CMS

Stakeholders need to prepare for the loss of long-term care's exemption to e-prescribing

Stakeholders need to prepare for the loss of long-term care's exemption to e-prescribing

The Centers for Medicare & Medicaid Services is set to lift long-term care's exemption from its e-prescribing rule as of Nov. 1. This is bigger news than most realize right now, and there has been no indication CMS is going to postpone things.

November 1: Will you be ready?

November 1: Will you be ready?

This year, it is the day after Halloween that might be scary. On November 1, prescribers, pharmacies and facilities in the long-term-care industry must cease the transmission of electronic medication orders via the HL7 and e-fax methods that predominate today.

The end of fee for service

The end of fee for service

The seeds that have flowered into the burgeoning of ACOs - groups of providers accepting the responsibility, and risk, for caring for the health of a designated patient population according to defined quality benchmarks (CMS measures quality of care using 33 measures in four key domains) - was planted long ago, in the baby boom.

CMS 'Open Door Forum' Wednesday

The next Skilled Nursing Facilities/Long-Term Care Open Door Forum operated by federal regulators will be Wednesday.

Latest therapy-billing showdown could be ominous sign for long-term care providers

Latest therapy-billing showdown could be ominous sign for long-term care providers

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Don't let anyone tell you that long-term care operators don't know how to read between the lines. They might not have known to fear a McKnight's Monday news item before it broke, but it definitely has their attention — and apprehension — now.

CMS should publicly push Congress to reform therapy payment system, long-term care provider association urges

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

The government plans a 'computer matching program' to combat improper Medicare, Medicaid payments

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The government plans to start a "computer matching program" to reduce improper payments from government health programs to providers and other entities, the Centers for Medicare & Medicaid Services announced in a memorandum Friday.

Why the survey system may never be fixed

Why the survey system may never be fixed

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Given certain realities about skilled-nursing facility inspections, we should not be wondering why cheating has occurred. Rather, we should be amazed it hasn't been more rampant.

Federal judge blocks new RAC contracts

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Adding to the ongoing controversy around Medicare's Recovery Audit Contractor program, a judge has ruled that the government cannot award new RAC contracts until disputed payment terms are resolved.

CMS updates coding instructions for hospice site of service, principal diagnosis

CMS updates coding instructions for hospice site of service, principal diagnosis

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A new Medicare hospice manual update includes instructions for which principal diagnosis codes are acceptable, and clarifies which codes should be used for services in a skilled versus non-skilled nursing facility. Billing staffs should be aware of these changes, which go into effect Oct. 1, the Centers for Medicare & Medicaid Services stated in an educational memorandum sent Friday via email.

The nursing home survey system is about to get a much closer look

The nursing home survey system is about to get a much closer look

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You had to know this was coming. Earlier this week, the New York Times reported that many nursing homes are submitting massaged staffing and quality indicator data to the feds. The alleged reason? So facilities could pull better Five Star ratings.

CMS: Discharge assessments must be completed when residents transfer to a non-certified bed within the nursing facility

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Skilled nursing facilities must complete a discharge assessment when a resident is transferred from a certified to a non-certified bed, even if both beds are in the same building, the Centers for Medicare & Medicaid Services emphasizes in a recent memorandum.

Also in the news for August 27, 2014 . . .

Dementia sharply increases stroke risk ... CMS releases training tool to build respect for LGBT long-term care residents ... Canes fitted to the hip are better for stroke patients ... 'Mindfulness' training improves sleep, reduces depression in early-stage dementia

Readmission penalty categories inspire more analysis and opportunity

Readmission penalty categories inspire more analysis and opportunity

The Medicare stakes are about to get higher.

CMS: Many skilled nursing providers have poor Medicare certification and recertification practices

CMS: Many skilled nursing providers have poor Medicare certification and recertification practices

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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.

Reducing emotion in long-term care

Reducing emotion in long-term care

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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.

Report: Long-term care providers pay the price for CMS' poor auditor oversight

Report: Long-term care providers pay the price for CMS' poor auditor oversight

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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.

Medicare Advantage organizations are unresponsive to provider questions, long-term care professionals tell CMS

Medicare Advantage organizations are unresponsive to provider questions, long-term care professionals tell CMS

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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.

Why be optimistic when anxiety is an option?

Why be optimistic when anxiety is an option?

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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.

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.

Better anti-fraud efforts are not appeasing lawmakers

Better anti-fraud efforts are not appeasing lawmakers

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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.

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.

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.

CMS changes mind on hospice drugs

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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.

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.

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.

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