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Centers For Medicare & Medicaid Services

Heart failure readmission rates tied to regional socioeconomic factors, research shows

McKnight's Staff May 18, 2012

Socioeconomic differences and factors such as the availability of physicians have a bigger impact on readmission rates for heart failure than a provider's performance, a new study asserts.

Final rule reduces regulatory burden for long-term care facilities

McKnight's Staff May 11, 2012

A new rule eases the regulatory burden on providers serving Medicare and Medicaid beneficiaries and has the potential to save the healthcare system $100 million in the first year.

Some Medicaid doctors to receive reimbursement rates that equal Medicare's

Physicians providing primary care services to Medicaid beneficiaries will see a federal payment increase to bring Medicaid payments in line with those of Medicare payments, government officials announced Wednesday.

Advocates for dual eligibles are concerned about the fast pace of demonstration project timeline

McKnight's Staff May 02, 2012

Medicare advocates are concerned about the speed with which the federal government is implementing care coordination plans for dual eligibles, according to reports.

Antipsychotic drug use correlated to staffing levels

McKnight's Staff May 01, 2012

While antipsychotic drug use overuse has decreased since 2005, nearly a quarter of U.S. nursing homes are still giving many residents the medications against recommendations, a Boston Globe analysis reveals.

Regulators have tightened up screening efforts for Medicare providers

McKnight's Staff April 24, 2012

Regulators have strengthened Medicare provider enrollment and toughened fraud prevention efforts, but it's too early to know how effective the initiatives will be, a new report reveals.

Reports forecast Medicare funding boost, dim overall outlook

McKnight's Staff April 23, 2012

The Affordable Care Act will help Medicare save over $200 billion through 2016, according to government actuaries. But questions as to Medicare's long-term solvency remain, another report from Social Security and Medicare Boards of Trustees states.

Nursing homes show strong interest in CMS dual eligible coordination initiative, official says

McKnight's Staff April 23, 2012

Skilled nursing facility operators have responded positively to a Center for Medicare & Medicaid Services initiative to reduce hospital readmissions among dual eligibles, agency officials said.

Quality measures needed to evaluate end-of-life care in nursing homes, study urges

McKnight's Staff April 17, 2012

As the number of people who choose nursing homes for end-of-life care continues to rise, more quality measures are needed to help consumers judge quality, a new study recommends.

Will nursing homes be subcontractors to the stars?

John O'Connor April 16, 2012

Nursing homes take care of 1.5 million residents each year. They pump more than $100 billion into the nation's economy. In many communities, they are the largest source of jobs. But as far as the Centers for Medicare & Medicaid Services is concerned, nursing facilities are little more than the help.

Troubling steps ahead for Nursing Home Compare?

John O'Connor April 13, 2012

A newly announced plan to mine data from Medicare Advantage plans might give many operators an unexpected spine shiver.

New Medicaid regulations give states flexibility with home and community based services

McKnight's Staff April 10, 2012

State Medicaid programs have been granted additional flexibility in providing home- and community-based services to elderly and disabled individuals, according to new regulations.

Study highlights cost-effectiveness of home healthcare as post-acute setting

McKnight's Staff April 09, 2012

When home healthcare is used as the first post-acute care setting after a hospital stay, it was found to be the most cost-effective care setting, new research suggests.

Providers would be overburdened by Medicare overpayment rule, expert notes

McKnight's Staff April 06, 2012

A proposed rule that would require Medicare providers to return overpayments within 60 days of detection could significantly increase administrative time and costs, an expert says.

Memo clarifies April 1 MDS 3.0 changes

McKnight's Staff April 03, 2012

Failure to keep up with the changes could be costly for providers, experts warned, so CMS released a memo to clarify a number of questions from skilled nursing facility operators.

Antipsychotics boost heart attack risk in seniors, study finds

McKnight's Staff March 30, 2012

Elderly dementia patients who are prescribed antipsychotics face a greater risk for a heart attack within the first month of treatment, a new study found.

Online expo concludes today

McKnight's Staff March 22, 2012

The capital landscape for long-term care continues to rebound, which is good news for operators looking to expand in 2012 and beyond, analyst Michael Hargrave told McKnight's Online Expo participants Wednesday.

Failure to prepare for MDS updates in the next 10 days could be costly, expert warns

McKnight's Staff March 21, 2012

If skilled nursing facilities are not prepared for the MDS 3.0 changes that will go into effect April 1, 2012, the consequences could be expensive, a top expert warned Wednesday.

Medicare auditors can request twice as many SNF medical records

McKnight's Staff March 20, 2012

Medicare recovery audit contractors (RACs) can now request twice as many resident medical records than previously allowed, according to the Centers for Medicare & Medicaid Services.

CMS clarifies Medicaid eligibility requirements under the Affordable Care Act

McKnight's Staff March 19, 2012

The Centers for Medicare & Medicaid Services announced a final rule clarifying eligibility and income standards for the expansion of Medicaid under the Affordable Care Act.

CMS delays implementation of stricter claims transmission standards

McKnight's Staff March 16, 2012

The Centers for Medicare & Medicaid Services announced Thursday it is again pushing back the deadline for compliance with a set of claims transmission standards.

Medicare enhances readability and fraud protections with streamlined benefit statements

McKnight's Staff March 08, 2012

Medicare recipients soon will be reaping the benefits of simplified benefit statements and will see added protections against Medicare fraud, the Centers for Medicare & Medicaid Services announced Wednesday.

Start with CMS contractor when facing claim issues, expert advises

March 02, 2012

Providers who have claims being returned or have problems with claim entry systems need to start with their Centers for Medicare & Medicaid Services contractor, a CMS spokesman said Thursday.

Federal officials crack $375 million home healthcare fraud scheme

McKnight's Staff February 29, 2012

Federal officials have brought down what they said is the largest home health fraud scheme ever concocted. The Centers for Medicare & Medicaid Services said around $375 million was billed incorrectly to Medicare and Medicaid, and announced the suspension of 78 home health agencies associated with physician Jacques Roy, M.D., of Rockwall, TX.

CMS releases Stage 2 meaningful use requirements

McKnight's Staff February 27, 2012

The Centers for Medicare & Medicaid Services has announced its second stage of requirements for healthcare providers looking to participate in electronic health records incentive programs.

CMS issues final rule for Medicaid demonstration

February 24, 2012

The Centers for Medicare & Medicaid Services has issued a final rule on procedures states must follow when running Medicaid demonstration projects.

Lack of documentation accounts for Medicare fee-for-service error rate

February 21, 2012

Medicare's fee-for-service error rate for fiscal 2010 would have fallen if compliance contractors had successfully obtained better claims documentation, a federal report found.

Footloose with Medicare dollars?: Investigators concerned by sharp increase in artificial feet

February 16, 2012

Physicians and federal investigators are concerned about a dramatic surge in Medicare spending for artificial feet for beneficiaries. While the number of diabetes-related lower limb amputations is falling, Medicare spending on artificial feet grew 60% in the last few years, according to an Associated Press investigation.

McKnight's Online Expo to cover audits, payments for SNFs

February 14, 2012

Medicare's recovery audit contractors (RAC) program recovered $398 million in overpayments in the first quarter of fiscal year 2012, according to a government report.

Common pay system for three post-acute care settings appears doable, new report says

February 09, 2012

Relief could be on the horizon for providers, regulators and other stakeholders who have struggled to find common evaluation and payment models for individuals who move between post-acute care settings, researchers say.