Podcasts about cms center

The Congressional Budget Office says the CMS Center for Medicare and Medicaid Innovation's experiments in value-based reimbursement have cost Medicare and taxpayers money. David Johnson and Julie Murchinson debate the right way to measure the return on investment in Medicare value-based care models on the new episode of the 4sight Health Roundup podcast, “Calculating the ROI of VBC,” moderated by David Burda.

Last week the Supreme Court blocked the OSHA vaccine mandate for large businesses. While this is a huge ruling, how exactly did this overturn and how was it decided? During this pandemic we have seen decisions being made based on doctrine. Do administrative agencies have the authority to implement medical mandates based on their interpretation of science?  To help us unpack what happened and where we might be headed with this ruling is our guest, attorney Ryan Heath. He does an amazing job explaining how OSHA had over reached their authority and power as interpreted by the Supreme Court. Remember that currently  healthcare facilities that operate under CMS ( Center for Medicare Services) still need to comply with vaccine mandates and this is a completely separate path that will play out differently. Time will tell. Ryan Heath is a licensed Arizona attorney with a background in criminal defense. He is also president and CEO of The Gavel Project, a new nonprofit organization that provides education and support to the public regarding the recent Covid-19 mandates/issues. Its mission is to fight unethical government/employer mandates and  protect the freedom of Americans, especially children. LINKS: The Gavel Project:  https://www.thegavelproject.com Ryan Heath on Substack: https://thegavelproject.substack.com/archive Universities and The Covid-19 Money Trail: https://www.thegavelproject.com/articles/universities-the-covid-19-money-trail-ryan-heath Supreme Court Blocks Ruling: https://rollcall.com/2022/01/13/supreme-court-blocks-vaccine-or-mask-mandate-for-larger-employers/ Sponsor:  Thanks to our sponsor MR Insurance! Please reach out to Michael Relvas' team, where their goal is to assist physicians in obtaining the most comprehensive coverage available to fit their unique situation. Click here!  www.mr-disability-insurance.com/bsfreemd Our Advice! Everything in this podcast is for educational purposes only. It does not constitute the practice of medicine and we are not providing medical advice. No Physician-patient relationship is formed and anything discussed in this podcast does not represent the views of our employers.  The Fine Print! All opinions expressed by the hosts or  guests in this episode are solely their opinion and are not to be used as specific medical advice.  The hosts,  May and Tim Hindmarsh MD, BS Free MD LLC, or any affiliates thereof are not under any obligation to update or correct any information provided in this episode. The guest's statements and opinions are subject to change without notice. Thanks for joining us! You are the reason we are here.  If you have questions, reach out to us at doc@bsfreemd.com or find Tim and I on Facebook and IG. Please check out our every growing website as well at  bsfreemd.com (no www)  GET SOCIAL WITH US! Instagram:: https://www.instagram.com/bsfreemd/ Facebook: https://www.facebook.com/bsfree

Hospice Audit SeriesAudits are a fact of life for hospices—it’s not a matter of “if” a hospice will be audited, but “when.” The alphabet soup of audits has expanded, from UPICs to SMRCs, CPIs, TPEs and more. With the hospice carve-in to Medicare Advantage, MAO audits will join the list. The recent pause in audits as a result of the COVID pandemic hints at increased activity as the pandemic wanes. In this series, Meg Pekarske and Bryan Nowicki of Husch Blackwell’s Hospice Audit team deconstruct the most recent developments in hospice audits, providing insight and guidance on the why, when and how of audits and—most importantly—what hospices can do about it.Today's Episode: CMS Program Integrity Audits Are Back!In this episode, Husch Blackwell’s Meg Pekarske and Bryan Nowicki discuss the new wave of CMS Center for Program Integrity (CPI) audits that have been issued during the past couple weeks. These CPI audits remain focused on long length of stay patients and typically involve hundreds of claims valued at over $1 million. As Meg and Bryan explain, these audits may signal a new approach to auditing by CMS, and it is important for hospices to refine their response and appeal strategy accordingly.

ACU-007 In this episode Mori West joins Stacey in a deep discussion about Acupuncture and insurance billing. Tune in to learn more about what goes on behind the scenes of claiming ground and sharing codes with other medical modalities. What is it going to take for Acupuncture to continue to be represented and make a strong showing with the AMA? TODAY'S GUESTMori West CPC is a certified professional coder and owner of Acuclaims, a Medical Billing company that works with Acupuncturists. For over a decade she has volunteered with various state and national Acupuncture associations and is currently the Insurance Chairman for the ASA, American Society of Acupuncturists. In addition, through her company Mori West Seminars she teaches insurance billing seminars on behalf of Acupuncture state associations, providing real world experience with up to the date information.YOU'LL LEARNWho the American Society of Acupuncturists are and why it is important for you to belong to your state association.The AMA owns the CPT codes and why it is important that we are represented on the board.Why the wording on codes is SO important and what we need to be watchful of with regards to wording.What is the latest hoopla with CMS (Center for Medicare and Medicaid Services) and their invitation for Acupuncturists to treat low back pain. Why new Acupuncturists need to learn about codes, billing and charting even if they decide not to take insurance.What new practitioners need to be aware of if they are employed and not processing their own billing. Stick around to the end and find out what has changed with regards to telehealth and mindfulness medicine.RESOURCESCenters for Medicare and Medicaid - CMSAcuclaims billing service.Learn about insurance billing at www.moriwestseminars.comLearn about American Society of Acupuncturists here www.asacu.org

A conversation with Ellen Schultz. How can we best commit to improving what’s vital in our local health care system? Commitment is will, resources, and time. Measuring can’t take more effort than improving. Engage people at the center: patients, clinicians, and the people that support them. Focus on relationships. Measure consistency and sustainability. As in any health effort – exercise weak muscles. Blog subscribers: Listen to the podcast here. Scroll down through show notes to read the post. Subscribe to Health Hats, the Podcast, on your favorite podcast player Please support my podcast. CONTRIBUTE HERE Episode Notes Prefer to read, experience impaired hearing or deafness? Find FULL TRANSCRIPT at the end of the other show notes or download the printable transcript here Contents with Time-Stamped Headings to listen where you want to listen or read where you want to read (heading. time on podcast xx:xx. page # on the transcript) Introducing Ellen Schultz 01:00. 1 Measurement of what, why? 05:19. 2 Why patient engagement? 15:11. 4 Relationship-centered measurement 17:27. 4 Is it scalable? 21:33. 5 Adjust and pivot - flexibility 25:34. 6 Consistency and sustainability 28:27. 6 Handwashing 33:40. 7 A great boss – we need to start with you 37:15. 7 Exercise those weak muscles 41:41. 8 A skill set 44:58. 9 Reflections 46:23. 9 Please comments and ask questions at the comment section at the bottom of the show notes on LinkedIn via email DM on Instagram or Twitter to @healthhats Credits Music by permission from Joey van Leeuwen, Boston Drummer, Composer, Arranger Sponsored by Abridge Thanks to these fine people who inspired me for this episode: Mary Barton, Jennifer Brustrom, Cynthia Cullen, Derek Forfang, Shelley Fuld Nasso, Frank Opelka, Kate Niehaus, Erin Krum, Casey Quinlan Links Ellen Shultz on LinkedIn Casey Quinlan: Healthcare is Hilarious, full disclosure: I sponsor Mighty Casey's podcast Valerie Billingham first used Nothing about me, without me in 1998 at the Salzburg Global Summit Report from the CMS Technical Expert Panel  (TEP) on Quality Measure Development Plan CMS definition of quality measures Related podcasts and blogs https://www.health-hats.com/cms-use-patient-experts-dont-pay-them/ https://www.health-hats.com/cms-quality-measures-people/ https://www.health-hats.com/give-me-my-dam-dataopen-source/ About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all this. To subscribe go to https://www.health-hats.com/ Creative Commons Licensing The material found on this website created by me is Open Source and licensed under Creative Commons Attribution. Anyone may use the material (written, audio, or video) freely at no charge. Please cite the source as: ‘From Danny van Leeuwen, Health Hats. (including the link to my website). I welcome edits and improvements. Please let me know. danny@health-hats.com. The material on this site created by others is theirs and use follows their guidelines. The Show Introducing Ellen Schultz Nothing about me, without me! Although she wasn’t the first to say it, I heard it first from my friend and fellow podcaster, Casey Quinlan. Valerie Billingham said it in 1998 at the Salzburg Global Summit. I first met Ellen Shultz in 2017 at a CMS (Center for Medicare and Medicaid Ser...

A conversation with Ellen Schultz. How can we best commit to improving what's vital in our local health care system? Commitment is will, resources, and time. Measuring can't take more effort than improving. Engage people at the center: patients, clinicians, and the people that support them. Focus on relationships. Measure consistency and sustainability. As in any health effort – exercise weak muscles. Blog subscribers: Listen to the podcast here. Scroll down through show notes to read the post. Subscribe to Health Hats, the Podcast, on your favorite podcast player Please support my podcast. CONTRIBUTE HERE Episode Notes Prefer to read, experience impaired hearing or deafness? Find FULL TRANSCRIPT at the end of the other show notes or download the printable transcript here Contents with Time-Stamped Headings to listen where you want to listen or read where you want to read (heading. time on podcast xx:xx. page # on the transcript) Introducing Ellen Schultz 01:00. 1 Measurement of what, why? 05:19. 2 Why patient engagement? 15:11. 4 Relationship-centered measurement 17:27. 4 Is it scalable? 21:33. 5 Adjust and pivot - flexibility 25:34. 6 Consistency and sustainability 28:27. 6 Handwashing 33:40. 7 A great boss – we need to start with you 37:15. 7 Exercise those weak muscles 41:41. 8 A skill set 44:58. 9 Reflections 46:23. 9 Please comments and ask questions at the comment section at the bottom of the show notes on LinkedIn via email DM on Instagram or Twitter to @healthhats Credits Music by permission from Joey van Leeuwen, Boston Drummer, Composer, Arranger Sponsored by Abridge Thanks to these fine people who inspired me for this episode: Mary Barton, Jennifer Brustrom, Cynthia Cullen, Derek Forfang, Shelley Fuld Nasso, Frank Opelka, Kate Niehaus, Erin Krum, Casey Quinlan Links Ellen Shultz on LinkedIn Casey Quinlan: Healthcare is Hilarious, full disclosure: I sponsor Mighty Casey's podcast Valerie Billingham first used Nothing about me, without me in 1998 at the Salzburg Global Summit Report from the CMS Technical Expert Panel  (TEP) on Quality Measure Development Plan CMS definition of quality measures Related podcasts and blogs https://health-hats.com/cms-use-patient-experts-dont-pay-them/ https://health-hats.com/cms-quality-measures-people/ https://health-hats.com/give-me-my-dam-dataopen-source/ About the Show Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once. We will listen and learn about what it takes to adjust to life's realities in the awesome circus of healthcare. Let's make some sense of all this. To subscribe go to https://health-hats.com/ Creative Commons Licensing The material found on this website created by me is Open Source and licensed under Creative Commons Attribution. Anyone may use the material (written, audio, or video) freely at no charge. Please cite the source as: ‘From Danny van Leeuwen, Health Hats. (including the link to my website). I welcome edits and improvements. Please let me know. danny@health-hats.com. The material on this site created by others is theirs and use follows their guidelines. The Show Introducing Ellen Schultz Nothing about me, without me! Although she wasn't the first to say it, I heard it first from my friend and fellow podcaster, Casey Quinlan. Valerie Billingham said it in 1998 at the Salzburg Global Summit. I first met Ellen Shultz in 2017 at a CMS (Center for Medicare and Medicaid Services) Technical...

Medicare Part A and B does NOT cover transportation. Some Medicare Advantage Plans will cover a certain number of rides per year to take you to the doctor, hospital or other medical facilities but that is an additional benefit. There is also a very limited scope of what you can use those services for. However, that may change in the future. Uber and Lyft are pitching an idea to Medicare and CMS (Center for Medicare Services) that they should be able to provide transportation as part of Medicare benefits or additional Medicare Advantage Plan benefits. Nothing has been set in stone but it’s a win-win situation for all parties. Uber and Lyft get government funding so they get paid and you are able to have transportation provided to you and it’s covered under your healthcare. The idea is that Medicare beneficiaries are provided a certain benefit amount ($1000 for example) a year and they can use that towards a ride from Uber or Lyft. As we said, nothing is set in stone but it is a very exciting idea that we hope gains some traction. If you have any questions regarding Medicare, please give our office a call at 1-855-368-4717 or visit one of our pages: https://www.seniorhealthcaredirect.com/ https://www.facebook.com/MedicareBob/ https://twitter.com/MedicareBob https://www.youtube.com/channel/UCy_avKva4VN0DBEgjP7I43w?view_as=subscriber

A recent change at the CMS (Center for Medicare and Medicaid Services) is going to revise the way medicare pays the HHA's (Home Health Agencies) starting in 2020.  One of healthcare's hottest subsectors has seen AMED rise 71% ytd, LHCG +40%, and EHC +38%.  However not all HHA's are created equal, and Spencer Pearlman of Veda Partners explains how EHC's revenue stream is MOST at risk.  

Fraud and waste are unfortunate facts of life for health care providers and payers. The Centers for Medicare and Medicaid Services have been moving steadily towards use of statistics and data analytics technology to reduce improper payments, and it has saved billions. Now, it is offering hel p to the Veterans Affairs Department. Jonathan Morse, deputy director of the CMS Center for Program Integrity, joined Federal Drive with Tom Temin on Federal News Radio to discuss.

Welcome, Medicare Nation! Today’s episode is a Q & A in which I answer questions from two listeners. If you have a question for me about Medicare, then email me: support@themedicarenation.com.  Let’s jump right in! From Mike, in Pleasanton, CA: If my doctor drops out of my HMO network, can I change to a Medicare Advantage plan that the doctor currently takes? Here’s the thing, Mike: when you enroll in Medicare Advantage, you are in a “locked-in” period unless you have a “special election.” A special election can occur for a number of reasons: if you moved to a different county with new plans, or if CMS (Center for Medicare Services) decided to terminate a Medicare Advantage policy and you need to find a new one. Another situation for special election would be if you are still working, at age 65 or over, and are covered under your employer’s plan and aren’t on Part B. If you need to drop your employer’s coverage and enroll in Part B, then a special election would exist. Unfortunately, doctors can drop out of an HMO or PPO anytime, although they do have to give 60 days’ notice.  Mike, you will have to change doctors unless this occurs between October 15 and December 7, which is the open enrollment period, or unless you have a special election period. Your situation would not be considered for special election. It’s unfortunate, but it is very common and happens to many people each year. The doctors do this because of money, but keep in mind that if you follow a doctor to another plan, then the same thing can occur again. I hope this helps. Visit www.callsamm.com or www.medicare.gov for more information.   From Sharon, in Austin, TX: How much will I have to pay to be in the hospital for 7 days? Well, Sharon, the answer depends upon your plan. If you have original Medicare, Part A, then you have what I like to call  “accommodations insurance.” This means overnight stays are covered, with a deductible of $1288 for any stay of 1-60 days. All services and procedures in the hospital would then be covered for you. From days 61-90, you would pay $322/day for the same coverage. Of any stay of more than 90 consecutive days, you can draw on your lifetime reserve of 60 days at a cost of $644/day. Keep in mind, though, that those extra 60 days are a “lifetime piggy bank” of days, and you can’t get them back once you use them. The old adage, "You use them - You lose them," applies here. If you have a Medicare Advantage plan, then they are all different. An HMO will have a smaller network, and your co-pay will range from $0-$250/day. A PPO network is larger, therefore, your co-pay for an inpatient hospital stay will range from $0-$425/day. You would need to contact your Medicare Advantage Carrier to determine the exact amount of what your inpatient hospital co-pay will be. There are also Medicare Supplements (MediGap) plans, such as the F plan, G plan, and N plan. For these plans, you pay your monthly premium, but then have $0 out-of-pocket "medically necessary" inpatient hospital stays. Other Medicare Supplement (MediGap) Plans have a Part A deductible. Again, you need to contact your Medicare Plan customer service representative to determine your exact cost. Sorry, I can’t be more specific since I don’t know your plan, Sharon, but I hope this information is helpful for you. Thanks for the question!   Do you have questions or feedback? I’d love to hear it! I may answer one of your questions on the air! email me: support@themedicarenation.com Thank you for listening! If you enjoyed this podcast, please subscribe and leave a 5 star rating and review in iTunes! (Click here)     Find out more information about Medicare on Diane Daniel’s website! www.CallSamm.com