Medicaid

Senators search for Medicaid agreement

Senators search for Medicaid agreement

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Senators sought middle ground in May over an Obamacare replacement bill and its ability to expand and fund Medicaid.

Court: Medicaid may collect SNF room-and-board outlays

Court: Medicaid may collect SNF room-and-board outlays

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In a ruling that could create ripple effects on state Medicaid programs around the country, Nebraska's highest court decreed that the state may pursue payment from beneficiaries for room-and-board costs for skilled nursing stays.

State News for June 2017

State News for June 2017

State drafting measures to create universal, single payer healthcare program after Canada's example

Averting deep Medicaid cuts key as Senators draft own health bill

Averting deep Medicaid cuts key as Senators draft own health bill

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Senate Republicans headed into the long Memorial Day weekend determined to make progress on a bill to replace Obamacare, but some notable players were guarded, if not outright skeptical, that much could be accomplished soon.

Medicaid just might sink Trumpcare

Medicaid just might sink Trumpcare

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With recent major funding proposals about Medicaid causing such a tizzy, it's fair to ask why the powers-that-be find Medicaid such a tempting piñata. There are two main drivers. But only one is usually mentioned in polite company.

The ACA repeal and its impact on nursing homes

The ACA repeal and its impact on nursing homes

The public dialogue surrounding repeal of the Patient Protection and Affordable Care Act, also known as Obamacare, has made little mention of the nuts and bolts of the legislation that would be lost when it is gone.

MedPAC wants to put SNF Medicare claims to the test

MedPAC wants to put SNF Medicare claims to the test

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Skilled operators have been telling lawmakers and regulators that they are the cheapest post-acute care option out there, and it appears the Medicare Payment Advisory Commission has not only heard the claim, but wants to take the industry up on it.

State to settle with nursing homes for $12 million

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Almost all South Carolina nursing homes in dispute with the state over Medicaid processing have agreed to a proposed settlement, according to local reports.

Where are we going with long-term care?

Where are we going with long-term care?

Long-term care was never planned. It was never even consistently defined. A generally useful definition is that it is a set of services to assist persons who have lost, or never acquired, basic capabilities for self-care and management.

Don't be worried about Medicaid funding cuts — be very afraid

Don't be worried about Medicaid funding cuts — be very afraid

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The long-term care industry's worst fears about what a Trump healthcare plan might contain have not just been met after last week's unveiling, they have been far exceeded.

Giving Trump a chance

Giving Trump a chance

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It's interesting to see how this sector has generally responded to Donald Trump's recent presidential victory. In some quarters, demonstrators have taken to the streets. Others are predicting Armageddon. As for the long-term care sector's response? You might say the silence has been just about deafening. So was the field pulling for Trump all along?

When the star goes down and payment's involved, beware

When the star goes down and payment's involved, beware

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A leader in the quest to increase long-term care insurance activity delivered a blow to its followers this week. The fallout might not be pretty.

Just when you think Medicaid payments couldn't get worse ...

Just when you think Medicaid payments couldn't get worse ...

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Providers have long-enjoyed a like-hate relationship with Medicaid. Many operators view the program much as a circus trainer might eye a recently acquired wild animal: There's lots of potential, but danger too.

Good news for Medicaid facilities

Good news for Medicaid facilities

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Nursing homes that take Medicaid beneficiaries or dual eligibles often know they are admitting low-income, chronically ill seniors. Now there is some good news: The Centers for Medicare & Medicaid Services announced it will increase payments for dual eligibles enrolled in one of 12 state-administered demonstration programs.

CMS sneaks a trick in with its treats

CMS sneaks a trick in with its treats

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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.

LeadingAge rallies against proposed Medicare, Medicaid changes

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A leading nursing home advocate is mustering support to combat massive changes the administration has proposed for Medicare and Medicaid participation.

It's pretty clear what they're really committed to

It's pretty clear what they're really committed to

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It was quite a week for ironic juxtaposition in the nation's capital.

Obtaining critical claims data may soon get easier

Obtaining critical claims data may soon get easier

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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?

Nursing homes blamed for high opt-out rates in dual eligible demo

Nursing homes blamed for high opt-out rates in dual eligible demo

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Huge numbers of dual-eligible beneficiaries are leaving a demonstration project that hopes to improve payments for people eligible for both Medicare and Medicaid.

GAO: Medicaid demonstration project costs not justified

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A new report to Congress says more justification is needed for the $146 billion being spent on demonstration projects, most of which have not been clearly shown to further the objectives of the Medicaid program. Medicaid funds more than two-thirds of U.S. nursing home care.

Also in the News for Thursday, May 14

Medical transport company failing to get patients to appointments on time, audit says ... Ohio settles Medicaid lawsuit ... Nursing home owner charged in Mohawk case

Also in the News for Wednesday, May 13

States look at protection for long-term care insurance buyers ... Right-to-die trial underway in Minnesota ... Unionized nursing home workers push legislators on Medicaid reimbursements

Weak data, unclear policy plague Medicaid payments: GAO report

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Medicaid provider payments are seriously hindered by limited data and "unclear policy," according to a new report to Congress that calls for greater oversight at numerous government-owned facilities where payments far exceed actual costs.

GAO: Small percentage of Medicaid beneficiaries costing much more

The Government Accountability Office last week released findings showing 5% of Medicaid-only eligible enrollees accounted for nearly 50% of the billions of government dollars paid in Medicaid-only eligible claims.

Playing fast and loose with Medicaid termination

Playing fast and loose with Medicaid termination

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There are many benefits to communicating to your cohorts in neighboring states, and not the least of it may be knowing when a provider is kicked out of Medicaid.

Senate to vote this week on new federal budget

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The U.S. Senate is scheduled to vote this week on a federal budget that promises to balance itself in nine years through billions of cuts in social programs and billions of extra dollars to defense.

Shady practitioners often go undetected across state lines: Report

Shady practitioners often go undetected across state lines: Report

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Nursing homes with visiting physicians or providers would do well to uncover their troubled histories with Medicaid or Medicare programs in other states or face billing nightmares, and worse, federal scrutiny.

Nursing home association wants no part of Medicaid managed care

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Managed care is not being warmly embraced by long-term care providers everywhere. Nearly 40 states are in various completion phases of transitioning to privatized Medicaid managed care systems, but Louisiana's nursing homes are defiantly resisting efforts there to have them join the party.

What will it cost you to stay in the post-acute care game?

What will it cost you to stay in the post-acute care game?

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More than just collecting data, providers need to use standardized, nationally recognized measures. Especially in this era of ACOs and alternative payment models. In the past, many individual providers used their own methodology to create their own "data driven" story.

Budget cut-hungry GOP walks fine line, eyeing 2016 elections

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House and Senate Republican lawmakers began working on a budget this week that could propose slashing Medicare and Medicaid in an effort to work toward a balanced budget without fiddling with tax rates, according to published reports.