Centers for Medicare and Medicaid Services

Developed in 1988, CLIA consist of regulations set in place by the federal government to improve the quality of laboratory testing. Under CLIA laboratories have to be certified by their state and CMS (Center for Medicare and Medicaid Services) before they can accept any human samples to test. Laboratories may have multiple certifications for multiple types of testing. CLIA has waived some test that has been determined to be simple, easy, and has a low-risk of erroneous test results. These waived…

Healthcare System is a very unique but complicated network of various health care providers. It includes profit and non-profit private owned hospitals, government hospitals, urgent care centers, primary care practices, specialty treatment centers, hospice services, and pharmacies. Majority of Americans pay for medical services through private insurance provided by theirs, their spouse or parent’s employer, which they have to pay a partial monthly premium cost. Individuals with low income are…

the Department of Human Services (HHS) (2015) reports the government has recovered a record high recovery of $10.7 billion in health care fraud. The…

programs continue to receive majority of government funding to create and support the newly established Center for Medicare and Medicaid Services because the overall expectation of the center is to conduct demonstration projects that test new ways to deliver and pay for health care in certain programs like Medicare and trying to identify approaches that reduce spending and improve quality. The center was established under the Affordable Care Act and its process for conducting new programs and…

hospital for heart failure, myocardial infarction or Pneumonia. Such qualities are measured in units of standard deviation. Hospital Value-based purchasing program is a center for Medicaid services and Medicare initiative which rewards acute-care hospitals with incentive payments for quality care they provide to the beneficiaries of Medicare. HVBP are normally applicable in acute care hospitals. Alternatives 1. Effect of Hospital Value based…

children moved into government subsidized housing. She was then able to obtain Medicaid and begin her…

1. Hospital Value-Based Purchasing (VBP) Program is part of the Centers for Medicare and Medicaid Services (CMS), which holds providers accountable for the cost and quality of care they provide to Medicare and Medicaid patients. The framework of the VBP Program was built around aims of “integrat[ing] information on quality with cost data, focus[ing] on managing the use of healthcare system[s] to reduce inappropriate care, and identif[ying] and reward[ing] best-performing providers” (286,…

(HITECH) Act aim to produce better health care. These regulations, laws, and standards, cover items from the transfer of information between involved parties through what constitutes acceptable electronic health records (EHR) as defined for Medicare and Medicaid. Wager, Lee, and Glaser, J. P. (2013) define a health information exchange (HEI) as "electronic movement of health related information among organizations according to nationally…

The Medicare community has oversight by the Center for Medicare and Medicaid Services, (CMS). Healthcare organizations are contracted to provide quality healthcare options for consumers by CMS however; each plan has limitations in those plan that prevent the consumer from obtaining that quality care they expect. Some of the main concerns that prohibit streamlining the process are plans dropping doctor’s mid-year without sufficient notice to members, coverage problems not clearly identified in…

Advantages of EHR over paper records include an expansive storage capability, availability of the data from many access points at the same time, and nearly immediate retrieval time (Gurley, 2003). The paper record is fragmented and depending on the charts used (e.g. some tend to fly open when dropped, causing paper to be scattered), pieces of the record can be lost. Additionally, when a patient is hospitalized more than once, their old chart must be retrieved in order to provide continuity of…