Medicare Part A

Part A claims under scrutiny

By

Government investigators will issue a report on skilled nursing facilities' Medicare Part A billing practices later this year, according to the latest annual work plan from the Department of Health and Human Services Office of the Inspector General.

OIG plans to scrutinize skilled nursing facilities' Medicare Part A claims

OIG plans to scrutinize skilled nursing facilities' Medicare Part A claims

By

Skilled nursing operators can expect to see a new government report on Medicare Part A billing practices released in 2014, according to the latest annual work plan from the Department of Health and Human Services Office of the Inspector General.

Ask the payment expert ... about changes related to Jimmo v. Sebelius

Ask the payment expert ... about changes related to Jimmo v. Sebelius

By

How come there are so many Medicare A denials when Jimmo v. Sebelius stated we could keep residents on Medicare A even if they are not improving?

CMS clarifies Medicare payment rules for SNF to SNF ambulance transportation

By

A skilled nursing facility discharging a Medicare Part A resident to another SNF is responsible for ambulance transportation fees, and no separate Part B claim should be made for that service, the Centers for Medicare & Medicaid stated in a recent memorandum.

Ambulance company reaches $8 million settlement to resolve charges over improper skilled nursing facility arrangements

By

The nation's second-largest ambulance services company has reached a settlement agreement over whistleblower charges of improper business dealings with skilled nursing facilities, Rural/Metro Corporation announced Tuesday.

Court nixes 3-day challenge, says doctors should decide

Court nixes 3-day challenge, says doctors should decide

By

A federal district court in Connecticut has dismissed a case filed by more than a dozen beneficiaries who challenged Medicare's "three-day rule."

McDermott targets the 'three-day rule'

McDermott targets the 'three-day rule'

By

Rep. Jim McDermott (D-WA) has introduced legislation that would eliminate a major hurdle to rehabilitation care and payments: the "three-day rule."

Five LTC commissioners issue full alternative report

By

Five members of the Congressional Commission on Long-Term Care have released a full report, providing an alternative to the commission report released last week. The five commissioners split with nine other panel members over that report, saying it should not be presented to Congress as the broad agreement of the group.

Medicare should cover SNF stays without prior hospitalization, American Medical Association asserts

By

The American Medical Association will work to change the 72-hour hospitalization requirement for Medicare Part A coverage of skilled nursing care. Delegates approved this resolution at the AMA annual conference in Chicago on Monday.

Lower SNF spending improves Medicare solvency outlook, report says

Lower SNF spending improves Medicare solvency outlook, report says

By

Government officials released good news about the long-term solvency of the Medicare program Friday. The projections were based in large measure on lower projected reimbursements for skilled nursing facilities.

CMS widens audits, hones in on Part A claims, expert says

CMS widens audits, hones in on Part A claims, expert says

By

The Centers for Medicare & Medicaid Services has increased its scrutiny of Medicare Part A filings recently and as a result, has reclaimed more funds than ever from providers, a long-term care compliance expert noted at a recent McKnight's Super Tuesday webcast.

'Serious' CMS oversight should compel providers to be duly vigilant about compliance, expert says

'Serious' CMS oversight should compel providers to be duly vigilant about compliance, expert says

By

Skilled nursing providers should ratchet up Medicare Part A compliance initiatives to meet the increasingly intense scrutiny of the Centers for Medicare & Medicaid Services, a compliance expert said in a McKnight's Super Tuesday webcast. "CMS is serious about this," said Leah Klusch, executive director of The Alliance Training Center.

Medically Complex Medicare Part B

Medically Complex Medicare Part B

By

While CMS tries to figure out how to proceed with the manual medical review process, we continue to track our caps and apply our modifiers. In the meantime, has anyone noticed how our typical Medicare Part B patients have become more medically complex than just a few years ago?

CMS seeks operator input regarding skilled nursing facility therapy payment changes

CMS seeks operator input regarding skilled nursing facility therapy payment changes

By

The Centers for Medicare & Medicaid Services is encouraging provider input as it seeks to change the payment system for therapy provided by skilled nursing facilities.

Fiscal molehill for rehab providers

Fiscal molehill for rehab providers

By

Well, we didn't completely go off the "fiscal cliff," but we're definitely heading for a downward slope.

Providers would be overburdened by Medicare overpayment rule, expert notes

By

A proposed rule that would require Medicare providers to return overpayments within 60 days of detection could significantly increase administrative time and costs, an expert says.

Better managing the Medicare Part A stay

Better managing the Medicare Part A stay

Discharge planning is the key element in managing Medicare Part A length of stay. A home assessment can significantly affect the process.

Managing the clinically anticipated Medicare Part A length of stay

Managing the clinically anticipated Medicare Part A length of stay

The Medicare adjustments of fiscal year 2012 have left the long-term care profession discussing and debating care strategies to ensure success and mitigate the reductions in reimbursement. A key indicator when analyzing clinical and financial solidity is the facility's clinically anticipated Medicare length of stay.

GAO: Medicare spent $48 billion on improper fee-for-service payments

The federal government spent nearly $48 billion on improper Medicare payments in 2010 according to a new report from the Government Accountability Office. The report was released just prior to a House Oversight Committee hearing on government efficiency.

Home healthcare costs often lower than post-acute care after hospitalization, analysis finds

Medicare beneficiaries with chronic health problems are far less likely to be readmitted to the hospital when discharged to their homes than if they receive other post-acute care services, a new analysis finds.

OIG: Medicare pays too much for nutrient therapy in nursing homes

Medicare's fee schedule for enteral nutrients under Medicare Part B was more than double the prices available to suppliers to nursing homes in 2006, according to a newly released report from the Department of Health and Human Services' Office of the Inspector General.

Extension of therapy caps exceptions process hinges on healthcare reform passage

By

Whether or not you are a fan of healthcare reform, here's one reason Congress should pass it: It would extend the therapy caps exceptions process.

Medicare Part A deductible to rise by $32 in 2010

The Medicare Part A deductible will increase by $32 in 2010 to $1,100, according to the Centers for Medicare & Medicaid Services.

Don't miss any McKnight's news

Featured Articles