Social Work Blog

DECEMBER 17, 2021

Recognizing the physical and emotional toll of these visitation restrictions, the Centers for Medicare & Medicaid Services (CMS) recently updated its guidance to nursing homes regarding visitation during COVID-19.

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Nursing Home Medicare Hospice Medicaid 98

Social Work Blog

JANUARY 28, 2022

On November 12, 2021, the Centers for Medicare & Medicaid Services (CMS) released updated guidance to Medicare- and Medicaid-certified long-term care (LTC) facilities (commonly known as nursing homes) regarding visitation during the COVID-19 pandemic. Center for Medicare Advocacy. November 12 Guidance.

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Nursing Home Medicare Medicaid Self-harm 93

Relias

OCTOBER 25, 2021

OTs working in home health can initiate the start of care in more situations beginning in 2022 under changes to the Medicare conditions of participation (CoPs). Under previous rules, an OT was not authorized by Medicare to conduct an initial assessment in home health. OTs Can Conduct Medicare Initial Assessment.

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Medicare Therapist Medicaid Clinic 97

Social Work Blog

SEPTEMBER 16, 2022

Following a recent update from the Centers for Medicare and Medicaid Services (CMS), NASW has received multiple inquiries regarding telehealth place of service codes (POS) for Medicare, Medicaid and private health insurance companies.

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Telehealth Medicare Medicaid Clinic 74

Swhelper

APRIL 26, 2018

One out of every five low-income Americans depends on Medicaid, the national insurance program for the poor jointly run by federal and state governments. Medicaid provides insurance coverage for a broad array of health services from pregnancy care and childhood immunizations to emergency hospitalizations.

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Medicaid Hospitals Government Medicare 52

Social Work Blog

JUNE 1, 2022

Following a recent update from the Center for Medicare, and Medicaid Services (CMS), NASW has received multiple inquiries regarding telehealth place of service codes (POS) for Medicare, Medicaid, and private health insurance companies.

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Telehealth Medicare Medicaid Clinical Social Work 72

Social Work Blog

DECEMBER 21, 2021

Medicare, Medicaid, TRICARE, Indian Health Service or the Veterans Affairs health system). Find Centers for Medicare and Medicaid Services (CMS) resources , including templates that can be used to prepare good faith estimates and model language for informing patients of their rights to GFE. Templates and Resources.

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Medicare Medicaid Clinic Social Worker 98

Social Work Blog

DECEMBER 21, 2021

Medicare, Medicaid, TRICARE, Indian Health Service or the Veterans Affairs health system). Here is a link to resources including templates by the Centers for Medicare and Medicaid Services (CMS) that can be used to prepare good faith estimates and model language for informing patients of their rights to GFE. Enforcement.

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Medicare Medicaid Clinic Government 116

Social Work Blog

NOVEMBER 4, 2022

The Center for Medicare and Medicaid Services (CMS) is seeking feedback from clinical social workers and other providers about how they should provide estimates for costs of services for patients who use their insurance to pay for health and mental health services.

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Medicare Medicaid Clinic Healthcare 85

Relias

OCTOBER 6, 2021

The State of Medicaid Programs and the Need for Grassroots Advocacy. Commercial insurance and private pay revenue sources rarely cover services for people with IDD, leaving Medicaid as essentially the sole payer for these services.

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Medicaid Advocacy Disability Human Services 105

Relias

APRIL 10, 2025

The Centers for Medicare and Medicaid Services (CMS) issued the Emergency Preparedness Rule to provide a national framework for healthcare organizations to improve their readiness for emergencies. This regulation established consistent emergency preparedness requirements for Medicare and Medicaid providers and suppliers of all types.

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Healthcare Medicare Medicaid Psychiatric 52

Relias

FEBRUARY 28, 2025

Key sources of IHS funding The IHS is primarily funded by federal appropriations, along with grants, Medicaid and Medicare reimbursements, and third-party billing. Medicaid and Medicare reimbursements Tribal health programs can enroll as Medicaid and Medicare providers to receive reimbursements for eligible services.

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Healthcare Medicare Medicaid Substance Abuse 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. Caregivers can take action to prevent pressure sores in older clients and avoid negative outcomes that can follow.

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Medicare Healthcare Patient Safety Rehabilitation 98

Relias

FEBRUARY 2, 2023

The 2023 Home Health Final Payment Rule , which the Centers for Medicare and Medicaid Services (CMS) released in October, increases Medicare payments for home health agencies by 0.7%, or $125 million, compared to 2022. While this seems like a treat, William A. The final rule includes a 4.1% net inflation rate update.

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Social Work Blog

APRIL 18, 2022

The Centers for Medicare and Medicaid Services (CMS) has released clarifying information about Part 2 of the No Surprise Act, Good Faith Estimates (GFEs). April 18, 2022. The frequently asked questions (FAQs) answer many of the questions that social workers asked when the No Surprise Act was implemented in January 2022.

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Psychotherapy Medicare Social Worker Nursing Home 98

Relias

AUGUST 15, 2022

Centers for Medicare and Medicaid Services (CMS) proposes a decrease in Medicare reimbursement for home health agencies by 4.2% The act mandates a six-year monitoring period for the Patient-Driven Groupings Model ( PDGM), the home health payment model implemented for Medicare in 2020. Mandatory Telehealth Reporting.

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Medicare Telehealth Hospice Medicaid 52

Relias

JANUARY 11, 2023

For example, less than 20% of Medicare spending is currently value-based. But momentum will continue, since the Centers for Medicare and Medicaid Services (CMS) announced in 2021 that it plans to transition fully to value-based reimbursement by 2030. Here’s what you need to know about value-based payments.

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Medicare Healthcare Medicaid Hospitals 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

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Medicare Clinic Medicaid Hospitals 10

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.

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Medicare Hospice Rehabilitation Hospitals 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.

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Medicare Hospice Healthcare Medicaid 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.

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Medicare Hospitals Medicaid Healthcare 52

Relias

MARCH 1, 2023

One approach that hospital officials are using to manage the readmission risk and avoid Medicare penalties is establishing a preferred SNF network. She encouraged hospital providers to increase the amount to 80%-90%.

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Social Work Blog

SEPTEMBER 8, 2022

On July 7, 2022, the Centers for Medicare and Medicaid Services (CMS) released its proposed rule of the Physician Fee Schedule (PFS) that announced proposed policy and practice changes for Medicare Part B payments beginning January 1, 2023. CMS is proposing several policy changes to Medicare telehealth services.

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Medicare Telehealth Clinic Mental Health 40

Relias

APRIL 18, 2022

Medicare payment models in skilled nursing and home health provide incentives for clinicians to be well versed in specialty areas such as skin and wound care. Chronic wounds affect about 15% of Medicare beneficiaries each year. Increase Reimbursements Based on Clinical Complexity. Build Your Reputation as a Specialist.

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Medicare Clinic Hospitals Medicaid 52

Relias

SEPTEMBER 1, 2022

With the successes reaped during the pilot of the Home Health Value-Based Purchasing (HHVBP) program, the Centers for Medicare and Medicaid Services (CMS) aims to accelerate the results nationwide. The program started in 2016 as a pilot to determine the impact of financial incentives on home health agencies in nine states.

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Medicare Hospitals Medicaid Healthcare 52

Relias

JANUARY 8, 2024

Medicare payment systems link patient satisfaction scores with reimbursement rates, making quality patient care a primary determinant of an organization’s viability and motivating healthcare administrators to implement patient satisfaction strategies. But gaining patient trust isn’t the only benefit of high patient satisfaction scores.

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Healthcare Medicare Hospitals Clinic 52

Relias

APRIL 18, 2025

Don Berwick, former Administrator of the Centers for Medicare and Medicaid Services This quote encapsulates the essence of patient-centered care. Listening to patients is the cornerstone of patient-centered care. Truly listening to patients and incorporating their feedback is fundamental to enhancing the patient experience.

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Healthcare Empathy Medicare Medicaid 40

Relias

APRIL 28, 2022

Throughout the cycle, the possibility of errors looms if your staff isn’t up to speed on the complex coding demands and rules set by hospitals, insurers, and the Centers for Medicare and Medicaid Services.

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Clinic Healthcare Medicare Medicaid 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.

Healthcare 52

Healthcare Medicare Hospitals Clinic 52

Beautiful Voyager

JANUARY 29, 2022

I begin looking further into more advanced rehabs, but research has shown me that I couldn’t find one mental rehabilitation center that accepted Medicaid or Medicare in the US. I still feel it did help me get further down the path to wellness, but I don’t think it is a long-term solution. This is a problem. Why is it not important?

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Mental Health Substance Abuse Rehabilitation Medicare 52

Relias

DECEMBER 13, 2021

An unintended, but positive offshoot of the pandemic is that the crisis highlighted home health’s “very quick and successful adjustments” and “versatility” to serve COVID-19 patients and millions of others served under Medicare, Medicaid, Veterans Administration, and other services.

Home Care 52

Home Care Healthcare Hospice Medicare 52

Relias

OCTOBER 20, 2021

Several factors drove these concerns, such as licensing, Medicare/Medicaid?reimbursement, Medicaid beneficiaries use telehealth services. SoonerCare Medicaid program. amount of telehealth adoption prior to the COVID-19 pandemic,?some some providers?were?weary weary of such innovations in behavioral healthcare.

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Healthcare Telehealth Human Services Medicaid 52

Relias

MARCH 12, 2025

For example, the Centers for Medicare and Medicaid Services (CMS) mandate facility assessments in long-term care facilities to ensure that staff competencies align with the needs of the patient population. Additionally, accrediting bodies emphasize the importance of competency verification as part of their quality standards.

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Patient Safety Healthcare Medicare Clinic 40

Relias

JUNE 1, 2022

Another case alleged that a health system defrauded the Centers for Medicare and Medicaid Services of $1 billion because doctors were pressured to add diagnosis codes to medical records that were nonexistent or unrelated to the visit.

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Clinic Justice and Corrections Medicare Healthcare 52

Relias

JUNE 1, 2022

Another case alleged that a health system defrauded the Centers for Medicare and Medicaid Services of $1 billion because doctors were pressured to add diagnosis codes to medical records that were nonexistent or unrelated to the visit.

Clinic 52

Clinic Justice and Corrections Medicare Healthcare 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. Increased scrutiny in hospices.

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Hospice Communication Clinic Patient Safety 52

Relias

AUGUST 9, 2023

Tis the season for evaluating training programs and checking everything twice to make sure you’re on the Center for Medicare and Medicaid Services’ and The Joint Commission’s nice lists. It’s more like stale coffee and the gentle clicking of keys on the computer.

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Engagement Healthcare Medicare Communication 52