Centers for Medicare and Medicaid Services

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  • John Q

    1127 Words  | 5 Pages

    has Medicaid. This limits his options on coverage and who he can go to. He has a condition that needs medical attention, high blood pressure, but because of his insurance he is finding it hard to get the care he needs. Many people have that problem but there are solutions to get the care you need. John lives in a rural area that doesn’t have any primary care doctors that take his insurance. He was able to find two doctors in his area but not a

  • The Mission Of Methodist Le Bonheur Healthcare

    789 Words  | 4 Pages

    hospital surveys (Salvucci, 2015). The introduction of value-based purchasing by the Centers for Medicare & Medicaid Services’ (CMS), implemented a program in which participating hospitals are paid based on the quality of care of the services the patient received (Hospital Value-Based Purchasing, 2015). Therefore, if hospitals want to recoup benefits from Medicare and Medicaid, excellent care and services must be provided. Therefore, Methodist Olive Branch along with our parent system,

  • New Avenues Of The Affordable Care Act

    1921 Words  | 8 Pages

    Since 1984, Medicare patients have been serviced under the prospective payment system of the Medicare program. Under this system, primary care providers are reimbursed for their services using a fixed payment for each patient that is determined by the patient’s diagnosis-related group at the time of the admission. Therefore, under the prospective payment system a hospital’s reimbursement is unaffected by the actual expenditures that are required to care for a patient. This newer reimbursement system

  • The Long Term Healthcare System

    2887 Words  | 12 Pages

    improve his health and well-being. This is the harsh reality of the long-term care industry that many have faced, including experts in the field such as Dr. Robert Kane, author of It Shouldn’t Be This Way: The Failure of Long-Term Care. Long-term services and supports (LTSS) are supposed to maximize the quality of care and the quality of life for the individual (Kane and West, 2005, p. 169). When that focus is lost, it is the responsibility of healthcare professionals, like myself, to bring that issue

  • Long Term Care Facility

    613 Words  | 3 Pages

    term care facilities use Joint Commission Accreditation as a benefit to show the quality and commitment to the health care organization. A long term care facility that is Joint Commission accredited will have a more appealing look to reimbursement centers and to the patient and families that they care for. Having this accreditation is also a risk management tool. The likelihood of a bad outcome is reduced if a facility is accredited by the Joint Commission. There is a team put together to come up with

  • Healthcare Of The United States

    1927 Words  | 8 Pages

    (Pennic J. , 2015) In regards to the misconception that “the new ICD-10 codes are simply increased and renumbered code sets,” gives an overview of how the ICD-9 and ICD-10 codes differ and the far-reaching effects of the new codes. (Medicaid, n.d.) This overview discusses the expansion of the code set and the increase in the number of codes, but it goes on to relate other characteristics of the codes. The codes were in desperate need of change due to the dramatic changes in healthcare

  • What Is The Hospital Consumer Assessment Of Healthcare

    1577 Words  | 7 Pages

    improving the quality of hospitals. The Hospital Quality Alliance (HQA) program that is overseen by and public and private entities, that include the Centers for Medicare and Medicaid Services (CMS) as well as the Joint Commission, is dominating this effort in the hospital district, generating reports quarterly on the delivery of effective services for mutual conditions. Even though the Hospital Quality Alliance has made this data more available to the public, there has not been enough information

  • The United States : A Multibillion Dollar Industry

    1370 Words  | 6 Pages

    Healthcare in the United States is a multibillion-dollar industry. Over time, the number of elderly people which have fallen victim to Medicare and Medicaid billing fraud has sky rocketed at an alarming rate. The Elder Abuse & Nursing Home Neglect Attorneys refer to this as an “overbilling epidemic” (n.d.). This means that many elders are being charged more money for the services they are receiving or in some circumstances, paying healthcare providers without receiving any care. Since most of them are unaware

  • Medicare, Medicaid

    692 Words  | 3 Pages

    Introduction The purpose of this paper is to give an overview of two federally and/or state funded programs. The programs that will be discussed are Medicare and Medicaid. In this paper will be information about who receives Medicaid/Medicare, the services offered by these programs, and those long term services that are not. Medicaid Medicaid is a joi8nt federal and state program. It provides health coverage to nearly 60 million Americans including children, pregnant women, seniors, and individuals

  • Medicaid Fraud

    1530 Words  | 7 Pages

    Medicaid Fraud HCS/545 July 9, 2012 Medicaid fraud comes in many forms. A provider who bills Medicaid for services that he or she does not provide is committing fraud. Overstating the level of care provided to patients and altering patient records to conceal the deception is fraud. Recipients also commit fraud by failing to report or misrepresenting income, household members, residence, or private health insurance. Facilities have also been known to commit Medicaid fraud through false billing