CMS

Final rate notice signals continued pressure on Medicare Advantage payments

Final rate notice signals continued pressure on Medicare Advantage payments

CMS recently finalized Medicare Advantage plan payment rates for Calendar Year 2015 and announced other changes to payment and program policies for MA and Part D plans. Although the announcement included some positive changes for plans, the overall impact is mostly negative.

A time for nursing homes to embrace the cheddar while they can

A time for nursing homes to embrace the cheddar while they can

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It can almost be classified as a case of no good deed going unpunished. However, even though this is about long-term care, let's not be quite so skeptical. Progress is progress.

Proposed Life Safety Code updates encourage more homelike environments

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Updated fire safety regulations could encourage more home-like healthcare environments while increasing security to safeguard against wandering, according to a proposed rule announced Monday.

Emergency prep rule for long-term care should specify amount of supplies to have on hand, advocacy group says

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Long-term care facilities should have specified amounts of fuel and supplies on hand as part of a forthcoming regulation on disaster preparedness, a prominent consumer advocacy group argues.

Medicare manual revision addresses civil monetary penalty policies, survey timeframes

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A long-term care facility slapped with a civil monetary penalty has a chance for an independent informal dispute resolution, according to new manual guidance from the Centers for Medicare & Medicaid Services.

Feds looking to QAPI, not penalties, for help

Feds looking to QAPI, not penalties, for help

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Centers for Medicare & Medicaid Services officials said they consider the upcoming Quality Assurance and Performance Improvement guidelines, not harsher penalties, as the better way to reduce adverse events in post-acute care.

Expert panel recommends functional status quality measures for skilled nursing facilities

Expert panel recommends functional status quality measures for skilled nursing facilities

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An expert panel convened by federal regulators has offered recommendations for functional status quality measures in skilled nursing facilities. Released Friday was a summary of the experts' advice to create a functional status quality measure in SNFs, as well as inpatient rehabilitation facilities and long-term care hospitals.

CMS is failing to ensure that terminated skilled nursing facilities and other providers are not billing Medicaid, watchdog agency says

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The Centers for Medicare & Medicaid Services needs to do a better job of ensuring that terminated Medicaid providers in a particular state, including skilled nursing facilities, don't reappear in another state, according to a new government report.

Reducing seniors' drug use, one iPod at a time

Reducing seniors' drug use, one iPod at a time

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For reasons that are understandable yet hard to countenance, antipsychotic drugs are widely used in nursing homes. Too often over-used, according to government statistics. But it's beginning to look like new help may arrive — in the form of the iPod.

Medicare to cover hospice and curative care simultaneously in new demonstration program

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Medicare will reimburse both hospices furnishing palliative care and providers offering curative services under a new demonstration program, the Centers for Medicare & Medicaid Services recently announced.

Providers could lose Medicaid money and patient information due to ICD-10 transition, researchers find

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Healthcare providers could experience financial and information losses when they make the mandated transition to the new International Classification of Diseases coding system in October, according to researchers at the University of Illinois-Chicago.

Getting ready for the unthinkable

Getting ready for the unthinkable

Natural disasters and catastrophic events by definition arise unpredictably and consequently do not remain even in the back of people's minds on a consistent basis.

CMS budget defines nursing home quality targets, requests an additional $50 million for surveys

CMS budget defines nursing home quality targets, requests an additional $50 million for surveys

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The Centers for Medicare & Medicaid Services' proposed budget for fiscal year 2015 requests additional funds for survey activities and lists the agency's targets for nursing home quality measures.

CMS to weigh comments on disqualifying convictions in crafting background check regulations

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Long-term care stakeholders generally support proposed regulations on background checks of direct care workers, according to an informational memorandum issued Friday by the Centers for Medicare & Medicaid Services.

Regulators to double down on QAPI after government report on adverse events in post-acute care

Regulators to double down on QAPI after government report on adverse events in post-acute care

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The Centers for Medicare & Medicaid Services sees the upcoming Quality Assurance & Performance Improvement guidelines, not harsher penalties, as the way to reduce adverse events in post-acute care, officials said on an Open Door Forum call Thursday.

Updated emergency prep checklist from CMS includes resident tracking procedures

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Long-term care facilities should have written plans for how they will track residents during evacuations, according to an updated emergency preparedness checklist from the Centers for Medicare & Medicaid Services.

Don't miss a webinar on bundled payments March 7

Don't miss a webinar on bundled payments March 7

Learn the basics of the bundled payment program offered by CMS in a webinar featuring expert Ellen Lukens.

Likely closure can't stop CMS termination

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Despite meeting criteria for "irreparable injury," a Rochester, NY-based skilled nursing facility that is appealing Medicare and Medicaid termination can't qualify for a stay of termination, a federal judge has ruled.

Ask the care expert ... about interpretive guidance

Ask the care expert ... about interpretive guidance

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I heard there was communication to surveyors on being required to cite the regulation and not the interpretive guidance. Where can I find this?

With ICD-10 transition date firm and testing imminent, Medicare agency releases new provider resources

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Long-term care providers can refer to newly released materials about looming ICD-10 testing and the overall transition to the new coding system, but they should not expect any delay in the Oct. 1 transition date, according to the head of the Centers for Medicare & Medicaid Services.

Long-term care groups applaud a pause in Medicare audits, urge permanent changes

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Long-term care stakeholders are praising the government's decision to temporarily pause the recovery audit contractor program, which is associated with a huge backlog of Medicare claims appeals.

CMS memo explains four-part testing approach for ICD-10 implementation

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A new transmittal from the Centers for Medicare & Medicaid Services provides details about its four-part approach to implementing ICD-10 codes for Medicare fee-for-service claims. Medicare providers will be required to use these codes for dates of service on and after Oct. 1, 2014.

CMS calls for additional participants in post-acute bundled payments programs

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The Centers for Medicare & Medicaid Services has issued a call for additional providers to take part in a bundled payment program that involves post-acute care.

CMS clarifies rules regarding vaccines, respite care for hospice patients

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The Centers for Medicare & Medicaid Services has loosened regulatory language regarding which providers can furnish vaccines to hospice patients, and has tightened enforcement of a five-day payment limit for respite care.

CMS wants tougher emergency prep rules

CMS wants tougher emergency prep rules

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Long-term care facilities would have to meet more comprehensive emergency preparedness guidelines if a newly proposed rule from the Centers for Medicare & Medicaid Services is enacted.

Open Door Forum on 'two-midnight' hospital stay policy Tuesday

The Centers for Medicare & Medicaid Services is holding a special Open Door Forum conference call at 1 p.m. (Eastern Time) Tuesday to discuss the "two-midnight" hospital inpatient policy. Callers also can ask questions about physician order, physician certification and medical review criteria. They were previously released in August in the fiscal 2014 Inpatient Prospective Payment System/Long-Term Care Hospital final rule.

A 'Super' physician-pay fix in the making?

A 'Super' physician-pay fix in the making?

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I suppose it's only fitting that during the week of the season's biggest football game, Washington healthcare wonks are discussing a potential huge punt of their own.

CMS needs to improve oversight of Medicare contractors' error rate reduction plans, report says

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Too many Medicare providers are receiving improper payments, and the Centers for Medicare & Medicaid Services should clamp down by doing a better job overseeing its contractors' error rate reduction plans, according to a new government report.

Jimmo correction: Assistants may provide maintenance services in skilled nursing facilities

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Skilled nursing facilities may be reimbursed for maintenance therapy services performed by assistants, the Centers for Medicare & Medicaid Services clarified in a recent Medicare Benefit Policy manual revision. CMS officials announced and explained the revision in an Open Door Forum call Thursday.

Overdocumentation and cloning in electronic health records are overlooked risks, investigators say

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Auditors reviewing Medicare and Medicaid claims from electronic health records are largely treating them in the same manner as paper claims, even though they pose unique risks for overbilling and fraud, according to a government report released Wednesday.

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