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Medicare

Obama targets Medicare, Medicaid waste

March 12, 2010

President Obama on Wednesday instructed the heads of all executive departments and agencies to increase their use of "Payment Recapture Audits" to reduce the amount of improper Medicare, Medicaid and other similar payments.

Medicare case-mix likely to become more clinically complex, NIC panel asserts

March 10, 2010

The looming Medicare payment system will encourage nursing home operators to embrace more clinically complex care, according to panelists who spoke Tuesday at the 2010 National Skilled Nursing Investment Forum. A favorable reimbursement level will push this case-mix shift, they noted.

Latest bill would extend therapy caps exceptions process through end of year

March 10, 2010

The Senate on Tuesday voted 66-34 to end debate on a package of healthcare stopgap measures. These include an extension of the therapy caps exceptions process.

Apply outcomes measurement to therapy services

Bill Goulding March 09, 2010

Outcomes measurement is a powerful tool that can help demonstrate the quality of therapy your long-term care facility is providing. Why not give it a try?

Shift long-term care payment responsibility from Medicaid to Medicare, research group suggests

March 08, 2010

In order to better coordinate care for nursing home residents who are dually eligible for Medicare and Medicaid, responsibility for long-term nursing facility services should be shifted from Medicaid to Medicare, suggests a recently released policy brief from policy research group Mathematica.

Sun Healthcare reports solid fourth-quarter, annual growth

March 05, 2010

Sun Healthcare on Wednesday reported "respectable" earnings growth of 7.7% for the fourth quarter of last year and 18.3% for 2009 overall. The nation's sixth-largest skilled nursing provider said Medicare payments for higher acuity residents, as well as upticks in its affiliated hospice and therapy businesses, drove results.

Court: Medicare hospice provider cap calculated improperly

March 04, 2010

The federal Medicare hospice provider cap is calculated in a way that is "arbitrary, capricious, an abuse of discretion, and unlawful," a federal court recently ruled.

Senators propose lifting cap on Medicare mental health benefits

March 03, 2010

Newly introduced legislation in the Senate would lift a lifetime cap on Medicare benefits for inpatient mental health services.

Federal government gives states more than $4 billion to help with Medicare Part D 'clawback' costs

February 22, 2010

The Obama administration is granting $4.3 billion to states to help them offset the cost of Medicare drug coverage for those dually eligible for Medicare and Medicaid.

Healthcare reform is still alive

Liza Berger February 22, 2010

The release of President Obama's healthcare reform proposal couldn't have come at a better time. The American Association of Homes and Services for the Aging is holding its advocacy conference in the capital this week.

Concerns grow over unsettled issues of therapy caps, Medicare physician pay

February 18, 2010

Tensions are rising among healthcare providers over two unresolved issues: the implementation of Medicare Part B therapy caps and an impending 21% pay cut to Medicare physicians.

Senate takes out therapy caps, physician pay provisions from jobs bill

February 16, 2010

Just hours after unveiling a jobs bill that would extend the therapy caps exceptions process and delay a pay cut for Medicare physicians, Senate leaders last week scrapped it in favor of a bill that contains neither of those provisions.

New draft legislation would extend therapy caps exceptions process

February 12, 2010

Senate Finance Committee leaders Thursday issued a draft of a jobs-creation bill. The legislation would extend the Medicare Part B therapy caps exceptions process and delay through Sept. 30 an impending 21% cut in payments for Medicare physicians.

Snowstorm in capital sidelines discussions on therapy caps, Medicare physician pay cut

February 11, 2010

A snowstorm that pummeled the East Coast this week has delayed the Senate's consideration of a jobs bill that would extend the Medicare Part B therapy caps exceptions process and prevent a pay cut for Medicare physicians, according to reports from Washington.

Medicare physician pay fix not bound by new 'pay-as-you-go' rules

February 08, 2010

Newly approved "pay-as-you-go" budget rules contain an important exception: They allow Congress to delay a pay cut for Medicare physicians for a number of years without necessarily taking money away from other areas of spending.

Obama's FY 2011 budget to extend FMAP increase, ramp up anti-fraud efforts

February 01, 2010

President Obama is scheduled to unveil his FY 2011 federal budget proposal today. The blueprint would provide states with some additional Medicaid funding and crack down on Medicare and Medicaid fraud.

Impact of proposed spending freeze on healthcare could be smaller than expected

January 27, 2010

President Obama is expected to call for a three-year, $250 billion discretionary spending freeze during his State of the Union address tonight. Its effect on healthcare might not be as bad as many think, according to recent analyses.

AAHSA members to call lawmakers today, urging them to pass healthcare reform

January 26, 2010

The White House has signaled that it may be scaling back the healthcare reform bill, and one long-term care group is speaking out about it.

Seniors, doctors demand physician pay fix

January 25, 2010

National organizations representing seniors, members of the military and physicians gathered in Washington Thursday to demand an end to the Medicare sustainable growth rate formula. The formula would be responsible for a scheduled 21% cut to Medicare physician reimbursements in March.

Many elderly women with dementia receiving unnecessary mammograms, report finds

January 25, 2010

Thousands of elderly women with severe dementia are receiving mammograms, despite recommendations that this group should not be subject to this medical procedure, according to a recent study.

Healthcare reform wrinkle affects Medicare therapy caps exceptions process

January 21, 2010

The potential collapse of healthcare reform could further stall the restoration of the therapy caps exceptions process for long-term care providers. Both the House and Senate bills would extend the process, which expired at the end of 2009.

A blow to healthcare reform

Liza Berger January 20, 2010

The buzz among long-term care providers today, as expected, is the upset in the Massachusetts Senate race. How healthcare reform will play out now is anyone's guess.

MedPAC recommends freeze on skilled nursing facility payments for fiscal year 2011

January 15, 2010

As expected, the Medicare Payment Advisory Commission (MedPAC) on Thursday recommended that skilled nursing facilities not receive a payment increase for fiscal year 2011.

Providers try to quash Medicare payment board proposal

January 13, 2010

A group of 74 healthcare groups, including the two major nursing home associations, urged congressional leaders this week to drop the Independent Payment Advisory Board proposal from healthcare reform legislation.

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

January 12, 2010

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.

Action-packed 2010 awaits nursing homes

Liza Berger December 31, 2009

Ah, the New Year. As much as many of us try to downplay it, the holiday carries an undeniable host of expectations. While I can't pretend I know how to read tea leaves, my prediction is that the coming year for nursing homes will not be a dull one.

Late release of CMS Medicare payment error report troubles Grassley

December 21, 2009

An official Medicare payment error report is a month past due, and Sen. Charles Grassley (R-IA) is not pleased about it.

Medicare plan collapses as Senate struggles for compromise on reform

December 16, 2009

A proposal to expand Medicare enrollment to adults aged 55 and older fell apart barely a week after it was first introduced in the Senate healthcare reform debate. That has been one compromise as Democrats work to pass the bill before the Christmas deadline.

An unwelcome gift from MedPAC

Liza Berger December 16, 2009

Ho! Ho! Ho! Merry Christmas! What has Santa brought you this year? The usual: A preliminary recommendation to freeze Medicare rates for the following year.

As life spans expand, so do Medicare, Social Security costs, study finds

December 15, 2009

By 2050, Americans could be living three to eight years longer than current government projections. That could result in significantly higher costs to Social Security and Medicare, a new study released Monday reveals.