The rate of improper Medicare payments to skilled nursing facilities has increased largely due to issues with certification and recertification statements, according to a recently released government memorandum. The Centers for Medicare & Medicaid Services document summarizes requirements that SNF physicians, non-physician practitioners (NPPs) and billing staffs must meet for compliance.
Long-term care may be a calling, but it's still a job, and it's an industry that would be served by a reduction of emotion. That's especially true when discussing the government, which is called out in histrionic terms fairly often.
Long-term care and other providers could be facing unfair burdens due to ineffective government oversight of Medicare auditors, according to a new report from a federal watchdog agency.
Several skilled nursing facility workers expressed frustration regarding communications with Medicare Advantage organizations during a public call with government officials Wednesday. Centers for Medicare & Medicaid Services representatives acknowledged that provider frustration in this area has been an ongoing issue, but they said that their hands essentially are tied.
Depending on how you like to interpret the news, nursing home operators are either facing some of the worst of times, or they've been infused with new life.
Hospices can expect an estimated 1.4% increase in their payments for the fiscal year 2015, the Centers for Medicare & Medicaid Services announced Monday.
Long-term care facilities and other Medicare providers increasingly have seen reimbursements influenced by the government's Fraud Prevention System, an official recently told a Congressional panel.
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 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.
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.
The Centers for Medicaid & Medicare Services has revised guidance on authorization of hospice drugs for those under Medicare Advantage and Part D plans, according to a new memo.
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.
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.
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.
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.
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.
Fraud prevention system doubled its improper Medicare payment collections ... Healthcare groups ask Supreme Court to declare False Claims Act penalty system unconstitutional ... New LTC administrator code of ethics updates discrimination and personal conduct language ... IA nursing home agrees to $500,000 settlement over improper therapy claims
Centers for Medicare & Medicaid Services announced that a proposed rule addressing changes in the Accountable Care Organizations program is coming soon, an official said at the Accountable Care Organization Summit on June 19.
It is critical to have a solid system for discharge planning that begins even before the resident is admitted to the facility. Individualized, resident-centered discharge planning will provide a solid system for quality transition and a crucial component of care at the preadmission assessment process.
The government's oversight of Medicaid managed care organizations is not strong, even though these entities cover about 50 million people and are growing rapidly, according to a recently released report from a watchdog agency.
For skilled nursing facilities, the Medicare SNF 3-day rule can make it difficult to place the right patients in the right setting at the right time. The 3-day rule requires that a Medicare beneficiary spend three nights in a hospital as an inpatient — observation stays do not count — before becoming eligible for Medicare-covered SNF care. This rule creates a challenge for SNFs as hospital lengths of stay decline for many of the conditions that SNFs treat.
Senators ask for provider input on healthcare data availability ... "Frailty index" can help predict post-surgery SNF admission ... Hospice association sues CMS over documentation rule ... Complex nursing home embezzlement case can go to trial
The Centers for Medicare & Medicaid Services will hold its Medicare Advantage & Prescription Drug Oversight & Enforcement 2014 Program Audits conference on Tuesday, June 24 .It is designed to "provide insight into how MA and Part D organizations can best prepare for a CMS performance audit." Participants can attend in-person or virtually.
If you listen to the lobbyists for medical device manufacturers, health information technology is the answer to our biggest healthcare troubles. America's registered nurses have a different perspective.
It is "totally wrong" for providers to let their PEPPERs fall into the hands of outside vendors, a leading long-term care coding and payment expert warned a national audience on Tuesday.
Providers aren't just being accused of coding therapy patients in higher payment categories than ever before. The charge is being backed by hard numbers in a recent memorandum from the Centers for Medicare & Medicaid Services.
As spring blends into summer, some nursing home operators are going to start feeling more heat — and it will have nothing to do with the weather. They will be given places on the proverbial hot seat. Well-earned seating arrangements, as it were.
Long-term care providers have a stronger hook than they probably realize regarding the toughening of penalties for hospitals with high readmission rates.
The readmission scores of nursing homes will be posted to the Nursing Home Compare website beginning in 2017, and the VBP program will begin Oct. 1, 2018. For the first time, facilities will not just face financial penalties, they will be incentivized to reduce readmissions
Decreased payouts for nursing home care was one reason that healthcare spending grew more slowly for seniors than for any other age group between 2002 and 2010, the Centers for Medicare & Medicaid Services announced Monday.