CMS

The G-codes are here for payment claims — ready or not

The G-codes are here for payment claims — ready or not By

Effective July 1, the Centers for Medicare & Medicaid Services will begin rejecting claims received for Medicare Part B patients that do not include the new requirement of G-coding. That really means providers need to be ready by June 1.

SNFs could see 50% payment reduction for Pre-Existing Condition Insurance Plan claims

SNFs could see 50% payment reduction for Pre-Existing Condition Insurance Plan claims  By

The federal government's Pre-Existing Condition Insurance Plan will reduce its payments to skilled nursing facilities by 50% as of June 15, according to the Centers for Medicare & Medicaid Services. The PCIP program received a budget of $5 billion in ACA funding, and CMS fears it will run out of money prior to 2014 given the current rate of pay-outs.

$1 billion available for projects to 'rapidly reduce' post-acute care costs, CMS announces

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The second round of the Health Care Innovation Awards is now underway, the Centers for Medicare & Medicaid Services announced Wednesday. CMS will distribute up to $1 billion to fund projects that aim to improve care while cutting costs for the Medicare and Medicaid programs.

CMS updates SNF Medicare manual to implement sequestration cuts

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The Centers for Medicare & Medicaid Services has updated the online Medicare Provider Reimbursement Manual, modifying instructions related to the 2% reimbursement reductions resulting from sequestration.

Senate confirms Tavenner as CMS administrator

Senate confirms Tavenner as CMS administrator  By

Marilyn Tavenner has become the first confirmed head of the Centers for Medicare & Medicaid Services in seven years. Advocates in the long-term care sector welcomed the news.

MDS update will expand use of modifications to make changes

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The Minimum Data Set manual will be revised to reflect a new correction policy, the Centers for Medicare & Medicaid Services recently announced.

NPWT yields positive results for patients

NPWT yields positive results for patients

Negative Pressure Wound Therapy ("NPWT") is one of the oldest forms of medicinal therapy used to heal the human body. Over the past decade there has been a significant increase in the use of this therapy.

CMS: Medicare rate increase would boost SNF payments by $500 million

CMS: Medicare rate increase would boost SNF payments by $500 million By

Total Medicare reimbursements to skilled nursing facilities would increase by $500 million in 2014 under the new payment rate proposed by the Centers for Medicare & Medicaid Services. The agency is also proposing a new Minimum Data Set item related to therapy.

Medicare safe from ACA-mandated cuts, official says

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Potential Medicare cuts called for by the Affordable Care Act will not occur, a chief government actuary has announced. Long-term care organizations said the news comes as a relief for providers who have weathered a series of recent payment reductions.

CMS: Hospices to receive $180 million more from Medicare next year

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Hospices will reap a 1.1% increase in Medicare payments in fiscal year 2014, according to a proposed rule issued by the Centers for Medicare & Medicaid Services.

Sequester cuts are bringing changes to survey process

Sequester cuts are bringing changes to survey process By

The Centers for Medicare & Medicaid Services will change some nursing home survey procedures in response to budget cuts from sequestration, according to memos released April 9. The CMS Survey & Certification budget has been reduced 5% from 2012, the agency announced.

Looking to open eyes about 'observations'

Looking to open eyes about 'observations' By

Bully for provider groups pulling out the stops to draw attention to the ludicrous mishandling of "observation stay" designations by many hospitals. One prong of the plan is to have providers supply anecdotes about individuals hurt financially and emotionally by the practice.

New calculation method would reduce readmissions penalties, CMS says

New calculation method would reduce readmissions penalties, CMS says By

The Centers for Medicare & Medicaid Services has proposed changing the way hospital readmission penalties are calculated as part of its 2014 Medicare rate update. Potential readmissions penalties for long-term care providers — such as those recently floated by the White House — would likely be based on the established CMS formula for hospitals.

Make CMS audits less burdensome, providers urge lawmakers

Make CMS audits less burdensome, providers urge lawmakers By

The Centers for Medicare & Medicaid Services could take a variety of steps to make audits less burdensome, healthcare providers stated in white papers submitted to members of the Senate Finance Committee. The committee released a report Thursday, summarizing stakeholders' input and recommendations for improving the audit process.

HHS wants $10 million potential payday for Medicare fraud whistleblowers

HHS wants $10 million potential payday for Medicare fraud whistleblowers By

The Department of Health and Human Services is trying to encourage Medicare fraud whistleblowers by substantially increasing their potential reward. The current maximum award of $1,000 would go up to $9.9 million per whistleblower if a recently proposed rule takes effect.

CMS revises survey guidelines for some long-term care providers with Immediate Jeopardy citations

CMS revises survey guidelines for some long-term care providers with Immediate Jeopardy citations   By

Regional authorities will decide whether to conduct full surveys of deemed long-term care providers that are cited for Immediate Jeopardy, according to recently revised guidelines from the Centers for Medicare & Medicaid Services.

National provider call: Tips on application process for Medicare Shared Savings Program

The Centers for Medicare & Medicaid Services will be hosting a national conference call on Tuesday for providers interested in applying to take part in the Medicare Shared Savings Program. The 90-minute session starts at 1:30 p.m. Eastern. The Shared Savings Program is designed to help provides take part in Accountable Care Organizations (ACOs). On Tuesday, experts will offer tips on completing a successful MSS Program application, and more info on ACOs.

CMS work group recommends approach for employing former criminals in long-term care settings

CMS work group recommends approach for employing former criminals in long-term care settings By

Long-term care providers and states should agree on what a "direct access employee" is and whether that person has a criminal conviction that should keep him or her from working in a nursing home, according to a a recently released report from the Long-Term Care Criminal Convictions Work Group.

CMS addresses physician task delegation

CMS addresses physician task delegation

Nursing home operators can now download a brief clarifying which tasks physicians may delegate to other practitioners caring for Medicare beneficiaries in skilled nursing facilities,

CMS changes nursing home inspections in response to sequestration cuts

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The Centers for Medicare & Medicaid Services will change some nursing home survey procedures in response to budget cuts from sequestration, according to memos released Tuesday. The CMS Survey & Certification budget has been reduced 5% from 2012, the agency announced.

Court ruling opens door for providers to seek reimbursement for Medicare bad debts

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Providers may be reimbursed for Medicare beneficiaries' bad debts even after sending them to a collection agency, a U.S. District Court judge has ruled.

F-Tag 322 (Feeding Tubes): Are our systems in order?

F-Tag 322 (Feeding Tubes): Are our systems in order? By

CMS recently made changes to surveyor guidance on feeding tubes. Nursing homes must look at their policies, documentation and education practices in order to assess whether a feeding tube is appropriate.

CMS clarifies physician delegation of tasks in skilled nursing facilities

CMS clarifies physician delegation of tasks in skilled nursing facilities By

Nursing home operators can now download a brief clarifying which tasks physicians may delegate to other practitioners caring for Medicare beneficiaries in skilled nursing facilities, the Centers for Medicare & Medicaid Services announced in a document released Wednesday.

Tavenner confirmation hearing set for next Tuesday

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The Senate Finance Committee will hold a confirmation hearing for Marilyn Tavenner, currently the acting administrator for the Centers for Medicare & Medicaid Services, on Tuesday, April 9.

Will there be a 'real' CMS administrator soon? It's looking so

Will there be a 'real' CMS administrator soon? It's looking so By

If you're a gambling person, it looks like the odds just got a whole lot better for Marilyn Tavenner becoming the next administrator of the Centers for Medicare & Medicaid Services. That's the person who manages the main funding streams of long-term care in the United States.

Automatic 2% Medicare cuts begin

Automatic 2% Medicare cuts begin By

The 2% reduction in Medicare payments known as sequestration began Monday. Providers should begin to see the impact by mid-April. The reductions will affect claims with dates of service or discharge on or after April 1, 2013.

Feds offer more support for workers' background checks

Feds offer more support for workers' background checks By

A federal agency is again offering to put its money where its mouth is when it comes to employee background checks for long-term care providers. All direct-care employees could potentially be affected.

State, CMS pair up on duals

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The Centers for Medicare & Medicaid Services and the state of Illinois are teaming up in a dual eligible payment demonstration.

Court upholds Immediate Jeopardy tags

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An Alabama nursing home that did not properly handle a resident with pressure sores on her feet is on the hook for Immediate Jeopardy fines of nearly $135,000, a federal appeals court recently affirmed.

Regulations for nursing home ethics programs and QAPI still in the works, administrators say

Regulations for nursing home ethics programs and QAPI still in the works, administrators say By

The Centers for Medicare & Medicaid Services is still working on the regulations for ethics and compliance programs that nursing homes were supposed to have implemented this month, CMS administrators admitted in an Open Door Forum call Thursday.

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