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Home Health Star Ratings CMS

Details: Apply to a substantial proportion of home health patients and have sufficient data to report for a majority of home health agencies. Show a reasonable amount of variation among home health agencies and it should be possible for a home health agency to show improvement in performance. Have high face validity and clinical relevance.

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› Url: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/HHQIHomeHealthStarRatings Go Now

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Home Health CMS

Details: Health IT Vendors: To use the suggested CDEs, download or print and use as guidance in creating or enhancing existing electronic clinical templates within your electronic health record (EHR) system. Providers: To use a printable clinical template , download and/or print the template, complete as applicable and file in the patient’s medical

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› Url: https://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/Electronic-Clinical-Templates/Other-Benefit-Templates/Other-Templates-home-health Go Now

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Home Health Agencies CMS

Details: The existing CoPs are the minimum health and safety standards that home health agencies (HHAs) must comply with in order to qualify for reimbursement under the Medicare program. Related Links CONDITIONS OF PARTICIPATION: HOME HEALTH AGENCIES

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› Url: https://www.cms.gov/Regulations-and-Guidance/Legislation/CFCsAndCoPs/homehealth Go Now

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Medicare Home Health Benefit Booklet

Details: health plan of care, both of which will occur every 60 days (or in the case of updates to the plan of care, more often as the patient’s condition warrants). Case-mix adjustment. The PDGM places each 30-day period into 1 of 432 case-mix groups. The case-mix payment rate adjustment .

› Verified 9 days ago

› Url: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Home-Health-Benefit-Fact-Sheet-ICN908143.pdf Go Now

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About the Health FFRDC CMS

Details: The Health FFRDC Operator is uniquely qualified and experienced to objectively analyze long-term health system problems, address complex technical questions, and generate creative and cost-effective solutions in strategic areas such as quality of care, new payment models, and healthcare system transformation.

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› Url: https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/CAMH/About-Health-FFRDC Go Now

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Coronavirus Waivers CMS

Details: Coronavirus waivers & flexibilities In certain circumstances, the Secretary of the Department of Health and Human Services (HHS) using section 1135 of the Social Security Act (SSA) can temporarily modify or waive certain Medicare, Medicaid, CHIP, or HIPAA requirements, called 1135 waivers. There are different kinds of 1135 waivers, including Medicare blanket waivers.

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› Url: https://www.cms.gov/about-cms/emergency-preparedness-response-operations/current-emergencies/coronavirus-waivers Go Now

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Oklahoma Health Care Authority Tribal Consultation Policy

Details: Health Care Authority (OHCA) is the single state agency with the responsibility of . Page 2 of 9 directing the administration of the Medicaid and SCHIP program in Oklahoma through various agency activities, including but not limited to. 1:

› Verified 9 days ago

› Url: https://www.cms.gov/Outreach-and-Education/American-Indian-Alaska-Native/AIAN/Downloads/Oklahoma-Health-Care-Authority-Tribal-Consultation-Policy.pdf Go Now

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Serving American Indians and Alaska Natives in Louisiana

Details: health care hospital and clinics, their own health, and the health of others. Patients enrolled in Medicaid, the Children’s Health Insurance Program, or Medicare enable Indian health hospitals and clinics to bill these programs for services provided. These programs bring money into the health …

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› Url: https://www.cms.gov/Outreach-and-Education/American-Indian-Alaska-Native/AIAN/Outreach-and-Education/pdf/brochure_OE-booklet06.pdf Go Now

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CLIA Laboratory Demographic Information Report

Details: ssm health medical group 3315 kethley road shawnee, ok 74804 #37d0697941 (405) 878-8170: 8/11/2021: physician office : accreditation : ssm health st anthony - oklahoma city 1000 n lee po box 205 oklahoma city, ok 73101 #37d0050352

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› Url: https://www.cms.gov/apps/clia/clia_start.asp?CLIANum=&LabName=&GeoCity=&state=OK&GeoZip=&appType=3&isSubmitted=clia2 Go Now

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Oklahoma EHB Benchmark Plan

Details: OKLAHOMA EHB BENCHMARK PLAN SUMMARY INFORMATION Plan Type Plan from largest small group product, Preferred Provider Organization . Issuer Name Blue Cross Blue Shield of Oklahoma

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› Url: https://www.cms.gov/CCIIO/Resources/Data-Resources/Downloads/Updated-Oklahoma-Benchmark-Summary.pdf Go Now

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Home Health VBP CMS

Details: the Home Health Value-Based Purchasing (HHVBP) Model; The HHVBP Model is designed to give Medicare-certified home health agencies (HHAs) incentives to give higher quality and more efficient care.

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› Url: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Other-VBPs/HHVBP Go Now

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Entities Approved to Use Enhanced Direct Enrollment CMS

Details: Enhanced direct enrollment (EDE) is a new pathway for consumers to enroll in health insurance coverage through the Federally-facilitated Exchange. This pathway allows CMS to partner with the private sector to provide a more user-friendly and seamless enrollment experience for consumers by allowing them to apply for and enroll in an Exchange plan directly through an approved issuer or web

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› Url: https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Marketplaces/EDE-ApprovedPartners Go Now

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Using Z Codes: The Social Determinants of Health (SDOH

Details: service organizations, providers, health plans, and consumer/patient advisory boards to identify unmet needs. • A can be used to identify opportunities for advancing health equity. Disparities Impact Statement • Identify individuals’ social risk factors and unmet needs. • Inform health care and services, follow-up, and discharge

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› Url: https://www.cms.gov/files/document/zcodes-infographic.pdf Go Now

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Health Disparites Guide

Details: the Health Research and Educational Trust to help health professionals understand the importance of collecting demographic data. A strong commitment to the collection of race, ethnicity, and language (REAL) data is essential to identifying and addressing disparities in quality of …

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› Url: https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/Health-Disparities-Guide.pdf Go Now

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Home Health PPS CMS

Details: Home Health PPS. The Balanced Budget Act (BBA) of 1997, as amended by the Omnibus Consolidated and Emergency Supplemental Appropriations Act (OCESAA) of 1999, called for the development and implementation of a prospective payment system (PPS) for Medicare home health services. The BBA of 1997 put in place the interim payment system (IPS) until

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› Url: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HomeHealthPPS Go Now

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Health Coverage Basics

Details: Health insurance and health coverage programs do even more. They pay for the big, unexpected events but also for some of the smaller, more expected things. For example, they help with the cost if you are in the hospital and also when you get a routine check-up. Having health insurance or …

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› Url: https://marketplace.cms.gov/technical-assistance-resources/training-materials/health-coverage-basics-training.pdf Go Now

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Center for Clinical Standards and Quality/ Quality, Safety

Details: health-care decisions on the patient’s behalf. Evidence that there is a legal representative may include guardianship, a power of attorney for health care decision-making, or a designated health care agent. A patient-selected representative participates at the request of a patient in decisions related to the patient’s

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› Url: https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/AdminInfo19-07-HHA.pdf Go Now

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Medicare Home Health Face-to-Face Requirement

Details: health care, or within the 30 days after the start of care •In situations when a physician orders home health care for the patient based on a new condition that was not evident during a visit within the 90 days prior to start of care, the certifying physician or NPP must see the patient within 30 days after admission

› Verified 5 days ago

› Url: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HomeHealthPPS/Downloads/face-to-face-requirement-powerpoint.pdf Go Now

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Home Health Patient-Driven Groupings Model CMS

Details: Home Health PPS Grouper Software (HHGS) Package (for claims starting 01-01-2021): The January 2021 release of the HH PPS Grouper software (v02.1.21) is now available in the “Downloads” section of the HH Grouper Software webpage. Included in the v02.1.21 HH PPS Grouper software update are the FY 2021 International Classification of Diseases, Tenth Revision, Clinical …

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› Url: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HomeHealthPPS/HH-PDGM Go Now

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Form Instructions for the HHCCN

Details: Form Instructions for the Home Health Change of Care Notice (HHCCN) CMS-10280 OMB Approval Number: 0938-1196 . Overview. Medicare currently requires home health agencies (HHAs) to issue HHCCNs to Medicare

› Verified 9 days ago

› Url: https://www.cms.gov/Medicare/Medicare-General-Information/BNI/Downloads/HHCCN-Form-Instructions.pdf Go Now

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State Operations Manual

Details: Medicaid patients, and patients utilizing any federally funded health plan options that are part of the Medicare program (e.g., Medicare Advantage (MA) plans). An HHA must also transmit an OASIS assessment for all Medicaid patients receiving services under a waiver program receiving services subject to the Medicare Conditions of Participation as

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› Url: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/som107ap_b_hha.pdf Go Now

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Medicare Home Health Benefit

Details: health plan of care, both of which will occur every 60 days (or in the case of updates to the plan of care, more often as the patient’s condition warrants). Case-mix adjustment The PDGM places each 30-day period into 1 of 432 case-mix groups. The case-mix payment rate adjustment

› Verified 7 days ago

› Url: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Medicare-Home-Health-Benefit-Text-Only.pdf Go Now

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CMS Manual System

Details: CMS Manual System Department of Health & Human Services (DHHS) Pub 100-02 Medicare Benefit Policy Centers for Medicare & Medicaid Services (CMS) Transmittal 10438 Date: November 6, 2020 Change Request 12023

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› Url: https://www.cms.gov/files/document/r10438bp.pdf Go Now

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Overview of the Patient Driven Groupings Model

Details: health plan of care, both of which still need to occur every 60-days (or in the case of updates to the plan of care, more often as the patient’s condition warrants). Physicians are separately paid by Medicare for certification and recertification for home health services.

› Verified 6 days ago

› Url: https://www.cms.gov/files/document/se19027.pdf Go Now

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Age and Gender CMS

Details: Health Expenditures by Age and Gender. Personal health care (PHC) spending by type of good or service and by source of funding (private health insurance, Medicare, Medicaid, out-of-pocket, and all other payers and programs) is available for five age groups: 0-18, 19-44, 45-64, 65-84, and 85 and over and for males and females for selected years from 2002 through 2014.

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› Url: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Age-and-Gender Go Now

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Medicare Mental Health

Details: health services, typically referred to as mental health services and includes substance abuse, affects a patient’s overall well-being. It’s important to understand Medicare coverage of these services. This booklet includes information on covered and non-covered services, eligible providers, Medicare

› Verified 1 days ago

› Url: https://www.cms.gov/files/document/medicare-mental-health.pdf Go Now

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Home Health Prospective Payment System (HH PPS) Rate

Details: Health (HH) Prospective Payment System (PPS). Please make sure your billing staffs are aware of these updates. BACKGROUND . Medicare updates the HH PPS rates it pays to HHAs for providing HH services annually as Section 1895(b)(3)(B) of the Social Security Act (the Act) requires. The CY 2021 HH PPS rate

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› Url: https://www.cms.gov/files/document/mm12017.pdf Go Now

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Home Health CAHPS (HHCAHPS) CMS

Details: Overview: HHCAHPS (Home Health Care Consumer Assessment of Healthcare Providers and Systems) Survey is the first national standardized and publicly reported survey of home health care patients’ perspectives of their skilled home care. The survey was nationally implemented on a voluntary basis in October 2009, and the survey was required for the Medicare annual payment …

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› Url: https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/CAHPS/HHCAHPS Go Now

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Health Insurance Portability and Accountability Act of

Details: CMS’ Original Medicare (fee-for-service) health plan, which includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance), is a HIPAA covered entity. CMS ensures Original Medicare’s uses and disclosures of PHI meet HIPAA privacy standards while providing and promoting high quality health care for beneficiaries.

› Verified 3 days ago

› Url: https://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/Privacy/Health%20_Insurance_Portability_and_Accountability_Act_of_1996 Go Now

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HOME HEALTH CERTIFICATION AND PLAN OF CARE

Details: HOME HEALTH CERTIFICATION AND PLAN OF CARE. 1. Patient's HI Claim No. 2. Start Of Care Date 3. Certification Period 6. Patient's Name and Address 7. Provider's Name, Address and Telephone Number 4. Medical Record No. 5. Provider No. From: To: 10. Medications: 11. ICD-10 12. ICD-10 Date Date 13. ICD-10 Date 8. Date of Birth 9. Sex Principal

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› Url: https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Pre-Claim-Review-Initiatives/Downloads/FAQ-65-HH-Cert-and-Plan-of-Care-example.pdf Go Now

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Glossary of Health Coverage and Medical Terms

Details: health care expense) made by you or your health care provider to your health insurer or plan for items or services you think are covered . Coinsurance Your share of the costs of a covered health care service, calculated as a percentage (for example, 20%) of the allowed amount for the service. You generally pay coinsurance plus any deductibles you

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› Url: https://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/Downloads/Uniform-Glossary-01-2020.pdf Go Now

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Home Health Process Measures Table

Details: Home Health Process Measures OASIS-D (effective 01/01/201 9) Centers for Medicare & Medicaid Services Page 1 of 4 . Home Health Quality Measures – Process . Notes: 1. Risk Adjustment: Process measures are not risk adjusted to compensate for differences in the patient population. This is because the processes of care in the measures apply to

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› Url: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/Downloads/Home-Health-Process-Measures-Table_OASIS-D_11-2018c.pdf Go Now

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COVID-19 Emergency Declaration Blanket Waivers for Health

Details: Health Care Providers . The Administration is taking aggressive actions and exercising regulatory flexibltiiies to help healthcare providers contain the spread of 2019 Novel Coronavirus Disease (COVID -19). CMS is empowered to take proactive steps through 1135 waivers as …

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› Url: https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf Go Now

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Medicare Claims Processing Manual

Details: B. Services to Include on the Claim for Home Health Benefits . Effective for all services provided on or after October 1, 2000, all services under the home health plan of care, except the following, are included in the home health PPS payment amount. Services that …

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› Url: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c10.pdf Go Now

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Penalty for Delayed Request for Anticipated Payment (RAP

Details: under the Home Health Prospective Payment System (HH PPS) from 60 days to 30 days. • Under the HH PPS, Medicare makes a split-percentage payment for most 60-day episodes/30-day periods of care. • The first payment is made in response to a RAP submitted at the beginning of the

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› Url: https://www.cms.gov/files/document/mm11855.pdf Go Now

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Medicare Mental Health

Details: health services, typically referred to as mental health services and includes substance abuse, affects a patient’s overall well-being. It’s important to understand Medicare coverage of these services. This booklet includes information on covered and non-covered services, eligible providers, Medicare

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› Url: https://www.cms.gov/files/document/medicare-mental-health-print-friendly.pdf Go Now

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Rural Providers and Suppliers Billing

Details: Rural Providers and Suppliers Billing MLN Booklet Page 3 of 50 ICN MLN006762 June 2019. TABLE OF CONTENTS. This booklet provides Medicare rural Critical Access Hospitals, Federally Qualified Health Centers, Home Health Agencies, Rural Health

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› Url: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/RuralChart.pdf Go Now

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Diagnosis Reporting on Home Health Claims

Details: diagnoses that are not appropriate for reporting on the home health claim. CR8813 instructs that the principal diagnosis reported on the home health claim should be the ICD-9-CM code that is most related to the current home health plan of care. HHAs should not submit manifestation codes as the primary diagnosis.

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› Url: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM8813.pdf Go Now

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Plan Year 2021 Health Insurance Marketplace Registration

Details: Individual Coverage Health Reimbursement Arrangements (HRAs) • As of January 1, 2020, employers can offer employees an . individual coverage HRA , which is an HRA that is integrated with individual market coverage or Medicare, instead of offering a traditional group health plan to provide reimbursements for medical care

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› Url: https://www.cms.gov/files/document/step-step-slides-plan-year-2021-health-insurance-marketplace-registration-and-training-returning.pdf Go Now

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Overview of the Patient-Driven Groupings Model (PDGM)

Details: patient information to place home health periods of care into meaningful payment categories and eliminates the use of therapy service thresholds. • PDGM will take effect January 1, 2020. • In conjunction with the implementation of the PDGM there will be a change in the unit of home health payment from a 60-day episode to a 30-day period.

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› Url: https://www.cms.gov/Outreach-and-Education/Outreach/NPC/Downloads/2019-02-12-PDGM-Presentation.pdf Go Now

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Disparities Impact Statement

Details: Health disparities—differences in health outcomes closely linked with social, economic, and environmental disadvantage—are often driven by the social conditions in which individuals live, learn, work, and play. Revised: Mar. 2021. Paid for by the U.S. Department of Health and Human Services. 1.

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› Url: https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/Disparities-Impact-Statement-508-rev102018.pdf Go Now

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FAQS ABOUT MENTAL HEALTH AND SUBSTANCE USE …

Details: plans and health insurance issuers. The MHPAEA final regulations require that a group health plan or health insurance issuer may not impose a non-quantitative treatment limitation (NQTL) with respect to MH/SUD benefits in any classification unless, under the terms of the plan (or health insurance coverage) as written

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› Url: https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/MHPAEA-FAQs-Part-45.pdf Go Now

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Rural-urban Disparities in Health Care in Medicare

Details: Rural-Urban Disparities in Health Care in Medicare. With just one exception, both FFS and MA beneficiaries living in rural areas reported health care experiences that were similar to the experiences reported by FFS and MA beneficiaries living in urban areas (see Figure 1). The exception pertained to annual flu vaccination rates, which were

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› Url: https://www.cms.gov/files/document/omh-rural-urban-report-2020.pdf Go Now

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The Role of Therapy under the Home Health Patient-Driven

Details: Finally, the quality scores on Home Health Compare incorporate the use of therapy services in patient outcomes. Home Health Compare is a website for patients and their families where they can compare HHAs to help them choose a quality HHA that has the skilled home health …

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› Url: https://www.cms.gov/files/document/se20005.pdf Go Now

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HH QRP and Public Reporting on Home Health Compare

Details: health agencies (HHAs) understand the Centers for Medicare & Medicaid Services’ (CMS) public reporting strategy for the HH QRP to account for CMS quality data submissions that were either optional or excepted due to the COVID-19 public health emergency (PHE). The impact on CMS’ Home Health Compare website refreshes are also outlined.

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› Url: https://www.cms.gov/files/document/hhqrp-pr-tip-sheet081320final-cx-508.pdf Go Now

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Home Health OASIS July 2018 Quarterly Q&As

Details: Home Health OASIS July 2018 Quarterly Q&As Page 1 of 4 Home Health OASIS July 2018 Quarterly Q&As Category 2 QUESTION 1: With the expansion of the One Clinician Convention noted in the CMS OASIS Q&A August 2017, information gathered during the last 5 days that visits were provided can be used to contribute to

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› Url: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/Downloads/Home-Health-OASIS-July-2018-Quarterly-QAs_FINAL_508-1.pdf Go Now

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MEDICAID PROMOTING INTEROPERABILITY PROGRAM …

Details: health agency (PHA) or clinical data registry (CDR) to submit electronic public health data in a meaningful way using certified electronic health record technology (CEHRT), except where prohibited, and in accordance with applicable law and practice.

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› Url: https://www.cms.gov/files/document/medicaid-ep-2020-public-health-reporting-objective-8.pdf Go Now

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Home Health PPS and Home Infusion Therapy Archive CMS

Details: Home Health Case-Mix Changes 2000-2009 Report & Tables (ZIP) Revision of the Case-Mix Weights for the HH PPS Report, Figures & Tables (ZIP) Analysis of 2000-2008 Home Health Case-mix Change Report (ZIP) Analysis of 2006-2007 Home Health Case-Mix Change: Final Report (PDF) "Analyses in Support of Rebasing & Updating the Medicare Home Health

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› Url: https://www.cms.gov/medicare/home-health-pps/home-health-pps-and-home-infusion-therapy-archive Go Now

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CCN SNF NAME CODE NUMBER NAME ADDRESS CITY STATE …

Details: health woods rehabilitation& center fourth manor old highway calla health llc west health llc holtville landing keller creek llc 34th gate pineview health woodley of first grove shore and villa trace center selma county brockfordroad of corley manor center, underwoodroad of john health northeast nursing main

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› Url: https://downloads.cms.gov/files/cjr-snflist-q2-2020.pdf Go Now

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