CMS Extends Open Enrollment Period and Launches
2 days ago · “Health care is a basic human right, and the Biden-Harris Administration is committed to making health coverage more accessible than ever. With the Affordable Care Act and the American Rescue Plan, the President has brought affordable health coverage to millions—many of whom now have insurance for the first time,” said CMS Administrator
Actived: 4 days ago
Home Health Providers CMS
(7 days ago) A Home Health Agency (HHA) is an agency or organization which: Is primarily engaged in providing skilled nursing services and other therapeutic services;Has policies established by a group of professionals (associated with the agency or organization), including one or more physicians and one or more registered professional nurses, to govern the
E-Health General Information CMS
(2 days ago) E-Health General Information. E-health refers to the use of web-enabled systems and processes to accomplish some combination of the following goals: Improve patient involvement in their medical care and their overall satisfaction with the health care experience. Control expenditures. A large number of e-health initiatives are underway by
About the Health FFRDC CMS
(9 days ago) The Health FFRDC Operator is uniquely qualified and experienced to objectively analyze long-term health system problems, address complex technical questions, and generate creative and cost-effective solutions in strategic areas such as quality of care, new payment models, and healthcare system transformation.
Biden-Harris Administration Announces Record-Breaking 12.2
(8 days ago) A new report released today by the Department of Health and Human Services (HHS) shows that more than 2.8 million people newly gained access to affordable health care under the Biden-Harris Administration through the 2021 Special Enrollment Period (SEP) on HealthCare.gov and State-based Marketplaces
CMS Manual System Department of Health & Transmittal 10859
(9 days ago) health care payment and service delivery models that have the potential to lower Medicare, Medicaid, and CHIP spending while maintaining or improving the quality of beneficiaries’ care. Section 1115A(d)(1) of the Act authorizes the Secretary to waive such requirements of Title XVIII of …
Quality Measures CMS
(5 days ago) Quality health care is a high priority for the President, the Department of Health and Human Services (HHS), and the Centers for Medicare & Medicaid Services (CMS). CMS implements quality initiatives to assure quality health care for Medicare Beneficiaries through accountability and public disclosure. CMS uses quality measures in its various quality initiatives that include quality …
Health Insurance Marketplace Home marketplace.cms.gov
(8 days ago) Health Insurance Marketplace. Welcome to the official Marketplace information source for assisters and outreach partners. On this site, you'll find information about assister programs and tools to help existing and new Health Insurance Marketplace consumers. Applications, Forms, & Notices.
Washington State Plan Amendment
(9 days ago) Indian Health Programs or Urban Indian Organizations furnish health care services to establish a process for the State Medicaid agency to seek advice on a regular, ongoing basis from designees of Indian health programs, whether operated by the Indian Health Service (IHS), Tribes or Tribal
Home Health Agencies CMS
(1 days ago) Home Health Agencies. The Interpretive Guidelines serve to interpret and clarify the Conditions of Participation for home health agencies (HHAs). The Interpretive Guidelines merely define or explain the relevant statute and regulations and do not impose any requirements that are not otherwise set forth in statute or regulation. The HHA survey
CMS Proposes Physician Payment Rule to Improve Health
(6 days ago) CMS Seeks Feedback on Health Equity Data Collection. CMS is committed to addressing the significant and persistent inequities in health outcomes in the U.S. by improving data collection to better measure and analyze disparities across programs and policies. In the proposed PFS rule, CMS is soliciting feedback on the collection of data, and on
New to the Marketplace marketplace.cms.gov
(3 days ago) These resources may help you as you assist people who are thinking about getting coverage through the Marketplace. The publications provide information on enrollment, the appeals process, income taxes, and how Marketplace coverage works. There are also promotional materials for college students and people who speak languages other than English.
Home Health PPS CMS
(5 days ago) Home Health PPS. The Balanced Budget Act (BBA) of 1997, as amended by the Omnibus Consolidated and Emergency Supplemental Appropriations Act (OCESAA) of 1999, called for the development and implementation of a prospective payment system (PPS) for Medicare home health services. The BBA of 1997 put in place the interim payment system (IPS) until
What’s a Health Savings Account
(7 days ago) A Health Savings Account (HSA) is a type of personal savings account you can set up to pay certain health care costs. An HSA allows you to put money away and withdraw tax free, as long as you use it for qualified medical expenses. You’re eligible to contribute to an HSA when you’re covered by certain high deductible health plans (HDHPs).
Health Coverage Basics
(3 days ago) Health insurance and health coverage programs do even more. They pay for the big, unexpected events but also for some of the smaller, more expected things. For example, they help with the cost if you are in the hospital and also when you get a routine check-up. Having health insurance or …
DEPARTMENT OF HEALTH SERVICES
(3 days ago) health care costs. The budget supports tools that permit patient control and provider sharing of secure health care data, allowing for better coordination of care and less duplication. Additionally, CMS is proposing to further modernize our programs to address the increasingrole of technology in seniors’ lives while safeguardingtheirdata.
Overview of New Health Reimbursement Arrangements
(1 days ago) is a group health plan funded solely by employer contributions that reimburses an employee’s medical care expenses up to a maximum dollar amount for a coverage period.* • HRA reimbursements are excludable from the employee’s income and wages for federal income tax and employment tax purposes.
Health Equity Technical Assistance CMS
(6 days ago) Trainings for Health Care Providers. MLN Events & Trainings Includes self-paced courses on a broad range of topics. The Using CMS Data for Research on Disparities in Health and Health Care webcast describes CMS data resources, files, and measures that can be used in studying disparities in health care.; The Sources and Use of Medicare Enrollment Information training reviews the source of …
Home Health Agency 1728-2020 form CMS
(9 days ago) Healthcare Cost Report Information System (HCRIS) Data Set - Home Health Agency (HHA) - The data included with this release includes all years (from FY2020 through present) of home health agency cost reports (CMS-Form-1728-20) received by HCRIS. This form is for cost reporting periods beginning on or after January 1, 2020, and ending on or after December 31, 2020.
Patient Protection and Affordable Care Act; Updating
(1 days ago) 2 days ago · In the Updating Payment Parameters, Section 1332 Waiver Implementing Regulations, and Improving Health Insurance Markets for 2022 and Beyond final rule, the Centers for Medicare & Medicaid Services (CMS) finalizes standards for issuers, Marketplaces, and Navigators. This rule is a continuation of the recent rulemaking process, as seen in parts 1 and
Home Health Prospective Payment System Booklet
(7 days ago) Medicare gets this information from home health claims. In total, there are 2*2*12*3*3 = 432 possible case-mix groups called home health resource groups (HHRGs) based on the variables in the case-mix method. The unit of home health payment is a 30-day period of …
MLN Telehealth Services CMS
(2 days ago) Rural Health Professional Shortage Area (HPSA) in a rural census tract The Health Resources and Services Administration (HRSA) decides HPSAs and the Census Bureau decides MSAs. Find potential Medicare telehealth originating site payment eligibility at HRSA’s .
Office of Minority Health
(Just Now) health, communities including racial and ethnic minorities, sexual and gender minorities, individuals with disabilities, and those living in rural areas, experience a lower quality of care and worse health outcomes than their non-minority counterparts.xxvii,xxviii,xxix Disparities persist,
Home Health QRP Spotlight and Announcements CMS
(Just Now) Please visit Care Compare or Home Health Compare to view the new and updated quality data which for this quarter will contain the annual refresh of the claims-based measures (Please note that the October 2020 refresh of the Home Health Compare/Care Compare Sites is the last scheduled refresh of this data until the January 2022 refresh. For
Home Health PPS Archive CMS
(8 days ago) Home Health Case-Mix Changes 2000-2009 Report & Tables (ZIP) Revision of the Case-Mix Weights for the HH PPS Report, Figures & Tables (ZIP) Analysis of 2000-2008 Home Health Case-mix Change Report (ZIP) Analysis of 2006-2007 Home Health Case-Mix Change: Final Report (PDF) "Analyses in Support of Rebasing & Updating the Medicare Home Health
HIPAA Basics for Providers: Privacy, Security & Breach
(2 days ago) health care professionals, page 4 • Added Information – Sharing patient information with family members and others, page 4 • Added Information – Incidental disclosures, page 5 • Added Information – Protecting and securing health information when using a mobile device, page 5.
Glossary of Health Coverage and Medical Terms
(6 days ago) health care facility licensed, certified or accredited as required by state law. Reconstructive Surgery . Surgery and follow-up treatment needed to correct or improve a part of the body because of birth defects, accidents, injuries or medical conditions. Rehabilitation Services .
Medicare Fraud & Abuse: Prevent, Detect, Report
(1 days ago) Health care professionals who exploit Federal health care programs for illegal, personal, or corporate gain create the need for laws that combat fraud and abuse and ensure appropriate, quality medical care. Physicians frequently encounter the following types of business relationships that may raise fraud and
Home Health Value-Based Purchasing Model
(1 days ago) The Home Health Value-Based Purchasing (HHVBP) Model provides financial incentives to home health agencies for quality improvement based on their performance relative to other agencies in their state. The goal of the model is to improve the quality and efficiency of delivery of home health care services to Medicare beneficiaries.
Behavioral Health Services
(8 days ago) Behavioral health care and services ” encompasses treatments and supports for behavioral factors in chronic illness care, care of physical symptoms associated with stress rather than diseases, as well as mental health conditions and diagnoses. F740 – Introduction to Behavioral Health Services
Welcome to the Medicare Secondary Payer (MSP) Overview …
(5 days ago) A Group Health Plan is health coverage sponsored by an employer or employee organization (such as a union) for a group of employees, and possibly for dependents and retirees as well. The term GHP includes self-insured plans, plans of government entities (Federal, State, and local), and employee organization plans such as union
CMS Proposes Rule to Increase Price Transparency, Access
(2 days ago) The Centers for Medicare & Medicaid Services (CMS) is proposing actions to address the health equity gap, ensure consumers have the information they need to make fully informed decisions regarding their health care, improve emergency care access in rural communities, and use lessons learned from the COVID-19 pandemic to inform patient care and quality measurements.
(Just Now) Data.Medicare.gov lists official data used on the Medicare.gov Compare websites and directories. We want to make this data available in open, accessible, and machine-readable formats. Here are the datasets that are available: List of some of the datasets in Data.Medicare.gov. Hospital Compare. Find and compare the quality of care at over 4,000
Overview of the Patient Driven Groupings Model
(6 days ago) health plan of care, both of which still need to occur every 60-days (or in the case of updates to the plan of care, more often as the patient’s condition warrants). Physicians are separately paid by Medicare for certification and recertification for home health services.
Evaluation of the Home Health Value-Based Purchasing
(8 days ago) Evaluation of the Home Health Value-Based Purchasing (HHVBP) Model Fourth Annual Report May 2021 . Arbor Research Collaborative for Health and L&M Policy Research. Alyssa Pozniak, Marc Turenne, Eric Lammers, Purna Mukhopadhyay, Vladislav Slanchev, Julia Doherty,
Definition and Uses of Health Insurance Prospective
(1 days ago) Under the home health prospective payment system (HH PPS), from October 1, 2000 to December 31, 2019, Original Medicare made a case-mix adjusted payment for up to 60 days of care using Home Health Resource Groups (HHRG). The HHRGs were represented on claims as HIPPS codes. Home health HIPPS codes were determined
HHS Marks Black Maternal Health Week by Announcing
(3 days ago) Today, the U.S. Department of Health and Human Services (HHS) marked Black Maternal Health Week by announcing actions to expand access to continuous health care coverage and access to preventative care in rural areas to improve maternal health outcomes. HHS Secretary Xavier Becerra announced that Illinois is the first state to provide
HEALTH ASSURANCE PENNSYLVANIA INC. TO OFFER MEDICARE
(Just Now) Health Assurance Pennsylvania, based in Pittsburgh, is now serving Medicare beneficiaries in Allegheny County, including the city of Pittsburgh. Beneficiaries can sign up for the plan during the current Medicare+Choice open enrollment. Health Assurance Pennsylvania is a subsidiary of Coventry Health Care Inc., based in Bethesda, Md.
TrailBlazer Health Enterprises, LLC CMS
(3 days ago) TrailBlazer Health Enterprises, LLC Organization Description: Part A bills and services, hospital care, skilled nursing care, and fraud. Regions: Region Six - Dallas: Covered States and Territories: New Mexico : Address: 8330 LBJ Freeway, Executive Center III Dallas TX 75243
Update to the Home Health Grouper for New Diagnosis Code
(6 days ago) The Grouper Contractor, 3M Health Information Systems (3M-HIS), developed the new HH Grouper, Version 01.1.20, software package to accommodate this new code, effective for claim From dates on or after April 1, 2020. The HH Grouper assigns each claim into a Home Health
Behavioral Health Integration Services
(Just Now) Behavioral health care manager performs proactive, systematic follow-up using validated rating scales and a registry • Assesses treatment adherence, tolerability, and clinical response using validated rating scales; delivers brief evidence-based psychosocial interventions such as behavioral activation or
Michigan MI Health Link Demonstration Frequently Asked
(Just Now) MI Health Link is a joint Medicare and Medicaid demonstration designed to integrate care forindividuals in Michigan who have both Medicare and Medicaid. Beneficiaries participating in MI Health Link will receive both Medicare and Medicaid coverage, including Part D prescription drugs, through new
Update to Osteoporosis Drug Codes Billable on Home Health
(6 days ago) guidelines for coverage under the home health benefit are met. HCPCS code J0897 is defined as 1 mg. Providers should report 1 unit for each 1 mg dose provided during the billing period. • Drugs that have the ingredients romosozumab-aqqg using HCPCS code J3111, if all existing guidelines for coverage under the home health benefit are met.
Addressing Social Determinants of Health in Demonstrations
(9 days ago) that help health care systems, managed care organizations, and integrated health networks outside of the FAI to plan for and implement relevant interventions, services, or benefits for vulnerable populations. 1. Addressing Social Determinants of Health in Demonstrations Under the Financial Alignment Initiative .
Memorandum of Understanding (MOU)
(5 days ago) Washington State Health Care Authority/Washington State Department of Social and Health Services) will establish a Federal-State partnership to implement HealthPathWashington: A Medicare-Medicaid Integration Demonstration to better serve individuals eligible for both Medicare and Medicaid (“Medicare-Medicaid Enrollees” or “beneficiaries”).