Medicaid

Bulk of Medicaid to be managed care in two years: Avalere

Bulk of Medicaid to be managed care in two years: Avalere

By

More than three-quarters of Medicaid beneficiaries will be enrolled in a managed care plan as of 2016, according to an Avalere Health analysis released Thursday. The numbers reveal that managed care growth is especially strong in states that are expanding Medicaid.

40 states plan to increase nursing home Medicaid rates

40 states plan to increase nursing home Medicaid rates

By

Reversing a trend of rate cutting during the Great Recession, most states are increasing Medicaid reimbursements for nursing homes, according to a recently released report. However, states also are accelerating efforts to reduce the number of nursing home residents, the report shows.

State News for October 2014

State News for October 2014

ILLINOIS — Gov. Pat Quinn (D) has signed a new law making it easier for people to lodge complaints against nursing homes.

Medicaid provider agreement remains legitimate during bankruptcy proceedings, judge rules

By

Medicaid must continue to make payments to a Florida nursing home undergoing bankruptcy proceedings, a federal judge rule recently.

Three states to examine risk, reform in Medicaid project

By

Alabama, Washington and Nevada are participating in a yearlong Medicaid project that could help share risk between states and the federal government, the National Governors Association said this week.

Also in the News for August 26, 2014

House Republican demands New York given back $15 billion in Medicaid overpayments ... Faith-affiliated companies can tell government they object to contraceptive mandate under new Obama accommodation ... States with higher Medicaid payments for office visits result in beneficiaries being more likely to be screened for cancer, study finds.

NY nursing home agrees to $2.2 million settlement in case of false documentation

NY nursing home agrees to $2.2 million settlement in case of false documentation

By

Nursing home operator Ralex Services Inc. has agreed to a $2.2 million settlement in a whistleblower case involving forged documents at a facility in New Rochelle, New York.

Also in the news for August 21, 2014 . . .

OH Supreme Court hears case of woman who transferred property then paid for nursing home through Medicaid ... Nursing home video education project part of new $19 million round of NIH funding ... Researchers identify neuron issue leading to Alzheimer's sleep issues, may lead to new therapies

Bed taxes and other troubling compromises

Bed taxes and other troubling compromises

By

As my colleague Tim Mullaney reported last week, the Government Accountability Office has been taking a closer look at Medicaid bed taxes lately. And the investigative arm of Congress doesn't seem to care much for the view.

Harkin: Divert funds from SNF settings

Harkin: Divert funds from SNF settings

By

Medicaid funds would more easily flow toward people wanting home- and community-based services — and away from nursing homes — under a new bill unveiled by Sen. Tom Harkin (D-IA).

Finally, a Medicaid funding plan that actually makes sense

Finally, a Medicaid funding plan that actually makes sense

When politicians talk about Medicaid funding and nursing homes these days, an unsettling theme often emerges: the need to spend less of the former on the latter.

AOD acquires Stratis Business Systems, Inc.

AOD Software has bought Stratis Business Systems Inc., a home health and home care cloud-based software system.

Medicaid overbilling allegations were 'inaccurate' and 'misleading,' Signature HealthCARE says

By

Authorities have asserted that Signature HealthCARE billed Medicaid for $2 million in unapproved costs, but this was an oversimplification that presented the company in an unfair light, the large long-term care provider contends.

Also in the news for July 7, 2014 . . .

Huge HIPAA breach inevitable, providers 'behind' crooks ... Nursing home doc has to pay back $57K to Medicaid ... Alzheimer's drug development not looking good ... Insulin pumps better than injections for diabetes care

Medicaid paying 32% less than Medicare Part D for medications

By

Medicaid is paying the lowest average price for 78 high-use and high-expenditure brand-name and generic drugs, a new federal report finds.

Signature HealthCARE charged with $2 million in unapproved Medicaid billings

By

Long-term care provider Signature HealthCARE billed Medicaid about $2 million for unapproved costs, auditors with the Tennessee Comptroller's Office charged Monday.

Take this to the bank: How to reduce money stress for LTC residents

Take this to the bank: How to reduce money stress for LTC residents

By

In my conversations with hundreds of long-term care residents over the years, I've found money to be an almost universally sore subject among them. Financial concerns continue to be a stressor for our residents even though they're living in the mostly money-free society of LTC. With some adjustments we can — and should — reduce our residents' financial distress.

You'll never guess where the latest Medicaid relief is coming from

You'll never guess where the latest Medicaid relief is coming from

By

If you are a long-term care provider relying on Medicaid dollars to make ends meet, Illinois is probably one of the last places where you'd want to be doing business. But Illinois also might have a program worth emulating wherever you are.

It's time to stop long-term care state rankings

It's time to stop long-term care state rankings

By

Minnesota routinely is named best state for long-term care, as it was last week in AARP's 2014 scorecard. AARP held a panel discussion to unveil the rankings, and of course an official from Minnesota was on hand to share his state's secret sauce. But the panel also featured a speaker from Mississippi, one of the lowest-ranking states. I came away thinking that Minnesota actually might not have much to teach Mississippi — and questioning what these types of state rankings accomplish.

 New payment models present opportunities for SNFs

New payment models present opportunities for SNFs

For skilled nursing facilities, the Medicare SNF 3-day rule can make it difficult to place the right patients in the right setting at the right time. The 3-day rule requires that a Medicare beneficiary spend three nights in a hospital as an inpatient — observation stays do not count — before becoming eligible for Medicare-covered SNF care. This rule creates a challenge for SNFs as hospital lengths of stay decline for many of the conditions that SNFs treat.

Hospitalist company with long-term care presence faces federal charges of upcoding

By

A hospitalist company that works with thousands of post-acute care facilities is officially facing federal charges that its clinicians routinely overbilled Medicare and Medicaid, authorities announced Tuesday.

Mother-daughter nursing home execs agree to lifetime Medicaid ban in case of $3 million fraud

By

Former Florida nursing home executives agreed to be "permanently excluded" from federally funded health programs in settling charges of a $2.75 million Medicaid fraud, according to a plea agreement signed June 5.

Nursing home owner facing $3 million Medicaid bill gets jail time for financial misdeed

By

A former nursing home owner who faces criminal charges and allegedly owes millions to Medicaid has been sentenced to 90 days in jail, Iowa officials announced Wednesday.

Emerging state approach to long-term care gives 'criminal intent' a whole new meaning

Emerging state approach to long-term care gives 'criminal intent' a whole new meaning

By

States are beginning to consider a bizarre new long-term care strategy that has many providers rightfully concerned.

Dual eligibles more likely to go from hospitals to lower quality nursing homes, referral process might need reform, researchers say

Dual eligibles more likely to go from hospitals to lower quality nursing homes, referral process might need reform, researchers say

By

People eligible both for Medicare and Medicaid go to lower-quality nursing homes after being hospitalized at a rate higher than Medicare-only patients, according to researchers from Brown and Harvard universities.

3 value-based purchasing strategies to help you get ahead

3 value-based purchasing strategies to help you get ahead

Long-term care providers have a stronger hook than they probably realize regarding the toughening of penalties for hospitals with high readmission rates.

New wrinkles for population experts — and providers — to consider

New wrinkles for population experts — and providers — to consider

By

It's hardly breaking news that we live in an aging nation. But a look inside the latest round of numbers might give providers more reason to feel optimistic about remaining solvent once the age wave hits.

House bill would expand program to keep younger people out of nursing homes

By

People younger than 55 would become eligible for a program to prevent unnecessary nursing home admissions if lawmakers pass a bill introduced Thursday in the U.S. House of Representatives.

Profile: A rare bird in Congress

Profile: A rare bird in Congress

By

When Rep. Diane Black (R-TN) was around 4 years old, she asked for a doctor's kit. But growing up in a working class family in Glen Burnie, MD, the future nurse and Congressman didn't know how to pursue her healthcare dreams.

OIG spends $75M on Medicaid oversight, recommends cost-saving measures

By

The Department of Health and Human Services Office of Inspector General spent $75 million on Medicaid oversight during the last fiscal year, a 4% increase over fiscal 2012, according to a new report.

Don't miss any McKnight's news

Featured Articles