Medicaid

More specifically, it is a law that “governs physician self-referral for Medicare and Medicaid patients” (StarkLaw.org, 2008). Essentially, the Stark Law prohibits physicians such as orthopaedic surgeons from referring their Medicare and Medicaid patients to “designated health services” (DHS) if said physician has any kind of financial relationship with that entity. As defined by Stark Law, a DHS refers to: clinical…

United States without paying any attention to their income level or their health status. The federal health insurance program caters a number of expenses that concern Medicare. These expenses are catered for by an external body, Centers for Medicare & Medicaid Services (CMS), which happens to be an affiliate of the United States department of Health and Human Services. Citizens who mainly benefit from this service are those that are of 65 years of age and individuals with lameness and permanent…

Healthcare Compliance Programs Lawyers The concept of healthcare compliance programs began in 1997 with a publication by the Office of Inspector General (OIG) within the US Department of Health and Human Services (HHS). That first program was designed for individuals and small group physician practices. Since that time, there have been an entire series of HHS OIG compliance guidelines addressing other segments of the health care industry that includes: nursing facilities, HHS research grants…

For example, nursing home residents who wish to be eligible for Medicaid find they cannot have more than $1,600 in assets, yet this does not mean their spouse is limited to this amount. The healthy spouse retains certain assets which the courts have deemed exempt, such as a home regardless of its value. Furthermore, the…

Accreditation is proving to an official organization that has authority to state if your organization meets the demands that are set for facility to show the team of accreditors that you are competent and have met a set of standards. When your facility gets accredited by the official organization the stakeholders are ensured that the facility meets a set of standards in quality and safety. Being an accredited facility means you have reached the gold seal in quality and safety for your patients…

Kimberly Dobladillo Article #1 HPR 65 Professor Forsberg October 4, 2017 Medicaid expansion was introduced during the Obama administration, since then it has provided many more Americans afford healthcare coverage. According to The Henry J. Kaiser Family Foundation article it shows that in 2015, there were over 43 million adults that had mental illness and around 10 million that had a serious mental illness. Such as depression, bipolar disorders or schizophrenia etc. When it comes to…

Related Groups (DRG) 291-293 found on paid claims data. DRG ‘s established through the inpatient prospective payment system are part the methodology of reimbursement created by the Centers of Medicare and Medicaid Services as a provision of the Social Security Act of 1886. (Centers of Medicare and Medicaid Services,…

towards our elder years, we begin to face important decisions as we anticipate and plan for the years to come. One of the more significant milestones occurs at age 65, when we become eligible for Medicare. According to the Centers for Medicare and Medicaid Services [CMS] (n.d.), Medicare is defined as, “the federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring…

I am writing this memo to present my findings about the Oregon Medicaid Innovation and show that it can be a very good model to implement in Maryland. Both Maryland and Oregon can benefit from a support from each other in the improvement of Medicaid. Summary Medicaid in the United States can be described as a social health care program for families and persons with inadequate resources and low income (Institute for Healthcare Improvement). Maryland is operating a state program referred to as…

The Medicaid program was made into law in 1965. It is sponsored by the state and federal government. The federal government pays fifty-seven percent and the state government pays the remaining forty-three percent. Pew Research Center provides information to the public about the issues going on around the world said, “Medicaid is the largest public health insurance program in the United States, covering both acute and long-term care for over sixty-six million low-income Americans” (Medicaid).…