Medicare

'Extenders' package would repeal therapy caps, but SNF payment changes may be included

'Extenders' package would repeal therapy caps, but SNF payment changes may be included

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Skilled nursing providers found both good news and bad news Thursday in a House bipartisan agreement statement on a Medicare extender package.

Medicare cuts, individual mandate repeal rolled into GOP tax bill

Medicare cuts, individual mandate repeal rolled into GOP tax bill

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Republican Senators on Tuesday added a provision to their tax overhaul bill that would roll back the individual insurance mandate included in the Affordable Care Act.

The hell with this guy

The hell with this guy

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Speaking at the same Mandalay Bay complex in Las Vegas from which a "madman" committed the deadliest mass shooting by a single person in U.S. history just two weeks earlier, American Health Care Association CEO Mark Parkinon delivered a bold, unscripted edict.

OIG wants $30M refund from rehab in NJ

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Fox Rehabilitation received at least $29.9 million in Medicare Part B payments for services that did not meet Medicare requirements, according to an August report by the Office of the Inspector General of the U.S. Department of Health and Human Services.

GOP budget that cuts $1 trillion from Medicaid over next decade may be smokescreen

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The House passed a budget proposal on Thursday that would slash roughly $1 trillion from the Medicaid program over the course of 10 years. But representatives aren't planning on seeing those cuts through, according to some observers.

CEO in nursing home podiatry scheme given 1 year in prison

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The former CEO of a healthcare company caught billing Medicare for unnecessary podiatry services for nursing home residents was sentenced last week to serve a year in prison and pay $1.8 million in restitution.

When no comment says a lot: A tale for nursing homes and hospitals

When no comment says a lot: A tale for nursing homes and hospitals

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One should never forget that some of the most brutal fights occur between brothers or sisters.

Person-centered care pushing aside nonsense

Person-centered care pushing aside nonsense

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I found it stunning when I recently read that more than a half million people had taken advantage of new Medicare coverage that pays for end-of-life discussions with their doctors. And there was hardly a peep about it.

How to police recidivist nursing homes: 3 strikes and you're out

How to police recidivist nursing homes: 3 strikes and you're out

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The Centers for Medicare & Medicaid Services has the option of terminating nursing homes from the Medicare and Medicaid programs that it deems harmful. But to say the government has been reluctant to do so would be an extreme understatement.

MedPAC calls for payment reforms to come even earlier

MedPAC calls for payment reforms to come even earlier

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Federal lawmakers' advisory panel for Medicare made it official in its report to Congress in June: It recommends implementation of a unified post-acute payment system beginning in 2021 — three years earlier than first proposed.

Paltry pay raise not unexpected

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Nursing home operators will receive a $390 million Medicare pay increase in fiscal 2018, the Centers for the Medicare & Medicaid Services announced in a rule proposed in late April.

With pay hikes like this, you might need a bankruptcy attorney

With pay hikes like this, you might need a bankruptcy attorney

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President Trump just announced a new plan to slash tax rates for long-term care operators and other businesses. But his desire to aid the corporate class has apparently not made its way to the Centers for Medicare & Medicaid Services.

Your money's no good here

Your money's no good here

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I'd say the thing we write about most often in this line of work is payment issues. As a long-term care provider, you are eternally under pressure with whether there will be enough to pay for everything.

Price says the right things on Medicare, Medicaid

Price says the right things on Medicare, Medicaid

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It would be unwise to assume that Rep. Tom Price (R-GA), the likely new head of Health and Human Services, is always going to align with the values of long-term care providers. But in the midst of a whirlwind of news around cabinet appointments, it is worthwhile for nursing home providers to take a deep breath and read about what Price did — and more importantly, did not — say this week.

Woman pleads guilty in Medicare genetic testing scheme targeting seniors

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As interest in genetic testing rises, one woman faces 10 years in prison for a $1 million Medicare fraud scheme that lured seniors into unnecessary genetic testing.

Medicare spending growing at slower rate

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Medicare spending slowed to a 4.5% growth rate in 2015, even as payments for nursing homes increased, according to a new analysis.

What the debate's entitlement discussion means for LTC

What the debate's entitlement discussion means for LTC

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While I never expected long-term care to be a serious part of discussion within the three presidential debates, the wonky part of my heart still jumped for joy when moderator Chris Wallace asked about entitlement programs during the last debate Wednesday night.

Nipping improper Medicare payments in the bud

Nipping improper Medicare payments in the bud

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Does the Centers for Medicare & Medicaid Services need its own Barney Fife to set its house in order? Some seem to think so.

Female docs paid less by Medicare than male counterparts, study finds

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Long-term care providers working with female physicians may be surprised to learn that Medicare pays them less than their male peers, according to a new analysis.

Obama administration races to make Medicare changes as healthcare industry objects

Obama administration races to make Medicare changes as healthcare industry objects

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As the clock clicks down on President Barack Obama's days in office, the administration remains focused on adjusting Medicare reimbursements, much to the annoyance of healthcare providers.

SNF owner led record $1 billion Medicare fraud ring, authorities say

SNF owner led record $1 billion Medicare fraud ring, authorities say

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The owner of more than 30 Miami-area nursing homes and assisted living facilities has been charged with leading a national record $1 billion-plus Medicare fraud scheme.

SNF Medicare margins: What MedPAC doesn't know

SNF Medicare margins: What MedPAC doesn't know

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The articulation of data is vitally important, and MedPAC is not the only entity interpreting, or misinterpreting, cost report and claim data.

CMS sneaks a trick in with its treats

CMS sneaks a trick in with its treats

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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.

Hospitals' plea will soon be nursing homes'

Hospitals' plea will soon be nursing homes'

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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.

Nursing homes and loopholes, a love story

Nursing homes and loopholes, a love story

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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.

LeadingAge rallies against proposed Medicare, Medicaid changes

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A leading nursing home advocate is mustering support to combat massive changes the administration has proposed for Medicare and Medicaid participation.

CMS lowers pay hike for skilled nursing facilities to 1.2%

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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.

Rare long-term care double win

Rare long-term care double win

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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's pretty clear what they're really committed to

It's pretty clear what they're really committed to

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It was quite a week for ironic juxtaposition in the nation's capital.

Has MedPAC been infiltrated?

Has MedPAC been infiltrated?

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Don't look now, but it appears that nursing home owners might have sneaked one of their own onto the Medicare Payment Advisory Commission.