Podcasts about medicaid services cms

Dr. Amelia Bond and Dr. Dhruv Khullar join us to discuss the long-term savings of accountable care organizations (ACOs) in the Medicare Shared Savings Program (MSSP). Their recent study in JAMA found that ACOs generate increasing savings over time, with physician-led ACOs demonstrating more significant savings. Learn about their study's methodology, policy implications for The Centers of Medicare & Medicaid Services (CMS) and where Dr. Bond and Dr. Khullar will focus their research next. Connect with us at acoshow@aledade.com or visit the Aledade Newsroom

Learn about The Centers for Medicare & Medicaid Services (CMS) a new model and how it can help you, your loved ones, and clients. The GUIDE Model aims to: + Improve quality of life for people living with dementia + Reduce stress on unpaid caregivers of people living with dementia + Connect to community resources, lessen Emergency Department and hospital utilization, and improve outcomes The Positive Aging Community recently hosted a discussion featuring Dr. Jennifer Pauldurai, a cognitive behavioral neurologist, and Tyler M. Lloyd, a Certified Dementia Practitioner, focusing on dementia care and the CMS-approved Guide program. Dr. Pauldurai shared insights into cognitive impairments and dementia, emphasizing the importance of understanding different types of dementia and the need for personalized treatment plans. She highlighted the significance of early diagnosis and the availability of new treatments for Alzheimer's disease. Tyler Lloyd introduced the Guide program, which aims to support unpaid caregivers and delay nursing home placements for individuals with dementia. The program offers free resources, including care navigation and respite care, for those with traditional Medicare and a dementia diagnosis. The discussion underscored the importance of community resources and support systems in managing dementia care, encouraging caregivers to seek help and utilize available programs to alleviate the challenges of caregiving.Dr. Jennifer Pauldurai board-certified neurologist Inova Health SystemTyler M. Lloyd, CDP GUIDE Dementia Program ManagerTranscript audio1336239963.pdfRecording link https://www.retirementlivingsourcebook.com/videos/guiding-an-improved-dementia-experience-guide-model-7891

In April, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the fiscal year 2026 Inpatient Prospective Payment System. This annual regulation introduces several initiatives that will have a direct impact on cardiothoracic surgery. The Society of Thoracic Surgeons is diligently reviewing all the proposed changes. They plan to submit their comments in the coming months to represent the interests of cardiothoracic surgeons and their patients effectively.

Join Col. Dr. Damon Arnold, host of America's Heroes Group, as he speaks with Julie Appleby, Senior Correspondent for KFF Health News. In this episode, they explore the implications of Julie's recent article, "The Ranks of Obamacare 'Fixers' Axed in Trump's Reduction of Health Agency Workforce," published on April 22, 2025. Discover how critical caseworker positions at the Centers for Medicare and Medicaid Services (CMS) are being cut, the consequences for ACA enrollees, and the broader impact on public health systems across the United States.Topics:Introduction to Julie Appleby and Her Work with KFF Health NewsOverview of the Affordable Care Act (ACA) Caseworker ProgramThe Role of Caseworkers: Who Are the "Fixers" and What Do They Do?The Trump Administration's Reduction in Health Agency WorkforceThe Fallout: How ACA Enrollees Are Affected by Caseworker LayoffsImpact on the CMS Exchange Customer Solutions GroupImplications for ACA Navigators and the Reduction in Support ServicesBroader Public Health Concerns: Medicaid, Mental Health, and Chronic DiseasesThe Future of Healthcare Access in the U.S.: What to Expect in 2025 and BeyondQ&A and Final Remarks

Dr. Jordan B. Peterson sits down for a candid discussion with Dr. Mehmet Oz, discussing the toxified food environment within the United States—pointing directly to its causes—and exploring not just possible, but immediate routes for change. These include better governmental oversight, but also the implementation of new technologies such as AI. Dr. Mehmet Oz, newly appointed by President Donald Trump as the 17th Administrator of the Centers for Medicare and Medicaid Services (CMS), is a cardiothoracic surgeon, professor emeritus at Columbia University, and former leader of the heart institute at New York Presbyterian Medical Center, known for innovations like the Mitraclip and over 400 publications in heart surgery, health policy, and complementary medicine. He gained national fame through The Dr. Oz Show, winning nine Daytime Emmys and authoring several New York Times bestsellers, before becoming the 2022 Republican nominee for U.S. Senate in Pennsylvania. A Harvard and UPenn MD/MBA graduate, Oz also co-founded the influential health platform Sharecare and the nationwide teen wellness initiative Healthcorps. His public influence has been recognized by Time, Forbes, and Esquire, making him a high-profile figure at the intersection of medicine, media, and policy. This episode was filmed on November 13th, 2024  | Links | For Dr. Mehmet Oz: On X https://x.com/droz?lang=en On Instagram https://www.instagram.com/dr_oz/?hl=en Dr. Mehmet Oz shares his vision for CMS https://www.cms.gov/newsroom/press-releases/dr-mehmet-oz-shares-vision-cms   

The fiscal year (FY) 2026 Inpatient Prospective Payment System (IPPS) proposed rule introduces significant reforms to hospital reimbursement, risk adjustment, and performance measurement.Key changes include the Centers for Medicare & Medicaid Services (CMS) transition to HCC Version 28, the use of the Community Deprivation Index (CDI) for socioeconomic risk adjustment and expanded inclusion of Medicare Advantage data in quality metrics.Launching in 2026, the proposed rule mandates episode-based payments with enhanced pricing accuracy. Hospitals must adapt by updating financial models, realigning quality strategies, and fostering cross-departmental collaboration. These changes emphasize equity, accountability, and transparency, all of which is designed to help in the positioning hospitals to lead in a value-driven healthcare environment.Strategic readiness is critical to thrive under IPPS 2026. Reporting this story, during the next live edition of Monitor Mondays, will be the broadcast's special guest Penny Jefferson.The long-running broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Folana Houston, senior government affairs liaison for Zelis, will report on congressional action taking place in Washington, D.C.• News Update: Dr. Drew Update will have an update to his recent reporting on transgender treatment practices.

Hosts Tod Ibrahim and David White discuss the recent federal confirmations at the National Institutes of Health (NIH) and Centers for Medicare & Medicaid Services (CMS), and explore their potential impact on kidney health policy

Hosts Tod Ibrahim and David White discuss the recent federal confirmations at the National Institutes of Health (NIH) and Centers for Medicare & Medicaid Services (CMS), and explore their potential impact on kidney health policy

A flurry of national news reports continues to document the large-scale restructuring taking place at the U.S. Department of Health and Human Services (HHS), where 10,000 jobs were reportedly slashed earlier this month, a move also impacting the workforce at the Centers for Medicare & Medicaid Services (CMS). An estimated 300 CMS workers are expected to be affected by this action, while NPR reported that the HHS teams focusing on sexual violence prevention were also eliminated – on the first day of April's Sexual Assault Awareness Month.Also recently, RACmonitor and Monitor Mondays have come into possession of a CMS memo, dated March 5, in which the agency warns that it may take action to prevent hospitals and other providers suspected of using “dangerous chemicals and surgical mutilation of children” relative to gender dysphoria, which the agency claims have “proliferated.” In fact, other executive actions taken by the Trump Administration also appear to have anticipated deleterious impacts on the health of America's LGBTQ+ population.It seems part of an overarching theme in which the Administration is waging social wars using gutted federal agencies more as a weaponized tactic than as a mechanism to serve the public.Reporting this story during the next live edition of Monitor Mondays will be physician Drew Updike, a recognized leader in hospital utilization management, denials, clinical documentation integrity (CDI), coding, and hospital operations.The long-running broadcast will also include these instantly recognizable features:• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Adam Brenman, senior government affairs liaison for Zelis, will report on congressional action taking place in Washington, D.C.• Monday Rounds: Dr. Shaemarke Magan, medical director for CaroMont Health in Gastonia, North Carolina, will make his Monday rounds, substituting for Dr. Ronald Hirsch.

It’s been a whirlwind week in public health. In this episode, host Steven Newmark breaks down a string of major developments coming out of the U.S. Department of Health and Human Services (HHS). From mass layoffs across HHS, including at the FDA, to the resignation of the country’s top vaccine regulator, these changes raise serious concerns—especially amid a rising measles outbreak. Tune in to hear what this means for patients, public health efforts, and the fight against vaccine hesitancy. Among the highlights in this episode: 00:50: Steven Newmark, Chief of Policy at GHLF, discusses HHS Secretary Robert F. Kennedy Jr.’s announcement of 10,000 staff layoffs, with the Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) being the most impacted 01:31: Steven reflects on RFK Jr.'s earlier warning to FDA workers to "pack their bags" and discusses concerns about maintaining service levels with a 25% workforce cut 02:08: Quoting Robert Califf, Steven shares the demoralization felt by former and current HHS staff, calling out the treatment of hardworking public health employees 02:38: Steven shares concerns from Chiquita Brooks-LaSure, former Centers for Medicare & Medicaid Services (CMS) head, particularly around the likely impact of layoffs on already underfunded nursing home inspections 03:20: Steven reports the forced resignation of Dr. Peter Marks, the FDA’s top vaccine regulator, and the alarming response from the public health community 04:06: Steven details Dr. Marks’ warnings about leadership skepticism toward vaccines, especially in light of the growing measles outbreak 04:34: Steven gives an update on the measles outbreak in Texas and other states, citing more than 500 cases nationwide and highlighting RFK Jr.'s unscientific treatment suggestions like vitamin A and cod liver oil 05:16: Steven discusses how HHS cuts are hampering efforts to track infectious diseases and fund vaccine research, even as the outbreak fuels a shift toward pro-vaccine sentiment in affected areas 05:49: Steven urges listeners to get vaccinated and ensure those around them—especially children—are protected with the Measles, Mumps, and Rubella (MMR) vaccine Contact Our Host Steven Newmark, Chief of Policy at GHLF: snewmark@ghlf.org A podcast episode produced by Ben Blanc, Director, Digital Production and Engagement at GHLF. We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to podcasts@ghlf.org Catch up on all our episodes on our website or on your favorite podcast channel.See omnystudio.com/listener for privacy information.

The Senate Finance Committee just advanced the nomination of Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services (CMS), bringing his confirmation one step closer to reality. In this bonus episode, Jen Taylor-Skinner is joined by Nourbese Flint, president of All* Above All, for a critical conversation about what's at stake. CMS oversees vital programs like Medicare, Medicaid, and the Affordable Care Act—making its leadership role one of the most powerful in shaping national healthcare policy. Dr. Oz, widely known for promoting unscientific treatments and holding controversial views, raises serious concerns—particularly for reproductive justice and the health of marginalized communities. Nourbese shares her perspective on the qualifications this role demands and reflects on the legacy of past CMS leaders, such as Chiquita Brooks-LaSure. We discuss the broader implications of Dr. Oz's potential confirmation, including its impact on maternal health and the risks posed to vulnerable populations. Our conversation also explores the importance of grassroots resistance and political engagement in holding policymakers accountable. Nourbese offers strategies for community action and underscores why staying informed and involved is more important than ever. Learn more about your ad choices. Visit megaphone.fm/adchoices

Aledade CEO, Dr. Farzad Mostashari, and best-selling author Geoffrey Moore explore how the concepts in Moore's influential book, “Crossing the Chasm” can be applied to accelerate adoption of value-based care. In order to move to mainstream adoption, it's crucial to focus on the niche market of “pragmatists in pain” who have an urgent need that the current system isn't solving. Our co-host Sean Cavanaugh, chief policy officer at Aledade, points out that oftentimes in the traditional fee-for-service model, the pragmatists in pain are independent primary care clinicians. Moore and Dr. Mostashari also share insights and recommendations for the new administration from their recent article, including focusing on primary care, defining the competition and paving the way for simplifiers who can help clinicians navigate the complexities of value-based care. Using this framework, the Center for Medicare & Medicaid Services (CMS) could accelerate expansion of value-based care to the majority of the nation's primary care clinicians as well as their patients. Connect with us at acoshow@aledade.com or visit the Aledade Newsroom.

In this episode, our hosts break down the latest health care news, from the cancellation of a long-running diabetes study to the rising number of measles cases across the U.S. They also discuss the nomination of Dr. Oz to lead the Centers for Medicare and Medicaid Services (CMS), potential Medicaid cuts tied to tax policy changes, and major layoffs at a key health research agency. Tune in to hear what these developments mean for patients and how they could impact access to care. Among the highlights in this episode: 00:35: Steven Newmark, Chief of Policy at GHLF, highlights the Trump administration’s decision to cancel funding for a 30-year diabetes study 01:09: Zoe Rothblatt, Director of Community Outreach at GHLF emphasizes the importance of long-term studies for chronic disease research 02:10: Steven shifts the conversation to the rising number of measles cases, noting over 300 reported cases so far this year 02:36: Zoe explains why the measles outbreaks are concerning, especially for immunocompromised individuals 03:27: Zoe advises those with chronic illness to monitor outbreaks and adjust travel plans accordingly 03:41: Steven discusses former CDC Director Dr. Rochelle Walensky’s call for a third MMR vaccine dose for certain infants aged 6-11 months traveling to high-risk areas 04:46: Steven transitions to discussing Dr. Oz’s nomination to lead CMS and his past support for Medicare Advantage plans and points out Dr. Oz’s openness to reducing Medicaid spending, which could limit access for low-income and disabled individuals 05:48: Steven discusses how Republican efforts to extend Trump-era tax cuts may lead to Medicaid budget cuts 07:41: Zoe reflects on how much uncertainty exists in health policy, emphasizing the need for advocacy Join GHLF’s 50 State Network, share your story, and get involved in advocacy to make a difference, email us at advocacy@ghlf.org 08:16: Steven shares news about potential layoffs at AHRQ, a lesser-known but critical health research agency and highlights AHRQ’s research on ultra-processed foods, childhood obesity, and diabetes-related hospitalizations 09:59: Zoe expresses concern that cutting such research undermines broader public health goals 10:11: Steven ends on a positive note, reporting that flu rates are dropping and COVID cases remain low in the U.S. Contact Our Hosts Steven Newmark, Chief of Policy at GHLF: snewmark@ghlf.org Zoe Rothblatt, Director of Community Outreach at GHLF: zrothblatt@ghlf.org A podcast episode produced by Ben Blanc, Director, Digital Production and Engagement at GHLF. We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to podcasts@ghlf.org Catch up on all our episodes on our website or on your favorite podcast channel.See omnystudio.com/listener for privacy information.

Hospitals routinely measure, analyze, and track adverse patient harm events, collecting information about and reporting on certain types of such events in order to meet the Centers for Medicare & Medicaid Services (CMS) program and state legal requirements.Prior work plans of the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) revealed that hospitals reported few harm events to state reporting systems.During the next live edition of Monitor Mondays, Dr. James Kennedy, president of CDIMD, will unwrap the January 2025 OIG proposal (OEI-06-18-00401) to evaluate hospital quality reporting, suggesting how hospitals' clinical documentation integrity (CDI) and coding workflows can address errors of omission or commission.Access the OIG's announcement at https://oig.hhs.gov/reports-and-publications/workplan/summary/wp-summary-0000907.asp.The venerable weekly Internet broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Adam Brenman, senior government affairs liaison for Zelis, will report on the latest news concerning healthcare legislation.

In this captivating episode of Taking Healthcare by Storm, delve into the world of expert insights as Quality Insights Medical Director Dr. Jean Storm engages in a thought-provoking and informative discussion with Ghinwa Dumyati, MD, Director of the Communicable Diseases Surveillance and Prevention Program at the University of Rochester Medical Center.Dr. Dumyati discusses infectious disease management in long-term care facilities, focusing on COVID-19, vaccination, infection control, antimicrobial stewardship, and combating multi-drug resistant organisms like Candida auris. She highlights the importance of collaboration between healthcare facilities and public health to address current and emerging threats. If you have any topics or guests you'd like to see on future episodes, reach out to us on our website. This material was prepared by Quality Insights, a Quality Innovation Network-Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication number 12SOW-QI-ARPA-030725-GK

In this week's episode, Quality Insights' Nursing Home Team gives updates as our contract extension as the QIN-QIO (Quality Innovation Network – Quality Improvement Organization) for Pennsylvania and West Virginia comes to an end on March 7.  Watch Video Recording Download TranscriptCheck out our other interviews by visiting https://www.qualityinsights.org/ qin/multimediaThis material was prepared by Quality Insights, a Quality Innovation Network - Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this mate rial do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication number QIN-QIO-03/03/25-0182

In this week's episode, we discuss how to manage the most common infections in long-term care settings, including respiratory, gastrointestinal, skin, and urinary tract infections. We will also discuss when to implement isolation precautions, key infection control measures, and evidence-based strategies to minimize the spread of infections. We're joined by Jennifer Brown, RN, BSN, CIC, Infection Preventionist and Quality Improvement Specialist at Quality Insights.Watch Video Recording Download Presentation SlidesCheck out our other interviews by visiting https://www.qualityinsights.org/ qin/multimedia This material was prepared by Quality Insights, a Quality Innovation Network - Quality Improvement Organization under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this mate rial do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication number QIN-QIO-02/20/25-0169

The Centers for Medicare & Medicaid Services (CMS) has finalized a significant policy change concerning the coding and reimbursements associated with 90-day surgical global periods. This development is poised to impact reimbursement processes for surgeons and their teams. With the new policy set to take effect on January 1, 2025, it is crucial for medical professionals to familiarize themselves with the details to ensure a smooth transition and continued compliance. This episode delves into the specifics of the policy, offering insights into its implications and necessary preparations.

Alex Lawson - A call for protecting the integrity of Social Security, Medicare, and Medicaid following reports that DOGE has accessed the Centers for Medicare and Medicaid Services (CMS) and intends to access SSA next. Trump to IRS: stop investigating Rich tax cheats and instead go catch some brown people who are here without authorization.Is anyone surprised PBS caves to Trump and closes their DEI program - I have my doubts this will help them. Morgan J Freeman: "Anthem Blue Shield Blue Cross -- just denied cancer follow-up MRI to check spread was deemed "not a medical necessity" and therefore “not authorized." See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Medicare Advantage (MA) plans are set to change with new Centers for Medicare and Medicaid Services (CMS) regulations and increased competition. This event explores the upcoming regulatory changes, including the annual review of Special Supplemental Benefits for the Chronically Ill (SSBCI), which will assess how these benefits impact member health. Starting in 2026, Medicare Advantage Organizations (MAOs) will also be required to notify members about unused supplemental benefits mid-year, improving health equity and ensuring enrollees are aware of available resources.Hear our conversation with Amy Schiffman, CEO of AgeTech DC and CMO of Heal Pros, and Doron Porat, co-founder and CEO of ActiveAging, about strategies for enhancing member outcomes and satisfaction, with a focus on addressing social determinants of health such as transportation, meals and housing support. Learn how MA plans can improve Star Ratings, boost retention and close care gaps by offering targeted, effective benefits. The event also showcases tools like ActiveAging's ActiveAgent platform, an AI-driven tool that ensures its members are fully utilizing supplemental benefits, driving engagement, satisfaction, retention and Star Ratings. Attendees gained key insights to remain competitive, meet CMS requirements and position their plans for long-term financial sustainability.This conversation was moderated by John Achoukian, executive in residence at MATTER.For more information, visit matter.health and follow us on social: LinkedIn @MATTERTwitter @MATTERhealthInstagram @matterhealth

Incoming President Donald Trump has picked TV celebrity Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services (CMS).

The Centers for Medicare and Medicaid Services (CMS) recently released additional guidance on the Two-Midnight rule that carries important implications for hospitals seeking to apply the rule correctly and consistently. In this episode of 1st Talk Compliance, host Kevin Chmura is joined by Stacy Pereira, Executive Director of Coding and Clinical Services in Panacea's KA Consulting Division, to continue the discussion surrounding the Two-Midnight rule and the challenges it poses. If you enjoyed Panacea's recent webinar on the topic, or you're simply looking for more information on how the rule might impact you, tune in for a deep dive into the potential challenges involved for hospitals seeking to apply the rule correctly, possible financial impacts of the rule's enforcement, and pitfalls of over- or underusing observation status. In case you missed our webinar on the Two-Midnight rule, you can watch it on-demand here.

Welcome to the Paint The Medical Picture Podcast, created and hosted by Sonal Patel, BA, CPMA, CPC, CMC, ICDCM. Thanks to all of you for making this a Top 15 Podcast for 4 Years: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://blog.feedspot.com/medical_billing_and_coding_podcasts/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Sonal's 14th Season starts up and Episode 1 features a BONUS episode featuring #ComplianceCapers with Betty Hovey. It debuted on June 7, 2024 with a conversation on the Targeted, Probe, and Educate Program (TPE) developed by the Centers for Medicare and Medicaid Services (CMS). June 2024 episodes on the TPE program were specially curated in advance and featured on Sonal's LinkedIn Live Events and Sonal's YouTube Channel. Sonal's LinkedIn Live event: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.linkedin.com/events/compliancecapers-episode22-targ7203842323556823040/theater/ Sonal's YouTube Channel: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.youtube.com/watch?v=o0YpbqaDyQQ&list=PLD5lAnNOMPGYjPJuU2nAq4ootNIdgGgwW&index=4&t=6s Thanks to HCPro®: Website: ⁠⁠https://hcpro.com/⁠⁠ If you'd like to be a sponsor of the Paint The Medical Picture Podcast series, please contact Sonal directly for pricing: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠PaintTheMedicalPicturePodcast@gmail.com⁠⁠⁠ --- Support this podcast: https://podcasters.spotify.com/pod/show/sonal-patel5/support

Health Affairs' Jeff Byers welcomes Senior Editor Leslie Erdelack back to the program to discuss the recently released 2023 health care spending report from the Centers for Medicare and Medicaid Services (CMS).Learn more about the report from our ahead-of-print article from Anne B. Martin and colleagues from CMS.Last week, Health Affairs announced that Editor-in-Chief Alan Weil will leave his role at the end of the year. Read about Weil's achievements during his tenure at Health Affairs.Related Articles:National Health Expenditures In 2023: Faster Growth As Insurance Coverage And Utilization Increased (Health Affairs)Beyond National Health Expenditure Data: Three Things I Wish Were Better Measured (Health Affairs Forefront)National Health Expenditure Projections, 2023–32: Payer Trends Diverge As Pandemic-Related Policies Fade (Health Affairs)

In this special season finale of The Health Advocates, our hosts look back on a year of legislative wins, advocacy milestones, and patient-driven successes in 2024. From step therapy reforms to copay accumulator bans, they highlight progress at both state and federal levels. Steven and Zoe also share their advocacy priorities for 2025, including the Safe Step Act, Help Copays Act, and continued vaccine advocacy. Join us as we celebrate the power of patient stories, look ahead to a critical year in health policy, and thank the advocates who made this progress possible. Among the highlights in this episode: 00:37: Our hosts kick off the final episode of 2024 by thanking listeners and celebrating this year’s achievements in advocacy and health policy 01:20: Steven Newmark, Chief of Policy at GHLF, highlights legislative victories: Oregon, Vermont, and Puerto Rico passed laws banning copay accumulator adjusters, while the Help Copays Act gains momentum federally 02:33: Our hosts discuss step therapy reforms, with Illinois, Vermont, and Wyoming joining 25 other states in passing protections. Steven shares progress on the Safe Step Act at the federal level 03:00: Zoe Rothblatt, Director of Community Outreach at GHLF, explains the importance of non-medical switching reforms, with Iowa achieving key wins alongside advances in biomarker testing legislation in several states 03:33: Steven introduces the work on Prescription Drug Affordability Boards (PDABs), where GHLF actively engaged in Colorado, Oregon, and Maryland to amplify patient voices 05:31: Zoe and Steven outlines priorities for 2025 at the state level, including copay accumulator bans, Share the Savings initiatives in New York, and continued focus on vaccines and drug affordability If you want to get involved with any of the issues mentioned above email us at advocacy@ghlf.org To learn more about the 50-State Network’s Advocating for Vaccines Training, visit: https://ghlf.org/vaccine-training-page/ 06:40: Our hosts set the stage for federal advocacy in 2025, emphasizing key legislation like the Safe Step Act, Help Copays Act, and Treat and Reduce Obesity Act (TROA) 08:12: Steven and Zoe reflect on the potential impacts of the Trump administration, including key nominations like RFK Jr. for the U.S. Department of Health and Human Services (HHS) and Dr. Oz for Centers for Medicare & Medicaid Services (CMS) 11:10: Our hosts discuss the complexities of the U.S. health care system, the burden on chronic disease patients, and the role of advocacy in improving access and affordability 15:16: Steven explains the importance of balancing public and private health care options to ensure fairness and equity for all patients 16:53: Zoe wraps up with a call to action for 2025 Join GHLF’s 50 State Network, share your story, and get involved in advocacy to make a difference, email us at advocacy@ghlf.org 17:47: Steven and Zoe exchange heartfelt reflections on the season, expressing gratitude to listeners and excitement for what’s to come in 2025 Contact Our Hosts Steven Newmark, Chief of Policy at GHLF: snewmark@ghlf.org Zoe Rothblatt, Director of Community Outreach at GHLF: zrothblatt@ghlf.org A podcast episode produced by Ben Blanc, Associate Director, Digital Production and Engagement at GHLF. We want to hear what you think. Send your comments in the form of an email, video, or audio clip of yourself to podcasts@ghlf.org Catch up on all our episodes on our website or on your favorite podcast channel.See omnystudio.com/listener for privacy information.

We're living in a hybrid world. And now the hybrid concept has become part of the coding and clinical documentation integrity (CDI) world.The process of physician querying is already a stressful activity for many CDI and coding professionals. It has recently become even more stressful, because many hospitals are receiving a new type of denial: a hybrid between coding and clinical validation. It arises when a payer denies a diagnosis added by query, because their auditor determined that the query was non-compliant.During the next live edition of Talk Ten Tuesdays, senior healthcare consultant Cheryl Ericson will return to the broadcast to help coders and CDI specialists (CDISs) better code and report amid this new added twist of a threat.Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Field Report: Substituting for Tiffany Ferguson will be Laurie Johnson, who is expected to report on trauma coding occasioned by Wednesday's fatal shooting of the UnitedHealthcare CEO, Brian Thompson.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• RegWatch: Former Centers for Medicare & Medicaid Services (CMS) career professional Stanley Nachimson will report on the latest regulatory news coming out of Washington, D.C.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention.

"There's been a degree of toxic positivity in US healthcare," says Dr. Sachin Jain, CEO of SCAN Health Plan. In this episode about healthcare's need for radical change, Dr. Jain challenges industry orthodoxy and calls for a leadership revolution. From Medicare Advantage turbulence to the failures of healthcare consolidation, he offers an insider's view of what needs to change.We cover:

The Centers for Medicare and Medicaid Services (CMS) measures and, in some cases, penalizes facilities whose inpatient mortality or readmission (up to 3 per cent of their traditional Medicare revenue) rates for pneumonia, heart failure, acute myocardial infarction, and other conditions exceed their established benchmarks. Since these measures are based solely on ICD-10-CM/PCS-based administrative data applied to algorithms developed by Yale University, inaccurate documentation and coding can unwittingly misrepresent a facility's excellent performance resulting in underserved underpayments.  During the next live edition of the long-running Internet broadcast, Talk Ten Tuesday, Dr. James S. Kennedy, president of CDIMD in Nashville, Tenn., will present five relatively simple CDI strategies involving the CMS mortality and readmission measures that, if implemented, will more accurately reflect your facility's excellent performance and lower or eliminate undeserved penalties.  Be sure to take notes and invite your colleagues from quality to listen as well.Also part of the broadcast will be these instantly recognizable panelists, who will report more news during their segments:Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention.

Care management is critical, especially for individuals with chronic conditions like dementia, because it ensures coordinated, comprehensive, and individualized care. Currently, more than 6.7 million Americans are living with dementia and Alzheimer's disease, and this number is projected to continue rising. While the impact of the disease on individuals is widely recognized, the personal and financial burden it places on caregivers is less often highlighted. Today, on Values-Based Care Insights, Dan Marino sits down with JVS Health's CEO Vanessa Guzman and Co-founder Seth Hyman to discuss the GUIDE Model, a Centers for Medicare & Medicaid Services (CMS) supplement for caregivers of patients with dementia and Alzheimer's disease. Gain insights into the valuable services within the GUIDE model that can support and benefit individuals living with dementia and their unpaid caregivers.

In this episode I tackle a range of topics from an intriguing double vision case linked to thyroid eye disease to the unexpected announcement of Dr. Oz as the new Director of the Center for Medicare and Medicaid Services (CMS). I explore the controversy surrounding Dr. Oz's appointment and what it could mean for the future of American healthcare. I also share stories from our Denver live show, including creative fan costumes. Takeaways: Dr. Oz's CMS Appointment Sparks Debate: I discuss the implications of Dr. Oz's new role as CMS Director, highlighting concerns about his history of promoting pseudoscience and its potential impact on healthcare policy. Thyroid Eye Disease Diagnosis: I share how I identified thyroid eye disease in a post-cataract surgery patient, emphasizing the importance of early detection to prevent severe complications like vision loss. Creative Fans Shine in Denver: At our Denver live show, a standout costume—a fan dressed as a Cosopt eye drop bottle—showcased the unique and humorous engagement of his audience. Challenges of Double Vision Cases: I walk through the diagnostic process for double vision, covering conditions like cranial nerve palsies, myasthenia gravis, and orbital tumors. CMS and Healthcare Leadership: Beyond Dr. Oz's appointment, I reflect on the importance of having practicing physicians in leadership roles to address real-world challenges in patient care and healthcare systems. — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live  We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – http://www.patreon.com/glaucomflecken Also, be sure to check out the newsletter: https://glaucomflecken.com/glauc-to-me/ If you are interested in buying a book from one of our guests, check them all out here: https://www.amazon.com/shop/dr.glaucomflecken If you want more information on models I use: Anatomy Warehouse provides for the best, crafting custom anatomical products, medical simulation kits and presentation models that create a lasting educational impact.  For more information go to Anatomy Warehouse DOT com. Link:  Anatomy Warehouse Plus for 15% off use code: Glaucomflecken15 Today's episode is brought to you by DAX Copilot from Microsoft. DAX Copilot is your AI assistant for automating clinical documentation and workflows helping you be more efficient and reduce the administrative burdens that cause us to feel overwhelmed and burnt out. To learn more about how DAX Copilot can help improve healthcare experiences for both you and your patients visit aka.ms/knockknockhi. Join 6,000 physicians nationwide who trust physician-founded PearsonRavitz with their insurance needs. Give yourself peace of mind and go to PearsonRavitz to schedule your free one-on-one consultation with a disability insurance expert. That's http://ww.pearsonravitz.com/knockknock to get more information and take the first step toward protecting your income and future. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices

According to the Associated Press, President-elect Donald Trump has announced key Cabinet nominations, including billionaire wrestling mogul Linda McMahon as Education Secretary and Dr. Mehmet Oz as head of the Centers for Medicare and Medicaid Services (CMS). McMahon has limited education experience but supports charter schools and school choice. Oz, a TV personality and former heart surgeon, ran an unsuccessful 2022 Senate campaign and is known for controversial medical claims. Trump also nominated Howard Lutnick, a Wall Street executive, as Commerce Secretary. Lutnick, a tariff advocate, will oversee trade policy and economic initiatives. These nominations signal Trump's agenda for his administration's return. Learn more about your ad choices. Visit megaphone.fm/adchoices

Send us a textIn this episode of the Advancing Surgical Care Podcast, ASCA Chief Executive Officer Bill Prentice talks with ASCA Chief Advocacy Officer Kara Newbury about the final 2025 ASC payment rule that the Centers for Medicare & Medicaid Services (CMS) released November 1.  Bill and Kara discuss the results of the annual rulemaking process on the ASC Covered Procedures List (ASC-CPL), the inflationary adjustment and reimbursements for specific surgical procedures, and ASC quality reporting requirements for the coming year. They also consider ways the recent presidential and congressional elections and the impending change in the Administration could impact surgery centers.

Long a contentious edict from the Centers for Medicare & Medicaid Services (CMS), the Medicare Two-Midnight Rule can be simplified into three basic elements.For the first time, Monitor Mondays, along with esteemed physician advisor Benjamin Kartchner, will be outlining them, along with all that's needed to undo the gordian knot of denials.During the next live edition of the venerable Internet radio broadcast, Dr. Kartchner will complete his discussion as to how detailed clinical updates, assessments, and rationale for continued hospitalization can preemptively address payer scrutiny and reduce denials while optimizing reimbursement for patient care.Other segments during the weekly broadcast will include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• Legislative Update: Matthew Albright, chief legislative affairs analyst for Zelis, will report on current healthcare legislation.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

Feeling parched?Well, you're not alone. Hospitals across the country are dealing with a saline shortage.Thanks to Hurricane Helene's unwelcome visit to the Baxter International facility in North Carolina, your IV bags may be running low. Imagine a busy highway suddenly reduced to a single lane: that's what this IV shortage feels like for impacted healthcare providers.During the next live edition of the long-running and popular live Internet radio program Talk Ten Tuesday, Dr. Nick van Terheyden will report on just about everything related to this topic, from switching to oral meds (because who needs a needle when you can swallow?) to challenging those pesky “keep the veins open” (KVO) orders (seriously, do you really need to keep those veins open all the time?)Join Talk Ten Tuesdays and leave feeling hydrated and empowered!Also part of the broadcast, these instantly recognizable panelists will report more news during their segments:• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will continue with the final installment in her three-part series on the significant changes in the newly released ICD-10 codes.• RegWatch: Former Centers for Medicare & Medicaid Services (CMS) career professional Stanley Nachimson will report on the latest regulatory news coming out of Washington, D.C.• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.Cozen O'Connor Public Strategies - The Beltway BriefingListen for of-the-moment insider insights, framed by the rapidly changing social and...Listen on: Apple Podcasts Spotify

For most healthcare geeks, Andy Slavitt may be best known as the Former Acting Administrator for the Centers for Medicare and Medicaid Services (CMS). For millions more, he is the podcast hero we didn't know we needed and the one we so clearly deserved as the host of Lemonada Media's award-winning podcast, "In The Bubble with Andy Slavitt."Launched just before the world went to shit in early 2020, In The Bubble became a literal voice of reason while we were sanitizing our Amazon boxes and fighting for toilet paper at Costco as if they were Cabbage Patch Kids in the 1980s. A weekly vocal elixir of sorts, Andy and his storied dry wit blended healthcare policy, layman's breakdowns, and human vulnerability with a healthy splash of entertainment thanks to such early guests as Tina Fey, Al Franken, and Matthew McConaughey. Each episode brought — and still brings —a little structure and sanity to an otherwise chaotic world. Today, Andy is currently USofCare Co-Founder and Board Chair Emeritus and still fighting the system for the benefit of all Americans to get less screwed by our broken healthcare system.In the Bubble has been on my Mount Rushmore of podcasts since day one. Subscribe on Apple Podcasts, Spotify, or wherever you get your podcasts.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Host Billy Mitchell continues his conversation with Andrea Fletcher, Chief Digital Services Officer at the Centers for Medicare and Medicaid Services (CMS), discussing CMS's approach to open-source technology and AI adoption. Fletcher highlights CMS's pioneering open-source program office, the first of its kind in the federal government, which enhances cybersecurity and promotes collaborative, cost-effective development. She explains CMS's partnership with the U.S. Digital Service (USDS) to address technology talent gaps, streamline processes, and navigate regulatory challenges. Fletcher also shares CMS's strategy for AI, focusing on workforce upskilling, fraud detection, and policy innovation to improve healthcare accessibility across diverse provider needs, from small clinics to large healthcare organizations. The Daily Scoop Podcast is available every Monday-Friday afternoon. If you want to hear more of the latest from Washington, subscribe to The Daily Scoop Podcast on on Apple Podcasts, Soundcloud, Spotify and YouTube.

Value-based care (VBC) is critical to the evolving healthcare landscape. As the U.S. population ages and healthcare costs continue to rise, achieving value-based care success has become a primary goal for the system, which seeks to optimize care while maintaining financial sustainability. According to the Centers for Medicare & Medicaid Services (CMS), by 2030, all Medicare beneficiaries are expected to be enrolled in accountable care arrangements.The stakes are high with this impending shift. How can healthcare providers deliver better outcomes while also cutting costs? What does the future of value-based care hold, and how are healthcare leaders preparing to adapt?On this episode of I Don't Care, hosted by Kevin Stevenson, healthcare expert John Carter, Brand Ambassador for Pinnacle Healthcare Consulting, sheds light on the evolution of VBC, key challenges, and emerging solutions to ensure value-based care success.Key Points from the Episode:Evolution of Value-Based Care: Carter tracks the progression from the Affordable Care Act's early initiatives to newer models like ACO REACH and the upcoming AHEAD model, emphasizing the need for innovative approaches to managing healthcare costs.The Role of Preventative Care: Both Carter and Stevenson stress that the healthcare industry must focus on preventative care and early intervention, especially as the baby boomer generation becomes fully Medicare-eligible by 2030.Specialist Integration in VBC: With a shortage of physicians, especially in specialty care, Carter highlights the need for better integration between primary and specialty care providers within VBC models to improve efficiency and patient outcomes.John Carter is the Brand Ambassador for Pinnacle Healthcare Consulting, where he works closely with teams across five companies under Pinnacle's umbrella to deliver tailored solutions for large national healthcare clients. Carter has become a key figure in advancing value-based care and has extensive experience in optimizing accountable care organizations (ACOs) and working with healthcare providers across the country.

Could you and your care team be at risk when you upgrade a patient from observation to inpatient simply because the patient passed a second midnight in the hospital, based on the Centers for Medicare & Medicaid Services (CMS) contentious Two-Midnight Rule?And what about the expectation? How does expectation enter this equation? And finally, what should be present to change that expectation?During the next live edition of Monitor Mondays, Ben Kartchner, MD, a prominent physician advisor, will thread the needle of this controversial regulation to give his perspective on how the two-midnight expectation can serve as your compass, helping you steer through regulatory challenges, ensure compliance, and prevent unnecessary denials.Other segments during the weekly Internet broadcast will include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Cate Brantley, a senior government affairs liaison for Zelis, will report on current healthcare legislation.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

In today's episode, I sit down with Sachin Jain, an old friend and very successful CEO of a healthcare company. We discuss how he integrated his interests in social justice and policy with his family's encouragement to pursue medicine, his ideas on mentorship, and the arc of his career.BioSachin H. Jain, MD, MBA is CEO of SCAN Group and SCAN Health Plan, one of the nation's largest not-for-profit Medicare Advantage plans, which serves more than 300,000 members across California, Nevada, Arizona, Texas and New Mexico. Previously, Dr. Jain was President and CEO of CareMore and Aspire Health, which served 200,000 Medicare and Medicaid patients in 32 states. He also served as Chief Medical Information & Innovation Officer at Merck & Co., was Senior Advisor to the Administrator of the Centers for Medicare & Medicaid Services (CMS) and was the first Deputy Director for policy and programs at the Center for Medicare and Medicaid Innovation (CMMI).Dr. Jain graduated from Harvard College and earned his MD from Harvard Medical School and MBA from Harvard Business School. He is Adjunct Professor at the Stanford University School of Medicine and is a member of the boards of America's Health Insurance Plans (AHIP), Omada Health, Advantage Healthcare Services, and The Paul & Daisy Soros Fellowships for New Americans. Follow Sachin on LinkedIn.Access free resources and learn more about Sheila and her team at Signet Education at signeteducation.com or on LinkedIn at https://www.linkedin.com/in/sheilaakbar/.

We are so happy to bring you this episode featuring Dr. Crystal Cobos, Director of the Brain Injury and Concussion Clinic at Institutes of Health and Anne McDonnell, Advocacy and Affiliate Specialist for the Brain Injury Association ofAmerica and former Executive Director of the Brain Injury Association of Virginia.In this episode, we discuss the recent development announced in late July by the Centers for Medicare and Medicaid Services: CMS now officially recognizes Traumatic Brain Injuries (TBI) as a chronic condition. According to the Brain Injury Association of America (BIAA) this is a victory for the brain injury community. CMS has added TBI to its list of chronic conditions for chronic special needs plans (C-SNPs) through its Medicare Advantage program, effective for the January 2025 plan year. What does this mean for brain-injured employees and the workers' compensation community? Bottom line? We see this as a good thing. Tune in to hear what more these two experts have to say about it. For more information about Institutes of Health, Brain Injury Services, visit:https://institutesofhealth.org/For more information about the Brain Injury Association of America, visit: https://www.biausa.org/¡Muchas Gracias! Thank you for listening. We would appreciate you sharing our podcast with your friends on social media. Find Yvonne and Rafael on Linked In or follow us on Twitter @deconstructcomp

Health and longevity are within reach for everyone, no matter from where you're starting. And it's never too late to begin.During the next live edition of Talk Ten Tuesdays, Dr. Nick van Terheyden will cover some key areas upon which to focus so you can start bringing about improvements in your life by making small, consistent changes that are expected to lead to lasting improvements in your well-being.Over the course of the next few coming Tuesdays, Dr. Nick will dive deeper into these areas and beyond to explore additional healthy fundamentals. You are invited you to send in your suggestions for future topics – for example, what exactly are macronutrients and micronutrients, and why should we know?Also during the broadcast, these instantly recognizable panelists will report more news during their segments:• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will begin a three-part series on the significant changes in the newly released ICD-10 codes.• RegWatch: Former Centers for Medicare & Medicaid Services (CMS) career professional Stanley Nachimson will report on the latest regulatory news coming out of Washington, D.C.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.Cozen O'Connor Public Strategies - The Beltway BriefingListen for of-the-moment insider insights, framed by the rapidly changing social and...Listen on: Apple Podcasts Spotify

The Centers for Medicare & Medicaid Services (CMS) has released the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code updates for the 2025 fiscal year (FY).The FY 2025 ICD-10-CM updates introduce more than 300 code changes, including 252 new codes, 13 deletions, and 36 revisions, reflecting ongoing advancements in clinical documentation and disease specificity. These code changes will go into effect for discharges on Oct. 1, 2024.During the next live broadcast of the popular Talk Ten Tuesdays Internet broadcast, produced by ICD10monitor, AGS Health Vice President of Coding Services Leigh Poland will return to share 11 key takeaways. These updates reflect the continuous evolution of medical coding to match advancements in medical practice, patient care, and research.Also during the broadcast, these instantly recognizable panelists will report more news during their segments:• The Coding Report: Pamela Scott, Vice President of Coding Support and Compliance Services with First Class Solutions, will report on the latest coding news.• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.Cozen O'Connor Public Strategies - The Beltway BriefingListen for of-the-moment insider insights, framed by the rapidly changing social and...Listen on: Apple Podcasts Spotify

Good morning from Pharma and Biotech daily: the podcast that gives you only what's important to hear in Pharma e Biotech world. Democrats have introduced a bill to make increased Affordable Care Act (ACA) subsidies permanent, arguing that if the enhanced tax credits expire, healthcare costs for millions of Americans will suddenly increase. Meanwhile, the Senate has voted unanimously to hold Steward Health Care CEO Ralph de la Torre in criminal contempt, marking the first time in over 50 years that such a charge has been sent to the U.S. Department of Justice. Additionally, the Centers for Medicare & Medicaid Services (CMS) is holding Accountable Care Organizations harmless for "highly suspect" Medicare billing practices. A home care agency has settled allegations that it accommodated "race-based requests" for aides, with the Equal Employment Opportunity Commission stating that the agency terminated assignments of black and Hispanic aides to adhere to patients' and family members' racial preferences. The top tech trends transforming healthcare today include leveraging new technologies to navigate workforce shortages, economic pressures, and consumer demands.Arch Venture Partners has raised $3 billion for a new fund to support AI biotech startups. Pfizer has pulled its sickle cell therapy, Oxbryta, from the market due to safety concerns. A study suggests that Novo Nordisk's Ozempic may lower the risk of opioid overdose in diabetics. Research has cast doubt on the benefit of anti-CD20 therapies in multiple sclerosis. The setback with Oxbryta has caused frustration among investors regarding Pfizer's business development track record. Novo and Evotec have partnered for stem cell research, while cancer and diabetes drugs are expected to dominate Medicare negotiations in 2025.Pfizer is pulling its sickle cell drug from the market and shutting down trials due to safety concerns. BioAge successfully priced a $198 million IPO, focusing on obesity drug research. An Italian biotech received $52 million to advance pediatric gene therapies. Arch raised another $3 billion biotech fund to pursue innovative science. The industry is seeing advancements in GLP-1 drugs and exploring new treatments for obesity.Roivant, led by CEO Matt Gline, has found success in the biotech industry by taking a unique approach to acquiring and selling assets from big pharma companies. Despite Gline's lack of experience in biotech, Roivant has weathered the tough biotech climate and generated substantial cash flow. The company's strategy involves investing in products that do not fit into the traditional categories of big pharma, leading to successful acquisitions and partnerships.Placer.ai's latest report explores the potential benefits of offering healthcare services in grocery stores to increase foot traffic and customer loyalty. The report delves into how the addition of a healthcare clinic can impact grocery store visitation patterns, which types of consumers are most likely to visit grocery stores with healthcare offerings, and how loyalty rates differ between stores with wellness centers and those without.Abcam offers antibodies, proteins, kits, and reagents for life science research, with a focus on immunoassays that accelerate throughput. Their SimpleStep ELISA kits provide fast results in 90 minutes or less with high sensitivity, specificity, flexibility, and reproducibility. The 384-well format allows for efficient scaling up with consistent results across labs. For more information on their immunoassays and advertising opportunities, contact Abcam directly. This message is part of a complimentary newsletter subscription to Biopharma Dive, a product of Industry Dive, Inc.

In this episode of the Advancing Surgical Care Podcast, ASCA Chief Advocacy Officer Kara Newbury leads a discussion with Dr. David Kenigsberg, a Florida-based clinical cardiac electrophysiologist and a member of ASCA's Cardiovascular Working Group. This short but insightful program focuses on the kinds of cardiovascular procedures that are being safely performed in the outpatient setting today as well as ASCA's efforts to persuade the Centers for Medicare & Medicaid Services (CMS) to add additional cardiovascular procedures to its ASC Covered Procedures List.

Let us know how you're enjoying the show or ideas for any future topics!In this episode, we're joined by Dan Anders ESQ. from Tower MSA, who brings us the latest insights on recent updates from the Centers for Medicare & Medicaid Services (CMS). Dan shares his unique journey from attorney to workers' compensation expert, revealing the path that led him to specialize in this crucial field. We delve into the complexities of Medicare set-aside (MSA) funds, discussing why it's essential to have a professional administrator to ensure compliance and effectively manage these funds. Dan also breaks down the recent CMS updates, exploring their impact on injured workers and why staying informed is vital. Whether you're a professional in the field or someone navigating a workers' compensation claim, this episode provides valuable information on managing MSA funds and understanding the latest regulatory changes. Tune in to stay ahead of the curve and gain a clearer understanding of these important updates. Learn more about DanFollow Dan on LinkedInTower MSAAmetros is changing the way injured individuals navigate healthcare by providing them with post-settlement medical management tools for their settlement funds. Ametros helps drive more simplified, secured, and supported settlements and saves money by working closely with injured workers, insurers, employers, attorneys, and Medicare to create a seamless experience.Learn how Ametros can support you.

Hospital-acquired infections can be significant malpractice issues. Gwen Rogers, a nursing expert in epidemiology, shares her knowledge on this subject. She explains how such infections are acquired and emphasizes that handwashing is still the best line of defense. Check out this podcast episode on Preventing Hospital Infections: Key Techniques and Liability Issues. She provides a long and invaluable list of questions that an LNC should ask about such infections, including several related to IV placement and maintenance and how not following the protocol can cause infections. Gwen goes into detail about the requirements for a medical center to act as Medicare and Medicaid providers. Such institutions are required to provide data for the Centers for Medicare and Medicaid Services (CMS). Attorneys have access to this information, which includes infection rates. She further goes into the complexities involved in these calculations and notes that different states have their own standards. Hospital-acquired infections can be serious, have long-term effects, and sometimes be fatal. Every LNC should be familiar with the nuances of this condition in its various forms. Here's What to Expect from the Podcast: Preventing Hospital Infections: Key Techniques and Liability Issues What is healthcare-acquired infection, and how do people get it? What questions should an LNC ask about hospital-acquired infections? How can you find out about the hospital's record regarding acquired infections? What are the "mandatories"? How can infections be prevented or alleviated? Listen to our podcasts or watch them using our app, Expert.edu, available at legalnursebusiness.com/expertedu. We want to hear from you! Click the red send voicemail button on the far right. (function(d){ var app = d.createElement('script'); app.type = 'text/javascript'; app.async = true; app.src = 'https://www.speakpipe.com/loader/laulw5fck6uczyhl834u7d3jfzpe7xy5.js'; var s = d.getElementsByTagName('script')[0]; s.parentNode.insertBefore(app, s); })(document); Get the free transcripts and also learn about other ways to subscribe. Go to Legal Nurse Podcasts subscribe options by using this short link: http://LNC.tips/subscribepodcast. https://www.youtube.com/watch?v=Vaj_F68R1-s Join us at our September 26-27 online LNC Success ® Conference Are you ready to advance your legal nurse consulting business? The LNC Success® Conference is a live two-day online event specifically designed for legal nurse consultant like you. Imagine transforming your practice with cutting-edge strategies and insights from industry leaders. Explore how to: Stand out in a competitive market Attract ideal clients effectively Create a compelling digital presence This conference offers a unique opportunity to connect with like-minded legal nurse consultants and gain the tools you need to thrive. From interactive workshops to expert-led sessions, you will learn actionable strategies to enhance your business. In addition to these valuable insights, you'll also have the chance to participate in hands-on activities that will help you apply what you've learned immediately. Whether you evaluate a nursing malpractice case or practice answering difficult questions, you'll leave with practical skills that can make a real difference in your practice. Don't miss out on this incredible opportunity to enhance your business and achieve your professional goals.  Register now and secure your spot at the LNC Success® Conference taking place on September 26 and 27. Your Presenter of Preventing Hospital Infections: Key Techniques and Liability Issues - Gwen Rogers Gwen Rogers is a certified infection preventionist and a Fellow in the Association for Infection Prevention and Epidemiology. She has over 30 years of nursing varied nursing experience most recently as the Director of a epidemiology department in a large ...

Recognizing that preventable medical errors, infections, and injuries are estimated to account for the deaths of 250,000 people annually, the Centers for Medicare & Medicaid Services (CMS) has expanded public reporting by hospitals on rates of patient safety events. Furthermore, CMS recently introduced the Patient Safety Structural Measure, effective 2025.Reporting on the details of this new initiative during the next edition of Talk Ten Tuesdays will be Leah Binder, president and CEO for The Leapfrog Group. Binder, long considered one of the more influential people in healthcare, is scheduled to be the special guest during the next live edition of the long-running and popular Internet broadcast, produced by ICD10monitor.Also during the broadcast, these instantly recognizable panelists will report more news:• The Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• News Desk: Timothy Powell, ICD10monitor national correspondent and regulatory expert, will anchor the Talk Ten Tuesdays News Desk.• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

Host Praveen Ranganath is joined by returning expert guest Dr. Ahmad Slim to discuss the unprecedented proposed rules from the Centers for Medicare and Medicaid Services (CMS) for 2025, which have the potential to DOUBLE cardiac CT reimbursement! For everyone in the cardiac CT community, we urge you to submit your positive comments to CMS before September 9, 2024. How do you do this? SCCT has made this process super simple -- just follow this link: https://scct.org/page/2024_CMS_OPPS_rule

In this episode, host Bidemi Ologunde discussed the recent data breach at Change Healthcare. The breach was facilitated by the absence of multi-factor authentication (MFA) on their Citrix portal, allowing threat actors to easily access and compromise the system. The attack, attributed to the ALPHV/BlackCat ransomware group, resulted in significant operational disruptions and financial losses estimated at $872 million​.The breach is particularly concerning because medical records, unlike financial information, do not have a shelf life and remain valuable indefinitely. This makes healthcare data a prime target for cybercriminals​​. The aftermath of the breach has seen a considerable impact on the cash flow of medical providers due to disruptions in payment processing and other critical services​.In response to the breach, government agencies like the Office for Civil Rights (OCR) and the Centers for Medicare and Medicaid Services (CMS) have taken steps to mitigate the impact. CMS, for instance, has allowed states to make interim Medicaid payments to affected providers​​, and OCR is actively investigating the incident and reminding covered entities of their breach notification obligations under HIPAA​.Lawmakers have also been engaged, with discussions around the breach occurring in senate hearings and the deployment of class-action lawsuits against UnitedHealth Group, accusing it of inadequate cybersecurity measures that led to the breach​.Support the Show.