Centers For Medicare & Medicaid Services

Court rules that SNF can't skip part of Medicare appeals process

Long-term care providers may not leapfrog standard administrative appeals in Medicare reviews, as one creative Louisiana nursing home was reminded last week.

Information security improves at Medicare contractors: OIG

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Information security at nine selected Medicare administrative contractors, at least as of two years ago, was improving, according to a recent report by the Department of Health & Human Services Office of the Inspector General.

Social Security numbers to be removed from Medicare beneficiary cards

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After more than 10 years of warnings by government investigators, the Centers for Medicare & Medicaid Services now has a mandate to remove Social Security numbers from enrollees' cards — a practice identified as one of the top personal financial threats seniors face today.

Ask the payment expert ... about RACs

Ask the payment expert ... about RACs

I thought the Recovery Audit Contractors were on hold, so why did I receive a request from our RAC for a Medicare Advantage resident?

Editor's desk: Stars losing their luster for 'punished' providers

Editor's desk: Stars losing their luster for 'punished' providers

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One gets the feeling that federal regulators, no matter how proper the official talk went, took a bit of pleasure in sending a message to providers when recently rebasing their star ratings.

Inspector General blasts agency for ignoring ZPIC scrutiny

Inspector General blasts agency for ignoring ZPIC scrutiny

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Ignoring a four-year-old warning to more thoroughly evaluate Medicare auditing contractors is among the pile of unheeded advice that could have saved the Medicare program billions of dollars in recent years, the Health and Human Services' Office of Inspector General charged Tuesday.

3M receives specific codes

3M Critical & Chronic Care Solutions Division announced the Centers for Medicare & Medicaid Services assigned product-specific Healthcare Common Procedure Coding System codes for the 3M™ Coban™ 2 Layer Lite Compression System (Cat #2794).

Ask the legal expert ... how to avoid deadbeat families

Ask the legal expert ... how to avoid deadbeat families

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What's the best way to prevent deadbeat families?

Ask the payment expert ... about regs vs. resident choice

Ask the payment expert ... about regs vs. resident choice

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We are going through culture change and wonder if surveyors will be more lenient with regulations if we do something that is resident choice?

CMS should push Congress on therapy rate upgrades: AHCA

CMS should push Congress on therapy rate upgrades: AHCA

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The Centers for Medicare & Medicaid Services should openly urge Congress to change therapy reimbursement, the nation's largest long-term care provider association stated in recent written comments to CMS Administrator Marilyn Tavenner.

CMS: Nurse shortage means hospices can keep using contracted workers

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Hospices can continue to rely on contract nurses because an ongoing nurse shortage is preventing providers from meeting their staffing needs, the Centers for Medicare & Medicaid Services announced in a recent memorandum to state survey agencies.

Judge blocks award of new RAC contracts

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Medicare's Recovery Audit Contractor program continues to struggle with controversy.

Hospice billings changed

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The Centers for Medicare & Medicaid Services recently updated instructions on coding hospice claims. Billing staffs should be aware of these changes, which went into effect Oct. 1, CMS stated in a memorandum about the Medicare manual update.

RACs collected nearly $2 million from skilled nursing facilities last year, report shows

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Recovery Audit Contractors recovered $1.8 million in Medicare overpayments made to skilled nursing facilities in fiscal year 2013, according to a Congressional report released Monday.

Rate hike will be only a part of the new Medicare reality

Rate hike will be only a part of the new Medicare reality

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Many providers are relieved that Medicare rates are slated to go up by 2% in the next fiscal year. After all, who wants to turn down $750 million, especially in a rate-cutting climate?

Why the New York Times' 'hatchet job' shows better days are coming to long-term care

Why the New York Times' 'hatchet job' shows better days are coming to long-term care

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A pall hangs over this sector at the moment, thanks to the New York Times.

CMS finalizes 1.4% increase for hospices

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Hospices can expect an estimated 1.4% increase in their payments for the fiscal year 2015, the Centers for Medicare & Medicaid Services announced Monday.

Looking at dementia beyond drugs and disease

Looking at dementia beyond drugs and disease

The emerging literature on "nonpharmacological interventions" has not succeeded in providing long-term solutions for many people, such that expressions of need continue to recur on a regular basis.

Medicare SNF rate finalized, reimbursements to increase by $750 million next year

Medicare SNF rate finalized, reimbursements to increase by $750 million next year

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Medicare skilled nursing facility reimbursements will increase by $750 million next year under a final payment rule announced Thursday by the Centers for Medicare & Medicaid Services.

Medicare should pay for skilled nursing services without a qualifying hospital stay, experts tell Senators

Medicare should pay for skilled nursing services without a qualifying hospital stay, experts tell Senators

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The time has come to eliminate hospital stay requirements for beneficiaries to qualify for Medicare coverage of skilled nursing services, experts told a Senate committee Wednesday.

Increased 'bed taxes' on nursing facilities warrant stricter federal oversight, report states

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States have been increasingly taxing skilled nursing facilities and other healthcare providers to fund Medicaid in recent years, and federal authorities should look more closely at this trend, according to a government report released Tuesday.

Long-term care facilities refusing free CMS resource on dementia, nurses association says

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Some nursing homes are not accepting a dementia training resource sent by the government, even though it is free and recommended, according to the American Association for Long-Term Care Nursing.

Congressional lawmakers grill top ALJ on appeals backlog, say too many providers are being put out of business

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Efforts to root out Medicare fraud have put far too many above-board providers in auditors' crosshairs, leading to a staggering backlog of appeals that has no easy fix, Congressional lawmakers and a top government official said during a hearing Thursday.

Senators blast Medicare audits, say RAC payments should be changed

Senators blast Medicare audits, say RAC payments should be changed

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The Medicare claims review process is unfairly burdening healthcare providers and failing to improve program integrity, due in part to the payment system for certain auditors, Senate leaders said during a roundtable hearing Wednesday.

Reducing readmissions should be No. 1 priority for reducing healthcare costs, quality experts say

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Reducing readmissions would have the most significant impact in bringing down U.S. healthcare costs, according to a survey of health quality experts.

 Skilled nursing facility readmissions should be an ACO quality measure, government proposes in payment rule

Skilled nursing facility readmissions should be an ACO quality measure, government proposes in payment rule

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Accountable care organizations should be assessed on the number of people who return to a member hospital within 30 days of being discharged to a skilled nursing facility, the Centers for Medicare & Medicaid Services has stated in a proposed rule.

CMS updates manual to reflect F-Tag guidance dating back to 2003

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The Centers for Medicare & Medicaid Services has revised the manual that long-term care facility surveyors refer to, updating interpretive guidelines related to F-Tags.

CMS announces Medicare appeals without administrative law judge hearings

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Long-term care providers will be able to appeal certain Medicare claims decisions without going through an administrative law judge hearing, the Office of Medicare Hearings and Appeals (OMHA) announced Thursday.

AHA pushes for payment policies to benefit hospital-based skilled nursing facilities

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The government should adjust Medicare payment policies to better support the type of care provided in hospital-based skilled nursing facilities, the American Hospital Association urged in a recent letter to a top healthcare official.

Skilled nursing providers and inpatient rehab facilities offer clashing views on Medicare payments as Congress hears testimony

Skilled nursing providers and inpatient rehab facilities offer clashing views on Medicare payments as Congress hears testimony

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Proposed Medicare payment changes have put the nation's largest long-term care association at odds with inpatient rehabilitation providers, and the two sides sought to sway legislators in advance of a Congressional hearing Wednesday.

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