMBER 21, 2021

For Medicare claims, you already track care quality and report it to the Centers for Medicare and Medicaid Services (CMS). Those quality ratings appear on Medicare’s Care Compare website and inform prospective clients how well you’re achieving positive outcomes. Improve Your Quality Ratings.

Medicare 52

Medicare Medicaid Staff Training Home 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. Increasing agency profitability.

Medicare 52

Medicare Business Medicaid Professional Development 52

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 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

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

MARCH 13, 2023

As a result, the Centers for Medicare and Medicaid Services (CMS) public rule on price transparency requirements for hospitals came into effect on January 1, 2021. Failure to obtain the correct and necessary documentation, demographic information, and signatures could delay payment to your organization.

Medicare 52

Medicare Medicaid Self-Care Best Practices 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. There is of course, the patient. Then there is the healthcare provider. This, in turn, leads to patient complaints.

Home Healthcare 52

Home Healthcare Medicaid Business Medicare 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 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. Fever began 2 days ago.

Medicaid 52

Medicaid Medicare Retirement Nurse Shortage 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

Relias

JANUARY 30, 2024

Healthcare organizations receive scores from the HCAHPS survey , which according to the Centers for Medicare and Medicaid Services, is “the first national, standardized, publicly reported survey of patients’ perspectives of hospital care.” The data is then tabulated to create the HCAHPS score.

Patient Satisfaction 52

Patient Satisfaction Patient Experience Medicare Self-Care 52

Healthcare Law Insights blog

JULY 7, 2023

Importantly, although the court assumed the relator engaged in some protected activity, the court found that in many of her communications she, at most, characterized discrepancies in therapy documentation as mistakes or possible computer glitches, not fraud. Another noteworthy FCA decision is out of the Sixth Circuit.

Pharmaceutical 52

Pharmaceutical Medicare Medicaid Communication 52