Relias

APRIL 28, 2022

Many participants have a role to play in the revenue cycle, and at each stage they must employ their specialized knowledge of how that patient interaction and service is documented in the patient’s health record. How Clinical Documentation Integrity Affects Revenue. CDI Affects More Than Financial Health.

Medicaid 52

Medicaid Medicare Patient Experience Education 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

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

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

Daily Nurse

AUGUST 7, 2023

“For example, an analysis by McKinsey & Co found that telehealth accounted for less than 1% of Medicare services before the onset of the pandemic, but by July of 2021, telehealth services accounted for about 13-17% of claims submitted to Medicare.

APRN 98

APRN Licensing Medicare HIPAA 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. 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

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

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

Amercan Journal of Nursing

JUNE 14, 2024

But despite the importance of documenting the problem, there remain only seven co-sponsors on the House bill and one sponsor on the Senate bill—out of a potential 535 members of Congress. Lisa Grabert, MPH, is an expert policy maker with nearly 20 years of experience crafting and implementing Medicare regulation and legislation.

Nurse Practitioner 111

Nurse Practitioner Medicare Self-Care Retirement 111

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

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

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

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

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

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

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

Nursing Review

NOVEMBER 11, 2024

It has mostly involved adding more items to the Medicare schedule, with each professional practising separately. The review proposes a new way of documenting and describing what can be done by a profession through what it calls a National Skills and Capability Framework and Matrix. Any change has been incremental and disjointed.

Medicare 52

Medicare Nursing Strikes Holistic Care Licensing 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

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

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

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. 2] To join OIG’s listserv, visit [link].

Medicare 52

Medicare Federal healthcare Communication 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. In 2020, PDGM changed reimbursement by focusing more on patient characteristics.

Medicare 52

Medicare Business Medicaid Professional Development 52

Relias

SEPTEMBER 23, 2022

The percentage of Medicare hospice beneficiaries dying with a diagnosis of dementia or Parkinson’s disease, some of whom have dementia, has increased from 9% in 2002 to almost 21% in 2019, according to the National Hospice and Palliative Care Organization’s Facts and Figure Report 2021 Edition. Document care preferences in advance.

Medicare 52

Medicare Communication Education 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 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

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

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

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

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

Healthcare Law Insights blog

MARCH 13, 2023

1] The jury identified $43 million in Medicare payments flowing from 64,575 kickback-procured claims. But the Anti-Kickback Statute applies to anything of value, given (a) knowingly and willfully, and (b) in return for referring a person or furnishing an item or service for which a Federal health care program (like Medicare) can pay. [2]

Medicare 52

Medicare 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

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