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.
A troubling proportion of hospices fail to provide skilled nursing care to patients approaching death or who are experiencing a crisis such as increased pain, according to a lengthy Washington Post article published Saturday. The Post report appeared one day after the government proposed increasing Medicare hospice payments in 2015.
Medicare would increase skilled nursing facility reimbursements by $750 million in 2015 under an updated payment rate proposed Thursday. CMS also will begin tying reimbursements to new statistical area designations set by the Office of Management and Budget.
COMS Interactive LLC has announced a collaboration with Remedy Partners Inc. around the Bundled Payment for Care Improvement program.
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.
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.
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.
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.
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.
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.
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.