For-profit hospices serve more extended-stay hospice patients than nonprofits, and are much more likely to file claims that exceed Medicare's aggregate annual cap for the hospice benefit, according to newly published findings.
The takeaway in a story last week about extrapolation and Medicare overpayments is, natch, how meticulous providers should be when filing claims — and to understand how individual claim problems can grow. And, boy, can they grow.
Among people eligible for Medicaid but not Medicare, long-term care residents are most likely to be among the costliest beneficiaries for a state, according to a new report from the Government Accountability Office. Sen. Charles Grassley (R-IA) requested the report, noting that much research has focused on those eligible for both Medicaid and Medicare, but has largely overlooked the Medicaid-only group.
A large number of rehabilitation patients seek hospital care shortly after being discharged from a nursing facility, according to recently published research.
The Senate has passed a bill to extend 2% cuts to Medicare reimbursements for an additional year, and the measure now is headed to the White House for President Obama's signature.
Major League teams don't celebrate World Series victories midway through the season. But politicians do the equivalent all the time. Consider a revised Medicare payment plan that was joyously unveiled on Thursday.
Skilled nursing facilities that implement a telemedicine service and teach staff to use it could reduce their hospital readmissions, but current payment systems do not encourage this, according to a forthcoming study in Health Affairs.
A Medicare expenditure for an episode of post-hospital care in 2008 ranged from about $5,700 to $14,500, depending on how the episode was defined, according to a new report from the Centers for Medicare & Medicaid Services.
Medicaid underfunded long-term care by the greatest margin on record in 2013, according to a new report from the American Health Care Association/National Center for Assisted Living, the nation's largest long-term care provider association.
Dramatic Medicare cuts to skilled nursing facilities played a significant part in keeping healthcare spending low in 2012, the Centers for Medicare & Medicaid Services announced Monday.
Healthcare reform, especially the expansion of Medicaid, will bring into focus the fragility of the safety net. This is a system that is for vulnerable seniors, but which has not been adequately financed.
Above-average skilled nursing facilities may become exempted from Medicare's prior hospitalization requirement, per legislation from Rep. Jim Renacci (R-OH).
About a quarter of Medicare beneficiaries rely on walkers or other assistive devices, according to a new study. Women were more likely than men to use devices.
Skilled nursing facilities and other post-acute providers would be eligible to participate in a Medicare bundled payment system proposed in a House of Representatives bill unveiled Thursday.
A bipartisan budget deal is on the verge of becoming law, after being passed by the U.S. Senate in a 64-36 vote on Wednesday. Long-term care leaders called for passage of the two-year spending plan after it was released last week, saying it will provide needed stability and end the type of political brinkmanship that closed the government in October.
The National Quality Forum has endorsed a controversial hospital quality measure that assesses Medicare costs for a whole episode of care, including time spent in post-acute settings, the organization recently announced.
Policymakers should freeze Medicare hospice reimbursements for 2015, according to recommendations supported by the Medicare Payment Advisory Commission.
A California physician received kickbacks from skilled nursing facilities as part of a large-scale scheme to defraud government health programs, authorities announced Friday. Ovid Mercene, M.D., pleaded guilty to the fraud and related tax charges in U.S. District Court.
Nursing homes still account for the vast majority of long-term care services available in the United States despite policies meant to encourage home- and community-based care, according to a new government report. The first-ever "National Study of Long-Term Care Providers" includes data on the capacity and operational characteristics of providers, and information about the people cared for in these settings.
The Senate Finance Committee has advanced a bill that would repeal the Medicare Part B cap on therapy reimbursements and replace it with a new outpatient therapy payment system.
The Medicare Payment Advisory Commission has recommended a 4% reduction in skilled nursing facility payments in 2016, prompting an outcry from providers.
Top House and Senate budget negotiators have carved out a deal that would end many parts of the across-the-board spending cuts known as sequestration, but long-term care providers would face an additional two years of reduced Medicare reimbursements.
The Centers for Medicare & Medicaid Services has revised the Medicare Benefit Policy manual to clarify that skilled care and skilled therapy may be covered even for conditions that will not improve, per the settlement in the high-profile Jimmo v. Sebelius case.
Specialized hospital units for patients under observation status could dramatically reduce the number of seniors forced to pay out-of-pocket for skilled nursing care, according to findings in the current issue of Health Affairs.
Medicare spending on nursing homes, home medical care and other outside care will increasingly come under the government microscope according to a Kaiser Health News/Washington Post report. Widely varied care, additional services and costs from state-to-state have drawn the attention of regulators.
A new policy meant to reduce the number of hospital observation stays should be delayed, and stakeholders should collaborate on a better way to achieve that goal, according to the American Medical Association and American Hospital Association.
On Oct. 31 (an ironic coincidence?) a report from the Office of inspector General frighteningly said Medicare paid some $23 million in benefits for more than 17,000 dead people in 2011. And my husband says I waste money.
A Florida-based hospice provider has agreed to pay $3 million to settle a whistleblower lawsuit alleging false Medicare claims, the U.S. Department of Justice announced Wednesday.
Younger people are more informed about long-term care financing and are more likely to be saving for their future needs than older Americans, according to a recent national survey.
Seniors who are neurotic are more likely to receive care in a nursing home, according to research in The Milbank Quarterly.