If you’re leaning toward pausing your vaccination requirement process, be ready to crank it back up on a dime, legal experts stress. After the Biden administration issued two COVID-19 vaccination regulations on Nov. 5 — one from the Centers for Medicare & Medicaid Services and one from the Occupational Safety and Health Administration — states […]
Mississippi’s Medicaid program ranks poorly for its access to and quality of care, but Medicaid expansion could increase healthcare coverage along with lowering state Medicaid spending. Mississippi could achieve lower state Medicaid spending over the course of five years by expanding its Medicaid program with the American Rescue Plan boost to federal matching, a […]
The number of beneficiaries in traditional Medicare using telehealth exploded 63-fold in 2020 from 840,000 in 2019 to nearly 52.7 million, a new study found. The study, released Friday (PDF) by the Department of Health and Human Services (HHS), comes as advocates are pressing to make key flexibilities the federal government enabled at the start […]
Medicare Advantage plans hold up their end of the contract with CMS, and provide, at a minimum, a fair reimbursement for services delivered. The physician advisor is a fast-growing specialty that has evolved into so much more than someone who performs endless chart reviews for observation status determinations, medical necessity reviews, peer-to-peer conversations with payors, […]
For most readers the results of this analysis will be amazing but true. Longtime RACmonitor contributor and R1 Physician Advisory Services Vice President Dr. Ronald Hirsch recently pointed site Publisher Chuck Buck in the direction of something that, frankly, wowed him: a PhD thesis from a young Columbia University student on the topic of […]
Additionally, those who were younger than 75, lived in the west and had internet connectivity were more likely to use video or voice calls to interact with their physicians. Medicare beneficiaries living in metropolitan areas were more likely to report that they used telehealth services, a new study revealed. Published in the Journal of Evaluation […]
Utah Imaging Associates began notifying nearly 600K of a healthcare data breach, and Eskenazi Health began notifying over 1.5 million individuals. Covered entities must post a notice on the home page of its website for at least 90 days if there are more than 10 individuals with out-of-date contact information to ensure that impacted individuals […]
Telehealth policies vary from state to state but in the past few months there have been some common regulation changes across the country. Specifically, states modified their Medicaid reimbursement policies for telehealth services, the Center for Connected Health Policy’s (CCHP) State Telehealth Laws and Reimbursement Policies Fall 2021 report revealed. CCHP gathered data from state […]
Along with that growth, the number of plans offering more than one benefit increased 15%, from 175 to 202. The findings show that under the Centers for Medicare and Medicaid Services’ reinterpretation of “primarily health-related” benefits, supplemental benefit offerings in Medicare Advantage – such as home-based palliative care, in-home support services, caregiver support and therapeutic […]
Zero-paid claims are defined as any claims submitted by healthcare providers that are not paid. The problem is that when performing statistical extrapolations, auditors (ZPICs, or Zone Program Integrity Contractors, and others) routinely screen out zero-paid items when they extract the claims from a sample. This is a violation of at least 12 parts of […]