Medicaid

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

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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.

Ryan budget proposal would hurt nursing home residents on Medicaid, critics charge

Ryan budget proposal would hurt nursing home residents on Medicaid, critics charge

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A Republican budget plan unveiled in the House of Representatives Tuesday would slash healthcare spending by $732 billion over the next decade, in part by reengineering Medicaid. The proposed changes could jeopardize benefits for a huge number of nursing home residents, critics said.

State News

State News

PENNSYLVANIA - The state's nursing home operators say they are approaching fiscal disaster as facilities look at razor-thin margins half the national average.

Feds recover $10 million in incorrect Medicaid payouts

Feds recover $10 million in incorrect Medicaid payouts

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Federal investigators recovered more than $10 million in incorrect Medicaid payments made to nursing homes in 2013, an annual review shows.

CMS is failing to ensure that terminated skilled nursing facilities and other providers are not billing Medicaid, watchdog agency says

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The Centers for Medicare & Medicaid Services needs to do a better job of ensuring that terminated Medicaid providers in a particular state, including skilled nursing facilities, don't reappear in another state, according to a new government report.

Most continuing care retirement communities are not 'isolating' settings, CMS clarifies in guidance on recent regulation

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Continuing care retirement communities don't create the same problem of isolation as skilled nursing facilities, according to new guidance on a recently finalized Medicaid regulation.

Housing department announces $120 million in funding to help with Olmstead compliance

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State housing agencies can apply for $120 million in new federal funding to support housing options for disabled people transitioning out of long-term care facilities, the Department of Housing and Urban Development recently announced.

Providers could lose Medicaid money and patient information due to ICD-10 transition, researchers find

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Healthcare providers could experience financial and information losses when they make the mandated transition to the new International Classification of Diseases coding system in October, according to researchers at the University of Illinois-Chicago.

Privately managed Medicaid threatens long-term care quality and options, New York Times article states

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People with complex needs could find themselves squeezed out of the most appropriate long-term care settings as Medicaid beneficiaries become enrolled in programs from private sector companies, The New York Times reported in a lengthy Page 1 examination of the subject Friday.

Hospitalized seniors likely to need family help, study finds

Hospitalized seniors likely to need family help, study finds

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Nearly half of hospitalized seniors facing a major treatment decision require help from family members, a new study finds.

Medicaid-only long-term care residents driving up state expenditures, report finds

Medicaid-only long-term care residents driving up state expenditures, report finds

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Among people eligible for Medicaid but not Medicare, long-term care residents are most likely to be among the costliest beneficiaries for a state, according to a new report from the Government Accountability Office. Sen. Charles Grassley (R-IA) requested the report, noting that much research has focused on those eligible for both Medicaid and Medicare, but has largely overlooked the Medicaid-only group.

Franken reintroduces bill to facilitate rides from nursing homes to medical appointments

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More Medicaid dollars would flow to volunteers who drive nursing home residents to medical appointments under a bill recently reintroduced by Sen. Al Franken (D-MN). Seniors living in rural parts of Minnesota currently are scrambling to find rides, due to a dispute between transportation companies and Blue Cross/Blue Shield.

The safety net for seniors

The safety net for seniors

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Healthcare reform, especially the expansion of Medicaid, will bring into focus the fragility of the safety net. This is a system that is for vulnerable seniors, but which has not been adequately financed.

Senators weigh need for individual mandate in long-term care financing reform

Senators weigh need for individual mandate in long-term care financing reform

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Senators and a panel of experts wrangled over whether effective long-term care reform hinges on a federal mandate for all individuals to buy some type of LTC insurance, at a Special Committee on Aging hearing on Thursday.

Doctor admits kickback role in sending homeless people to nursing homes, hospitals

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A California physician received kickbacks from skilled nursing facilities as part of a large-scale scheme to defraud government health programs, authorities announced Friday. Ovid Mercene, M.D., pleaded guilty to the fraud and related tax charges in U.S. District Court.

First-ever CDC report: Nursing homes provide most long-term care nationwide, alternative settings gain ground in the West

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Nursing homes still account for the vast majority of long-term care services available in the United States despite policies meant to encourage home- and community-based care, according to a new government report. The first-ever "National Study of Long-Term Care Providers" includes data on the capacity and operational characteristics of providers, and information about the people cared for in these settings.

10,000 lakes and one less nursing home: Spotlight on a facility closure

10,000 lakes and one less nursing home: Spotlight on a facility closure

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Minnesota appears to be on the ball when it comes to long-term care. It regularly rates at or near the top when states are ranked on LTC services. Yet, Minnesota also is on the leading edge of a more troublesome long-term care trend, and it's something we all should be paying attention to.

Boost for expanding Medicaid: Researchers find preventive care rises with broader insurance coverage

Boost for expanding Medicaid: Researchers find preventive care rises with broader insurance coverage

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People with health insurance are not more likely to engage in risky behaviors, but instead focus more on preventative care according to new research.

CBO analyzes Medicaid caps to curb federal healthcare spending

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The federal government could reduce its Medicaid contributions to states as a deficit reduction measure, but the move likely would achieve savings only by putting seniors at risk, according to the Congressional Budget Office.

Young people becoming more realistic about future long-term care needs, survey finds

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Younger people are more informed about long-term care financing and are more likely to be saving for their future needs than older Americans, according to a recent national survey.

Expanded meal deliveries could reduce nursing home admissions, but cost benefits vary by state, researchers find

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Modest expansions of meal delivery programs could reduce the number of Medicaid beneficiaries in nursing homes, but such a plan would not be cost-effective in every state, according to newly published research.

Shutdown update: DC cuts off Medicaid payments, CMS confirms limited surveys

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In a blow to Medicaid-certified long-term care providers in the nation's capital, officials announced the District of Columbia would not make Medicaid payments during the federal government shutdown.

When it comes to paying for long-term care, public and private options can both fail

When it comes to paying for long-term care, public and private options can both fail

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What happened last week in Washington was not exactly highlight reel material. That is, unless you want to showcase public sector dysfunction.

Poll: Many believe that long-term care financing is mostly private pay

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Many Americans mistakenly believe that long-term care in the United States is primarily paid for out-of-pocket, according to the latest poll to show how deeply people misunderstand this aspect of the healthcare system.

CMS 'arbitrarily' approved SNF Medicaid cuts in Pennsylvania, appeals court rules

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A group of nursing home operators has won a moral victory over the Centers for Medicare & Medicaid Services, with a federal appeals court saying the agency made Medicaid reimbursement cuts without considering the consequences, but without the court ordering financial relief.

Congress should increase funding for non-institutional care, link payment and performance, Medicaid directors tell LTC commission

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The U.S. system for providing long-term care should be changed to reduce the number of people living in facilities and better align spending with health outcomes, according to comments that state Medicaid directors sent to the Congressional Commission on Long-Term Care.

Nursing homes beneficial for Medicare program, researchers find

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Nursing homes often decrease residents' need for services covered under Medicare, according to new research published by the Centers for Medicare & Medicaid Services. The results reinforce the idea that accountable care organizations can lower costs by partnering with long-term care facilities.

Nursing home operators get a little respect

Nursing home operators get a little respect

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Attitude determines altitude. You make your breaks. People are about as happy as they make their minds up to be. They're all somewhat overused yet admirable sayings people live by. Nursing home operators might want to remember them. Otherwise, it's easy to miss that providers aren't always getting hammered by authorities or officials.

Taking care of Medicare and Medicaid's dual-eligibles: A job for Super- , er, Ombudsman

Taking care of Medicare and Medicaid's dual-eligibles: A job for Super- , er, Ombudsman

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Giving long-term care stakeholders a reason to cheer, California recently requested a federal waiver to implement Cal MedConnect, a demonstration project meant to improve care coordination for people who qualify for both Medicare and Medicaid.

Study links poor financial performance and 'de facto' nursing home segregation; raises questions about admissions

Study links poor financial performance and 'de facto' nursing home segregation; raises questions about admissions

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Nursing homes with a high proportion of black residents tend to underperform financially, according to recently published research that raises difficult questions about admissions practices and healthcare disparities.

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