CMS

OIG: Government should consider more drug substitution

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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.

Slavitt, Conway rise in rank at CMS

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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.

Officials: More additions and rebasings of nursing home ratings to come

Officials: More additions and rebasings of nursing home ratings to come

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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.

RAC groups battle provider plea for short-stay payment relief

RAC groups battle provider plea for short-stay payment relief

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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.

CMS delays repayment final rule a year

CMS delays repayment final rule a year

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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.

Changes to Five Star expected, providers fear lower ratings

Changes to Five Star expected, providers fear lower ratings

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The Centers for Medicare & Medicaid Services is expected to unveil major changes to Nursing Home Compare today that could cause facilities to lose rating stars, according to industry sources.

ICD-10 transition going better than expected for healthcare operators

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Despite two delays and a host of costly implementation issues over the past year, most healthcare providers will likely make a successful transition to the 10th round of ICD codes, a General Accountability Office report has concluded.

Providers complain to feds about ACO structure, want more incentives

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A new rule proposing sweeping changes to the Medicare accountable care model offers few incentives and could dissuade greater participation, 34 leading healthcare organizations and industry groups said Friday in a joint letter to the Centers for Medicare & Medicaid Services.

Medicare Advantage funding could be cut

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Supporters of Medicare Advantage program are roundly criticizing President Obama's fiscal 2016 budget plan to slash more than $36 billion in its funding over the coming decade.

Provider groups push for RAC reform

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Hospital industry groups said Thursday they'd rather the government reform the Recovery Audit Contractor program than simply throw more money at fixing an onerous backlog of more than 800,000 Medicare appeals cases.

CMS to ease reporting rules for EHR Incentive program

The Centers for Medicare & Medicaid Services has proposed easing the reporting rules for providers implementing electronic health records, which could come as good news for long-term care providers increasingly pushed to move to adopt EHR in an effort to improve care transitions and become a part of bundled payment systems.

CMS awards Recovery Audit DME contract

The Centers for Medicare & Medicaid Services has given a recovery audit contract to Connolly LLC, a subsidiary of Connolly iHealth Technologies, in Region 5. The firm will oversee Medicare claims for Durable Medical Equipment, Home Health and Hospice, in this new, fifth nationwide region.

More than $80 million paid out to Pioneer ACO beneficiaries, report finds

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Nearly $81 million has been made in payments on behalf of beneficiaries in Pioneer accountable care organizations through Sept. 30, a new report finds.

3M receives specific codes

3M Critical & Chronic Care Solutions Division announced the Centers for Medicare & Medicaid Services assigned product-specific Healthcare Common Procedure Coding System codes for the 3M™ Coban™ 2 Layer Lite Compression System (Cat #2794).

Another revenue stream threatened?

Another revenue stream threatened?

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For just about every skilled nursing facility out there, this is probably a good time to break out the flop sweat. That is, unless the prospect of being culled from one of your most vital revenue streams is nothing to worry about.

New ACO proposals could leave long-term care providers smiling

New ACO proposals could leave long-term care providers smiling

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If nothing else, federal health officials displayed Monday that they are intent on getting this accountable care organization (ACO) thing right. Or at least closer to "right" than it has been.

Brennan to lead new CMS office

Brennan to lead new CMS office

Niall Brennan is the first Center for Medicare & Medicaid Services Chief Data Officer, the agency announced. He will lead the new Office of Enterprise Data and Analytics.

Replace the Five Star Quality Ratings system with points?

Replace the Five Star Quality Ratings system with points?

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There's a need to fix what's broken with the Five Star nursing homes-ratings system, and the way to do it is obvious.

The schizophrenia of patient-centered care

The schizophrenia of patient-centered care

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Is it me or sometimes do the wide interpretations within the State Operations Manual (the dreaded "RED book") make you want to question your entire existence? I mean, we've been working so diligently toward Culture Change and the true meaning of person-centered care. Nationally, I thought we were making headway. But nooooooo.

CMS promises ICD-10 software six months in advance

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Providers will receive needed coding and billing software six months before the ICD-10 transition date, the Centers for Medicare & Medicaid Services has announced. This is double the lead time that providers had for a planned 2014 transition, which was delayed by a year.

Also in the news for Nov. 4, 2014 . . .

Health center owner fined $43 million in nursing home patient recruiting scam ... CMS defines "one-on-one" provider training ... Men shorter than five-foot-five are 50% more likely to die from dementia ... UK docs to begin telling patients their 'brain age'

Antipsychotics goal gets reset

Antipsychotics goal gets reset

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Long-term care providers are being asked to reduce the use of antipsychotic medications among residents by 25% by the end of 2015, and 30% by the end of 2016.

Also in the news for Oct. 31, 2014 . . .

Minnix hopes White House aging conference will spur 'huge shift' ... CMS finalizes home health payment reductions ... Dementia is now No. 1 killer of women in England

Also in the news for Oct. 30, 2014 . . .

CMS offers hospitals more flexibility to settle disputed inpatient claims ... Nursing homes interested in new secondhand smoke detector, Dartmouth researchers say ... Australian researchers announce Alzheimer's blood test progress ... SCAN Foundation releases blueprint for person-centered healthcare systems

CMS expands therapy payment research

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The government is expanding its research into alternative therapy payments, to consider more holistic changes to the way Medicare reimburses skilled nursing facilities, the Centers for Medicare & Medicaid Services announced Tuesday.

CMS: Nurse shortage means hospices can keep using contracted workers

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Hospices can continue to rely on contract nurses because an ongoing nurse shortage is preventing providers from meeting their staffing needs, the Centers for Medicare & Medicaid Services announced in a recent memorandum to state survey agencies.

Hospice billings changed

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The Centers for Medicare & Medicaid Services recently updated instructions on coding hospice claims. Billing staffs should be aware of these changes, which went into effect Oct. 1, CMS stated in a memorandum about the Medicare manual update.

SNF, CCRC spending expected to rise 69%

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Spending on nursing homes and continuing care retirement communities is expected to roughly keep pace with total U.S. healthcare spending during the next decade, according to the annual "National Health Expenditures Projections" report released last month.

Lawmakers demand answers about rating system quirks

Lawmakers demand answers about rating system quirks

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After The New York Times noted that providers are apparently gaming the Five Star rating system by enhancing staffing and quality data, federal lawmakers quickly put an indignant pen to paper.

Reporting neglected, OIG says

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Slightly more than half of the nation's nursing facilities reported abuse or neglect allegations as required in 2012, a new report from the Office of Inspector General alleges. Such relatively low compliance indicates that more guidance and oversight is warranted, the report concludes.

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