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Medicare

Obama's budget proposal would reduce Medicare payments

February 07, 2012

President Obama's 2013 budget proposal calls for spending cuts to Medicare and Medicaid, including a reduction in Medicare payments to nursing homes.

Americans' lifespan shorter than previously thought, study finds

February 07, 2012

A group of researchers has developed a more accurate way of calculating mortality rates of the oldest Americans, which might lead to more realistic cost projections for Social Security and Medicare.

OIG: Cutting Medicare and Medicaid fraud still a top concern

February 03, 2012

Eliminating Medicare and Medicaid fraud should be a priority for the Department of Health and Human Services as it works to implement healthcare reform programs, according to a new report.

CBO: Federal healthcare spending could double by 2022

February 01, 2012

Federal spending on Medicare and Medicaid is expected to double by 2022, reaching $1.8 trillion or 7% of the entire economy, according to a new Congressional Budget Office report.

As states cut Medicaid funds, nursing home group proposes bad debt fix

February 01, 2012

Forty states have either frozen or cut Medicaid-financed nursing home care for seniors between 2009 and 2011, a new survey has found.

Report: Correcting Medicare Advantage overpayments could save billions

January 27, 2012

Correcting overpayments in the Medicare Advantage program could save the federal government billions of dollars, according to a new Government Accountability Office report.

Report: Correcting Medicare Advantage overpayments could save billions

January 27, 2012

Correcting overpayments in the Medicare Advantage program could save the federal government billions of dollars, according to a new Government Accountability Office report.

Rethink frequency of bone density tests, investigators advise

January 20, 2012

Frequent bone density tests for senior women may not be needed, according to a new study.

SNFs should focus on partnerships, quality, to weather uncertain future, experts say

January 16, 2012

In order to survive an uncertain financial and regulatory environment, skilled nursing operators need to look at partnering with other healthcare systems and improving the quality of care, analysts say.

U.S. healthcare spending growth at historic low rate

January 10, 2012

Overall spending on healthcare in the United States grew at historically low rates in 2009 and 2010, according to a report from the Centers for Medicare & Medicaid Services.

SGR fix?! Don't get me started!

Jacqueline Vance January 09, 2012

So here's a Sustainable Growth Rate (SGR) 101 primer so you will understand why I am so upset.

GOP presidential candidate: Eliminate the Centers for Medicare & Medicaid Services

January 06, 2012

Republican presidential hopeful Rick Santorum says he favors privatizing Medicare and says he would like to see the elimination of the Centers for Medicare & Medicaid Services. Programs administered at least in part by CMS account for an overwhelming majority of payments made to skilled nursing providers

Hospice provider fraudulently cycled patients through nursing homes, hospices, whistle-blower suit claims

January 05, 2012

Hospice company AseraCare allegedly defrauded Medicare by cycling beneficiaries through nursing homes and hospice care, according to a whistle-blower suit announced this week.

Yes, it was a good year

John O'Connor December 22, 2011

If you're like most operators, you're probably staggering toward the end-of-year holidays. And your unsteady gait may have nothing to do with spiked eggnog.

Report: Medicare should cover nutritional counseling for chronic conditions

December 20, 2011

Medicare should reimburse for medical nutrition therapy (MNT) — or consultations with a registered dietician — to prevent and treat chronic health conditions such as hypertension, obesity, cancer and renal disease.

Skilled nursing groups slam MedPAC recommendations to revise payment system

December 20, 2011

Leading provider groups are sharply critical of a Medicare advisory committee's recommendation that the Centers for Medicare & Medicaid Services should massively overhaul the skilled nursing facility reimbursement system and rates.

Former TX administrator convicted of healthcare fraud, anti-kickback violations

December 13, 2011

A former nursing home administrator was found guilty of receiving illegal payments for referring residents for fraudulent ambulance transport services.

Berwick decries Medicare and Medicaid fraud and waste in parting interview

December 06, 2011

On the heels of his departure from the Centers for Medicare & Medicaid Services, Donald Berwick, M.D., said he came to Washington with an agenda to eliminate waste from the system.

Bill would exempt providers from automatic Medicare cuts

December 02, 2011

Many long-term care providers feel they earned at least a moral victory late last month when the president's so-called debt-reduction "super committee" could not agree on recommendations. That meant nothing worse than automatic 2% across-the-board cuts could be imposed. Now, there may be a reprieve on the horizon from even the 2% cuts.

LeadingAge: Tough times ahead for long-term care providers

November 30, 2011

LeadingAge President and CEO Larry Minnix openly acknowledged Wednesday afternoon that the next two years could be tense and difficult for long-term care providers. He was just one of a handful of experts painting a grave outlook.

CMS expands Medicare fraud patrol program

November 28, 2011

The Centers for Medicare & Medicaid Services is offering $9 million in grants to expand a program that trains retirees to spot Medicare fraud.

Report: Triggered Medicare cuts would hit hospitals harder than nursing homes

November 23, 2011

Nursing homes will be impacted less than hospitals and physicians if the automatic cuts to Medicare providers are implemented, a new report finds. The 2% across-the-board Medicare cuts are scheduled as a result of the failure of the Congressional "super committee" to reach a deal.

Providers react to super-committee's failure to reach debt deal

November 22, 2011

Members of the congressional "super-committee" announced Monday that the panel has failed to devise a deficit reduction plan ahead of its Wednesday deadline, drawing sharp criticism from provider groups. The 12-member, bipartisan committee was tasked with finding a way to trim $1.2 trillion from the federal budget deficit over 10 years by a Nov. 23 deadline.

Government saved $17.6 billion in 2011 due to fraud prevention programs

November 16, 2011

A government crackdown on improper payments in federal programs, such as Medicare and Medicaid, cut wasteful payments by $17.6 billion in 2011, the Office of Management and Budget reported Tuesday. The administration's Campaign to Cut Waste saved $7 billion in Medicare fee-for-service payment errors between 2010 and 2011, according to the OMB.

How to make your nursing facility RAC-ready

Bryan Baird November 08, 2011

As skilled nursing facilities adjust to the changes to Medicare that arrived early last month, they must be ready for Recovery Audit Contractors. RACs are independent auditors for the government that are preparing to audit every facility that has submitted Medicare claims.

Report questions ACOs' cost-effectiveness for providers

November 07, 2011

Accountable care organizations could very well improve the quality of healthcare, but incentivizing lower spending also could cause providers to cut corners, a new report suggests.

National Medicare RAC Summit to uncover answers on Monday

November 03, 2011

The 6th National Medicare RAC Summit will be held Monday in Washington. The pre-conference Recovery Audit Contracting "boot camp" will run from 8 a.m. to 12 p.m. and delve into industry best practices. The main program will run from 1 p.m. to 5:30 p.m. and feature sessions on topics such as audit strategies of the Office of Inspector General and the top 10 inpatient and outpatient issues of interest to Medicaid auditors. The event will take place at the Renaissance Washington, DC, Downtown Hotel.

All eyes turn to deficit-reduction 'super-committee' and possible provider payment cuts

October 27, 2011

The president's special debt-reduction 'super-committee' will hold a hearing Tuesday to review proposals, some of which include big healthcare-funding cuts. The secretive, bipartisan committee, which comprises lawmakers from both chambers of Congress, has been atypically tight-lipped about its ongoing discussions. Recommendations on how to eliminate more than $1 trillion in federal spending will be due no later than three weeks after Tuesday's hearing. A report earlier this week said panel Democrats are nearing agreement on a proposal that would cut about $400 billion in Medicare funding. However, details about where the cuts would be made, like many aspects of the panel's deliberations, were not specified. Long-term care providers have prepared themselves for potential 2% "across the board" cuts but fear they will be targeted for even more.

Getting proactive on hospital readmissions

Ben Adkins October 21, 2011

Long-term care providers have plenty at stake when it comes to the issue of hospital readmissions, and working to reduce them. As debt ceiling talks and federal budget woes raise the specter of additional cuts to programs such as Medicare and Medicaid, it behooves LTC providers to seek creative solutions to curb healthcare spending and retain revenue.

Group advocates for single, coordinated program for dual eligibles

October 18, 2011

A leading Medicaid trade group told members of the so-called debt-reduction "super-committee" that shifting dual eligibles — individuals who are eligible for both Medicare and Medicaid benefits — into a single, coordinated program could save $148 billion in federal expenditures over 10 years.