May 16, 2013
Whether you are an employee, resident, citizen or member of another group, you can learn from the lessons I've learned while exhaustively investigating a story about running and saving county nursing homes in America.
Government lawyers and opponents of Medicare's "observation stay loophole" squared off in court on Friday, when a federal judge convened the first hearing in the Bagnall vs. Sebelius case.
May 02, 2013
Total Medicare reimbursements to skilled nursing facilities would increase by $500 million in 2014 under the new payment rate proposed by the Centers for Medicare & Medicaid Services. The agency is also proposing a new Minimum Data Set item related to therapy.
Potential Medicare cuts called for by the Affordable Care Act will not occur, a chief government actuary has announced. Long-term care organizations said the news comes as a relief for providers who have weathered a series of recent payment reductions.
Hospices will reap a 1.1% increase in Medicare payments in fiscal year 2014, according to a proposed rule issued by the Centers for Medicare & Medicaid Services.
April 30, 2013
The Centers for Medicare & Medicaid Services has proposed changing the way hospital readmission penalties are calculated as part of its 2014 Medicare rate update. Potential readmissions penalties for long-term care providers — such as those recently floated by the White House — would likely be based on the established CMS formula for hospitals.
April 26, 2013
The Department of Health and Human Services is trying to encourage Medicare fraud whistleblowers by substantially increasing their potential reward. The current maximum award of $1,000 would go up to $9.9 million per whistleblower if a recently proposed rule takes effect.
April 21, 2013
Operational compliance for providers is taking on growing importance when it comes to Medicare covered services. The next McKnight's Super Tuesday webcast, May 7, will provide strategies providers can use to keep federal watchdogs at bay. The session, featuring noted expert Leah Klusch, will start at 1 p.m. Eastern Time and offer tips that will help ensure the best possible outcomes for residents and facilities.
April 16, 2013
I was sympathetic when the Partnership for Sustainable Health Care called for a speedier shift away from fee-for-service last week — and I also thought about Purell. Yes, that Purell.
April 09, 2013
Fuaja Singh completed his last marathon in Hong Kong only a few weeks before he turned 102 years old recently. He said he feels it might be time to retire from running marathons, but he plans to continue running as a hobby. You know what that means.
April 09, 2013
Medicare recovery audit contractors (RACs) can request as few as 20 records in a 45-day period from skilled nursing facilities and other providers as of April 15, according to the Centers for Medicare & Medicaid Services. This is a reduction from the current 35-record minimum request.
Substantial Medicare cuts will be on the table after the White House budget is released Wednesday, administration officials have indicated. The proposed budget is expected to include about $400 billion in Medicare savings over 10 years.
Providers may be reimbursed for Medicare beneficiaries' bad debts even after sending them to a collection agency, a U.S. District Court judge has ruled.
A provision of the Affordable Care Act on kickbacks could snare innocent providers, panelists said at a recent American Health Lawyers Association conference. The new law considers any Medicare claim resulting from a violation of the anti-kickback law to be "false and fraudulent."
The Centers for Medicare & Medicaid Services will undertake targeted audits focused on upcoding in electronic health records, according to Acting CMS Administrator Marilyn Tavenner.
Increasing hospice enrollment would save the Medicare program millions of dollars annually, according to a new report.
March 28, 2013
Government agencies and lobbyists are famous for conducting studies that prove a point — theirs, namely. That's why I'll be very interested to see who will have the courage to conduct one of the most important long-term care-related studies that should be completed over the coming year.
A provision of the Affordable Care Act on kickbacks could ensnare innocent providers, panelists said at a recent American Health Lawyers Association conference.
March 26, 2013
Geographic variations in Medicare payments can be largely explained by how much skilled nursing and post-acute care is being used, according to a recently released interim report from the Institute of Medicine.
March 25, 2013
Both houses of Congress passed budgets late last week, setting up the next phase of the ongoing debate over healthcare spending.
Nursing homes in the United States are generally efficient and able to control expenses without sacrificing quality of care, according to a recently released study in the Healthcare Management Review.
March 20, 2013
Representatives Sam Graves (R-MO) and Adam Schiff (D-CA) recently reintroduced a bill to ease audit burdens on long-term care providers. Initially put forward in Oct. 2012, the Medicare Audit Improvement Act would change the way Medicare recovery audit contractors (RACs) operate.
Medicare payments to skilled nursing facilities should be cut 4% in 2014 and then steadily reduced in subsequent years, the Medicare Payment Advisory Commission said in a March 15 report to Congress. Rates should be decreased to achieve $10 billion in savings by 2018, the group said.
Senate Budget Chairman Patty Murray (D-WA) unveiled a proposed budget Wednesday, offering a plan that contrasts with the one offered earlier in the week by Rep. Paul Ryan (R-WI).
March 15, 2013
Thursday's Congressional hearing about immigration policy became a forum for discussing how the recently proposed budget from Rep. Paul Ryan (R-WI) would affect long-term care providers.
Lawmakers in the House and Senate formally introduced legislation to close the so-called "observation stay loophole" on Thursday.
March 13, 2013
Rep. Paul Ryan (R-WI) submitted a proposed budget calling for large cuts to Medicaid and partial privatization of Medicare on Tuesday. The budget — which includes repealing the Affordable Care Act — would save the federal government $2.5 trillion in healthcare costs over the next decade, according to Ryan.
March 12, 2013
Tennessee-based nursing home operator Grace Healthcare LLC will pay the federal government more than $2.7 million, settling charges that Grace violated the False Claims Act by billing Medicare for unnecessary rehabilitation therapy.
A newly enacted sequester may be trimming Medicare payments to skilled nursing operators, but the sector remains strong and poised for future growth. That assessment was delivered Wednesday by the head of the nation's largest nursing home association at a conference in San Diego hosted by the National Investment Center for the Seniors Housing & Care Industry.
Increasing hospice enrollment would improve care for beneficiaries while saving the Medicare program millions of dollars annually, according to a study in the March issue of Health Affairs.
