Guest Columns

Former CMS administrator scolds long-term care providers — but he has it all wrong!

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Steve Moran
Steve Moran
McKnight's Long-Term Care published an article titled "Former top Medicare official scalds long-term care leaders"  on September 26. According to this article, Tom Scully, the former chief of the Medicare & Medicaid Services Administration, brutally chastised the long-term care industry for exploiting a change in the Medicare reimbursement rules that allowed providers to extract an extra $5 billion from the system in less than a year.

His proposition was that the long-term care providers should have known that it would not last and would damage their lobbying efforts for the foreseeable future. He has it wrong on so many counts. Last year, I pointed out:

  • The system, as designed by the government, is adversarial in nature, meaning that the government works to pay out as little possible and the providers work to get paid as much as possible while not breaking the rules, which is exactly what they did.
  • The government is that stupid! If they had thought out the rule change it would have been easy to figure out how the providers would react. This was an easily predictable outcome.
  • You could even make a case that if the providers had not taken advantage of the rule change, they would have been violating their responsibility to their investors.
  • The providers did nothing that was illegal or even against the rules. It is hard to even figure out how to apply morality to this particular situation.
  • At the end of the day, even with the “take backs”, the long-term care providers who were the most aggressive in taking advantage of the system ended up financially better off than if they had not.
  • At least some of those providers who "did the right thing" ended being penalized for not taking advantage of the system.

The blame for this colossal waste of tax money, my money and your money, lies squarely at the feet of the CMS.

 Steve Moran is a blogger for Senior Housing Forum.

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