Download Free Medicare Program Contract Year 2015 Policy And Technical Changes To The Medicare Advantage And The Medicare Prescription Drug Benefit Programs Us Centers For Medicare And Medicaid Services Regulation Cms 2018 Edition Book in PDF and EPUB Free Download. You can read online Medicare Program Contract Year 2015 Policy And Technical Changes To The Medicare Advantage And The Medicare Prescription Drug Benefit Programs Us Centers For Medicare And Medicaid Services Regulation Cms 2018 Edition and write the review.

This report provides a general overview of the Medicare program including descriptions of the program's history, eligibility criteria, covered services, provider payment systems, and program administration and financing.
Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.
Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
The Social Security Administration (SSA) administers two programs that provide benefits based on disability: the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. This report analyzes health care utilizations as they relate to impairment severity and SSA's definition of disability. Health Care Utilization as a Proxy in Disability Determination identifies types of utilizations that might be good proxies for "listing-level" severity; that is, what represents an impairment, or combination of impairments, that are severe enough to prevent a person from doing any gainful activity, regardless of age, education, or work experience.
Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.
Publisher's Note: Products purchased from Third Party sellers are not guaranteed by the publisher for quality, authenticity, or access to any online entitlements included with the product. Discover the medication therapy management solution—with this definitive, up-to-date sourcebook The need to improve the use of medications has major implications for the nation’s healthcare system. Burdened by high costs and an ineffective process of providing medication therapy, the current prescription drug environment poses considerable risks to patient safety. Medication therapy management (MTM) is designed to address these deficiencies—and this essential text gives pharmacists all the right MTM tools to identify and eliminate drug-related problems that can cause potentially severe adverse events. Medication Therapy Management delivers the most relevant insights into MTM—a vital service that is gaining momentum due to the rapid growth of patient-centered care, healthcare information technology, new practice models (e.g., Patient Centered Medical Home), and new payment methods. Cohesively organized, this expert-authored guide begins with an introduction to data sets for MTM, covering essential topics such as establishing quality and performance improvement, the payer perspective, conducting the comprehensive medication review, and reimbursement. The second part of Medication Therapy Management reviews MTM data sets for a wide spectrum of disorders, from asthma and atrial fibrillation to HIV and heart disease. Enhanced by the latest perspectives on therapeutics, including completely up-to-date tables throughout, Medication Therapy Management is a practical, skill-building roadmap for optimizing drug therapy and enhancing patient outcomes. Features • Everything you need to provide successful MTM services and empower patients to take an active role in their medication and overall healthcare • Turnkey disease-based data sets help you apply proven MTM principles to common disorders • Helpful appendices cover therapy management characteristics and answers to key questions; the MTM practice model and training survey; and the Medicare Part D MTM program standardized format