With so many regulatory changes kicking in on Oct. 1, it's no wonder providers were likely too distracted to notice the latest "trick" by the Centers for Medicare & Medicaid Services.
When the Centers for Medicare & Medicaid Services announced in July that it was implementing a system of bundled payments for knee and hip operations in 75 geographic areas of the country, it prompted CFOs and accountants at many skilled nursing facilities to ask themselves an awkward question: What is our share of the episode cost to CMS, and what does this procedure actually cost us?
If you wait to only react to the process, you will have to bite off more than you can chew when the deadlines come.
A leading nursing home advocate is mustering support to combat massive changes the administration has proposed for Medicare and Medicaid participation.
It's all you hear about in healthcare today: from Volume to Value. With the July 30 release of the PPS proposed rule, we see how this discussion now applies to staffing.
SPH Analytics announced approval from the Centers for Medicaid & Medicare Services to administer the Consumer Assessment of Healthcare Providers and Systems for the Physician Quality Reporting System survey.
Medicare skilled nursing facilities would get a net 1.2% pay increase — totaling $430 million — in fiscal 2016 under a final rule issued by the Centers for Medicare & Medicaid Services late Thursday.
Reporting direct care hours is nothing new, but the Affordable Care Act takes it to the next level with mandatory quarterly electronic submission of staffing and census data. This focus on staffing ratios should not come as a surprise — but you could be in for a shock if you don't pay attention to your details.
It was quite a week for ironic juxtaposition in the nation's capital.
The government plans to make new claims data and other resident-care information available to providers and entrepreneurs as never before. Is it too good to be true?
Over the next few weeks, the Centers for Medicare & Medicaid Services is expected to unveil an ambitious and comprehensive policy-making effort that promises to completely transform and radically overhaul the Medicaid managed care marketplace.
Two CMS tags —F-Tag 329, which addresses unnecessarily using antipsychotic drugs, and F-Tag 309, which addresses taking steps to reduce antipsychotic drug use — are used by nursing home surveyors to identify specific federal nursing home regulations in order to evaluate whether a nursing home is meeting quality of care, quality of life, safety, among other standards.
Brown researchers examined the change in last-year-of-life Medicare expenditures during the most recent expansion of the program that began in 2004 and continued through 2009.
A popular acid reflux medication was the costliest drug paid for by Medicare Part D in 2013, while a blood pressure medication was the most frequently prescribed, according to a new report on prescription drug prices.
Physician participation in the CMS Physician Quality Reporting System and Electronic Prescribing Program grew 47% from 2012 to 2013, according to a federal report released late last week.
A special one-hour, web-based open door forum will be held May 7 to explain to providers the new set of star ratings for the Home Health Compare website, the Center for Medicare & Medicaid Services announced.
Long-term care providers would do well to know the lesson from one Pennsylvania continuing care facility, which averted costly litigation when it discovered and later reported irregularities of more than $1 million in Medicare claims.
For recovery auditing professionals everywhere, performance-based payments are a financial best practice and the industry standard. The client wins when no upfront expenses occur and payments are made only when actual dollars are returned.
A new Government Accountability Office report recommends sweeping government reforms that would mitigate fragmentation and duplication of a number of Medicare and Medicaid programs.
If someone asked you if your hospice was compliant with the Centers for Medicare & Medicaid Office of Inspector General's Effective Compliance Program Guidance for Hospice, what would you tell them?
Some things will always stay etched in our mind. Where were you on February 12, when CMS publicly announced immediate changes to the Five Star Quality Rating System for Nursing Homes?
A federal appeals court last week ruled that the Centers for Medicare & Medicaid Services violated federal contracting regulations when it stretched out payment terms for recovery audit contractors.
A federal appeals court has upheld fines emanating from a pair of deficiencies found and affirmed at a California nursing home. But the provider and its legal counsel are thrilled because the court also ruled that 25 other alleged deficiencies should be reviewed for relevance.
Nursing homes' biggest national ally and advocate is making the rounds on Capitol Hill this week in an effort to convince Congress to let die a lengthy experiment to withhold therapy claims while it roots out fraud.
The 2015 National Impact Assessment of the Centers for Medicare & Medicaid Services Quality Measures Report shows "clear progress in improving the healthcare delivery system to achieve the three aims of better care, smarter spending, and healthier people."
Drug substitutions saved the government $13 million last year, but more drug substitutions under Medicare Part B would have saved an additional $6 million, the Office of Inspector General for Health and Human Services concluded in a recent report to Congress.
A number of internal promotions and a few staff acquisitions from a Health and Human Services' insurance unit highlight a series of leadership changes at the Centers for Medicare & Medicaid Services, it was announced on Monday.
Nearly one-third of the nation's skilled nursing facilities lost a rating star due purely to administrative changes Friday, when regulators also emphasized that more quality measures will be added next year — when another round of Five Star scores rebasing also could take place.
Third-party firms that audit Medicare bills for payment issues are pushing back hard against a hospital association plea for more favorable short-stay reimbursements, adding to the ongoing unwelcome specter of audits among all providers, including those in long-term care.
The Centers for Medicare & Medicaid Services on Tuesday made official its plan to postpone implementation of a new rule on collecting hundreds of millions of dollars in overpayments until Feb. 16, 2016 — but providers remain on the hook for returning the money before then.