Medicare Part B
Government investigators are preparing reports on skilled nursing facilities' Part B billing practices and background check processes, according to the recently released annual work plan from the Health and Human Services Office of Inspector General.
If the Medicare Part B program had used average Medicare Part D drug dispensing and fee rates, it would have saved the government $110 million in 2011, according to a report from the Department of Health and Human Services Office of Inspector General released Sept. 16.
Federal judge dismisses nursing home 'kickback' case; upholds large X-ray company's 'swapping' method of billingSeptember 02, 2014
The way mobile x-ray company Mobilex bills nursing homes is acceptable, a federal judge recently determined. Mobilex is the nation's largest provider of mobile diagnostic services. It had been facing whistleblower charges that it effectively paid kickbacks to nursing homes through an arrangement known as "swapping."
Administrators have multiple departments to oversee, so it is important that they have a method to determine if their therapy department is running efficiently, meeting its goals and adding to the strategic success of the facility. There are several metrics and indicators of a successful therapy department.
Stacy A. Darling, MBA, MPT, AT, RAC-CT, is the new vice president of operations in the long-term care consulting team at Post Acute Consulting, LLC.
Long-term care providers will be able to appeal certain Medicare claims decisions without going through an administrative law judge hearing, the Office of Medicare Hearings and Appeals (OMHA) announced Thursday.
With therapy documentation being put under the microscope more than ever, you would be wise to make sure standardized assessment tools are at your fingertips. Unbiased views of data and outcomes information are what you need for care planning and execution.
A provider-sponsored survey recently uncovered huge backlogs of therapy claim reviews for beneficiaries who exceeded the Medicare Part B caps limits.
Provider groups are urging lawmakers to address outpatient therapy payments in addition to fixes to Medicare's physician payment system, according to Cynthia Morton, executive vice president of the National Association for the Support of Long-Term Care.
Better ulcer care contributed to a nearly 50% decrease in diabetes-related leg amputations between 2000-2010, according to a study in the current issue of Foot & Ankle International.
A New Jersey-based outpatient therapy provider should pay back the government for $3.1 million in improper Medicare reimbursements identified in a recent audit, according to the Department of Health and Human Services' Office of Inspector General.
Effective July 1, the Centers for Medicare & Medicaid Services will begin rejecting claims received for Medicare Part B patients that do not include the new requirement of G-coding. That really means providers need to be ready by June 1.
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?
The American Health Care Association and National Center for Assisted Living came out in support of bipartisan legislation to permanently repeal Medicare Part B therapy caps for skilled nursing facilities. The legislation was introduced in both the House of Representatives and the Senate on Feb. 15.
A keynote address by Farzad Mostashari, MD, ScM, the National Coordinator for Health Information Technology, will highlight opening day of the annual winter Legislative and Regulatory Conference of the National Association for the Support of Long-Term Care.
Every time we send our patients to the hospital for rehab-related tests, exams or services, these services are billed to Medicare Part B, and, therefore, reduce our cap allowances. Any small oversights could have major impacts on our ability to successfully track therapy cap levels. Here's some help.
Instead of spending more time doing hands-on patient care, therapists who work with Medicare beneficiaries have been strapped with increased administrative tasks, sometimes leading to delayed services, or worse.
Providers will have their say about the future of Medicare Administrative Contractors.
What a mess — and that's probably an understatement! Medicare Part B decided to roll out its new manual medical review process by dividing providers into three phases. If you are unfortunate to be part of the Phase One group, you have my deepest sympathies.
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.
Members of a Congressional conference committee need to authorize the longest possible exceptions extension for Medicare Part B therapy services, according to a coalition of therapy advocates.
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.
Doctors across the United States are taking a wait-and-see approach while Congress decides whether or not to allow a scheduled 23% cut in Medicare reimbursement rates to take effect on Dec. 1.
It's hard to believe we're in the midst of another conference season. The American Health Care Association's annual meeting already has passed and the American Association of Homes and Services for the Aging's is about a week away.
Consolidating drugs covered by Medicare Part B and Part D under Part D could save Medicare nearly $150 million, according to a new report from the Centers for Medicare & Medicaid Services.
As the end of the year approaches, long-term care providers will be lobbying to extend the therapy caps exceptions process, which is set to end Dec. 31. Another therapy issue—a proposed rule to reduce payments when multiple therapy procedures are provided to a Medicare beneficiary in one day—also is on providers' radar screens.
The financial outlook for the seniors' healthcare program has been "substantially improved" by the new healthcare reforms, according to a new report from the Medicare Board of Trustees released Thursday.
Another proposed rehab rule threatens to cut significant revenues from long-term care providers.
A recent Washington Post analysis of the use of "ultra-high" reimbursement categories for nursing homes "paints a negative, incomplete picture of the growing role and tangible benefits associated with skilled nursing facility (SNF) patient care," two leading long-term care advocates said.
The RUG-IV classification system will not start until Oct. 1, 2011, under the new healthcare reform bill.