The articulation of data is vitally important, and MedPAC is not the only entity interpreting, or misinterpreting, cost report and claim data.
With so many regulatory changes kicking in on Oct. 1, it's no wonder providers were likely too distracted to notice the latest "trick" by the Centers for Medicare & Medicaid Services.
I was truly surprised when I didn't hear long-term care leaders excitedly jumping around, yelling, "See! See! Us too! Us too!" last week. It was a simple report, sure, but one that should have sent the frantic-meter bouncing.
You can bet that nursing home-hired actuaries, lawyers, consultants and other assorted bean counters are going over new rules with a fine-tooth comb. They are looking for the next generation of potential revenue streams — and any loopholes to them. If they exist, they will be found, and implemented.
A leading nursing home advocate is mustering support to combat massive changes the administration has proposed for Medicare and Medicaid participation.
Medicare skilled nursing facilities would get a net 1.2% pay increase — totaling $430 million — in fiscal 2016 under a final rule issued by the Centers for Medicare & Medicaid Services late Thursday.
So much for the dog days of summer getting close. Long-term care advocates were already at full woof on Tuesday — and that's a good thing.
It was quite a week for ironic juxtaposition in the nation's capital.
Don't look now, but it appears that nursing home owners might have sneaked one of their own onto the Medicare Payment Advisory Commission.
The government plans to make new claims data and other resident-care information available to providers and entrepreneurs as never before. Is it too good to be true?
Huge numbers of dual-eligible beneficiaries are leaving a demonstration project that hopes to improve payments for people eligible for both Medicare and Medicaid.
The Health & Human Services' Inspector General is advising the agency to have its Medicare contractors chase down more than $33 million that might have been overpaid to physicians as a result of seemingly innocent coding errors for services.
Far more than half of the $360 billion in Medicare payments made just two years ago were based on traditional fee-for-service models without regard to quality or value, according to an independent report released Tuesday.
Prescription drug prices are likely to resurface as a hot political potato in the looming presidential race, beginning with the president's recent bombshell that he wants to let Medicare bargain on drug prices.
If providers were charged a fee for challenging Recovery Audit Contractor findings, there wouldn't be the current overwhelming backlog of Medicare appeals, says the administration — and, surprise, the auditors themselves.
Medicare beneficiary smart cards would have a limited impact on reducing fraud and could even introduce "new, more sophisticated fraud schemes," a new report by the Government Accountability Office concludes.
Much of last week's historic bill that created new payment rates for Medicare doctors was left unfunded by lawmakers, and now GOP budget hawks are presenting ideas that provoke anxiety in the sector.
More than just collecting data, providers need to use standardized, nationally recognized measures. Especially in this era of ACOs and alternative payment models. In the past, many individual providers used their own methodology to create their own "data driven" story.
House and Senate Republican lawmakers began working on a budget this week that could propose slashing Medicare and Medicaid in an effort to work toward a balanced budget without fiddling with tax rates, according to published reports.
New AARP research reveals that the use of hospital "observation" status is having a substantial impact on out-of-pocket healthcare costs and follow-up care decisions for many Medicare beneficiaries.
With Medicare and Medicaid costs soaring, federal and state agencies are looking at various avenues to rein in costs. Fraudulent billings from healthcare providers costs taxpayers millions of dollars each year and is an area of focus for government agencies.
Few things signal the fresh start of a presidential campaign season better than stump speeches calling for Medicare and Social Security cuts. And 2015 is no exception.
The Senate overwhelmingly voted to pass H.R. 2 Tuesday night, paving the way for repeal of the Medicare Sustainable Growth Rate and drawing the praise of the largest nursing home association in the country.
Long-term care leaders who have widely endorsed a House proposal to permanently "fix" the Sustainable Growth Rate formula, might be suffering buyer's remorse after learning Friday that the bill might not provide the lasting relief it promises. But they're still hopeful as the Senate reconvenes Monday.
A San Diego man will serve 2½ years in custody after being ordered to repay the government nearly $1 million for what prosecutors say were phony Medicare claims for medically unnecessary and unsupervised tests on unsuspecting seniors, the FBI reported.
After giving the ruling a few days to sink in, several patient advocate groups now say a Supreme Court decision will end up hurting Medicaid beneficiaries more than anyone.
The Centers for Medicare & Medicaid Services said it will hold physician claims for 14 calendar days, thereby delaying 21% rate cuts otherwise set to take effect Wednesday.
Non-whites covered by Medicaid and Medicare are significantly more likely to be readmitted to a hospital within 30 days after total joint replacement surgery than whites, according to a new study that was unveiled on Thursday at the 2015 Annual Meeting of American Academy of Orthopaedic Surgeons.
As expected, the House of Representatives on Thursday repealed the Medicare Sustainable Growth Rate (SGR), earning loud praise from the American Health Care Association.
Praise for Congress for proposing a bill that would reset Medicare physician pay rates could be a little less hearty, after details emerged Tuesday that the measure would also include penalties as high as 100% for providers delinquent with income tax payments.