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31 Mar 2023, 1:22 pm
Of note, starting in 2024 and going forward, the No UPCODE Act would require Center for Medicare & Medicaid Services (“CMS”) to: Use two years of diagnostic data in in calculating the risk-adjusted payment rates, rather than the one year reviewed currently; Not consider diagnoses collected from a chart review or health risk assessment when making risk adjustments for health status, a common risk adjustment approach of plans; Establish… [read post]
30 Mar 2023, 7:30 pm
Audits’ Purpose Under the Medicare Advantage (MA) program, the Centers for Medicare & Medicaid Services (CMS) makes […] [read post]
30 Mar 2023, 7:10 am
Further, there are several statements and rules from the Center for Medicaid and Medicare (CMS) which will be changing to accommodate the IRA’s provisions. [read post]
30 Mar 2023, 7:10 am
Further, there are several statements and rules from the Center for Medicaid and Medicare (CMS) which will be changing to accommodate the IRA’s provisions. [read post]
29 Mar 2023, 9:58 am
Berdzik, chair of the Employment and Labor and Healthcare practice Groups at Goldberg Segella, payroll-based data collected by the Centers for Medicare and Medicaid Services shows that 75% of New York’s nursing homes cannot meet its 3.5 hour staffing requirement. [read post]
27 Mar 2023, 2:56 pm
The Maryland Primary Care Program is part of the Maryland Total Cost of Care Model that has been agreed to by the state of Maryland and the Centers for Medicare and Medicaid Services. [read post]
27 Mar 2023, 5:00 am
As part of the Inflation Reduction Act (IRA) of 2022, the Centers for Medicare & Medicaid Services (CMS) is required to establish the Medicare Drug Price Negotiation Program (Negotiation Program) to negotiate maximum fair prices (MFPs) for certain high expenditure, single source drugs and biologicals. [read post]
24 Mar 2023, 12:24 pm
The two executive orders join the Occupational Safety and Health Administration’s emergency temporary standard and the Centers for Medicare and Medicaid Services’ healthcare rule as unsuccessful attempts to mitigate the effects of COVID-19 with vaccine mandates. [read post]
23 Mar 2023, 1:02 pm
In the final year of the Trump administration, just before the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) sought to push the outer bounds of this question by announcing the Healthy Adult Opportunity (HAO) initiative. [read post]
23 Mar 2023, 4:30 am
The job description is ambiguous: some language indicates a Classical Ombuds role ("advocate on behalf of residents and staff of the Veterans’ Home and to receive, investigate and resolve through administrative action, in a timely manner, complaints filed by residents and staff"); yet other language is more in line with an Organizational Ombuds role ("provides neutral and confidential assistance to resolve conflict and serves as an advocate for fairness, source of support and… [read post]
21 Mar 2023, 6:30 am
The information related to upcoming announcements by CMS adjusting the reimbursement rates for Medicare and Medicaid services. [read post]
21 Mar 2023, 6:30 am
The information related to upcoming announcements by CMS adjusting the reimbursement rates for Medicare and Medicaid services. [read post]
21 Mar 2023, 6:07 am
Check with Medicare.gov: The Centers for Medicare & Medicaid Services (CMS) maintains a database of nursing homes that participate in Medicare and Medicaid. [read post]
20 Mar 2023, 5:00 am
The Centers for Medicare & Medicaid Services (CMS) recently announced updates to the voluntary self-referral disclosure protocol (SRDP), including revisions to streamline SRDP submissions. [read post]
17 Mar 2023, 2:51 pm
On February 28, 2023, six of the seven Medicare Administrative Contractors (MACs), who administer Medicare reimbursement on behalf of the Centers for Medicare and Medicaid Services (CMS), came together for a multijurisdictional contractor advisory committee (CAC) meeting. [read post]
16 Mar 2023, 1:14 pm
Check with Medicare.gov: The Centers for Medicare & Medicaid Services (CMS) maintains a database of nursing homes that participate in Medicare and Medicaid. [read post]
16 Mar 2023, 11:27 am
Wellstar receives a significant amount of income from federally funded Medicare and Medicaid programs. [read post]
16 Mar 2023, 8:13 am
In this episode of the Diagnosing Health Care Podcast: In conjunction with the national COVID-19 public health emergency (PHE), the Centers for Medicare & Medicaid Services and other federal agencies have issued waivers and other declarations with the goal of giving providers flexibility in order to render services during the PHE. [read post]
15 Mar 2023, 8:50 am
The budget proposal focuses on several key areas, including: ensuring Medicare solvency, closing the Medicaid coverage gap, making permanent ACA enhanced subsidies, building upon drug price negotiation reforms, and boosting funding for Medicaid home and mental healthcare services. [read post]
15 Mar 2023, 5:00 am
Department of Health and Human Services’ (HHS) Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule to implement requirements of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). [read post]
