May 01, 2013
The Centers for Medicare & Medicaid Services has issued a fact sheet, that clarifies the conditions the terms under which "maintenance therapy" will be covered by Medicare.
Skilled nursing operators now have greater flexibility in allowing non-physicians to do certain tasks. The Centers for Medicare & Medicaid Services clarified what may be delegated in an April 3 brief.
April 01, 2013
A federal agency is again offering to put its money where its mouth is when it comes to employee background checks for long-term care providers. All direct-care employees could potentially be affected.
The Centers for Medicare & Medicaid Services and the state of Illinois are teaming up in a dual eligible payment demonstration.
Providers will have their say about the future of Medicare Administrative Contractors.
February 01, 2013
Providers will have to hold their breath a little longer after receiving Medicare payments, thanks to a little-publicized provision of recently signed fiscal cliff legislation.
February 01, 2013
What happens if my therapy company makes an error on the MDS and as a result, a change of therapy was missed? Are we still responsible?
January 01, 2013
Providers are used to the Medicare Payment Advisory Commission promoting stingy or non-existent reimbursement recommendations.
While the administration has been flexible about numerous aspects of Medicaid expansion called for in the healthcare reform law, there is at least one thing that is not negotiable: States will not get full federal funding from states that go only part way on expanding their Medicaid programs.
The government's so-called "Money Follows the Person" program has had a disappointing start, officials announced recently.
December 01, 2012
The Obama administration settled a lawsuit in November that opens the door for expanded skilled nursing care and rehab therapy for some individuals with chronic diseases.
A new federal work plan declares that even the Medicare contractors charged with keeping close tabs on long-term care facilities will be put under the microscope during fiscal 2013.
November 01, 2012
A miscalculation by the Centers for Medicare & Medicaid Services means that more than 1,400 hospitals with comparatively high readmissions rates will lose more federal funding than previously thought, the agency revealed in October.
If providers feels like they're under more intense scrutiny than ever before from Medicare recovery audit contractors, there is a good reason: They are.
People seeking Medicaid coverage for long-term care are subjected to differing asset-verification checks among the states, a new report finds.
September 01, 2012
An Affordable Care Act provision testing pay-for-performance incentives faces an uncertain future after a federal demonstration program testing it has so far brought "disconcerting" results.
At least one high-ranking lawmaker is pushing to cut off Medicaid funding to providers who have unpaid taxes.
The U.S. Supreme Court came down against organized labor recently in a 7-2 ruling that opens the door for objections to unexpected fee increases or special assessments.
August 01, 2012
Regardless of whether states choose to expand Medicaid under healthcare reform law, they are facing huge fiscal crisis conditions, largely due to rising healthcare costs and government pension obligations, new research says.
Federal regulators have relented and given state Medicaid programs a full year to collect and return overpayments made to providers.
Results of a new study confirm long-term care providers' suspicions that they are being denied access to many post-hospitalization patients due to hospitals' admitting and coding practices.
May 01, 2012
Regulators have severely underestimated added costs that would result under a proposed rule requiring the prompt return of self-detected reimbursement overpayments, according to at least one expert.
Skilled nursing facilities will experience $3 billion less in Medicare funding over the next 10 years due to recently passed legislation. A handful of states will absorb the worst of the cuts, according to a new analysis.
April 02, 2012
A "punt" by the U.S. Supreme Court left long-term care providers breathing a deep, maybe temporary, sigh of relief regarding California's proposed Medicaid funding cuts.
At least providers can't say they weren't warned about major changes to the new MDS 3.0 and other resident assessment tools that started this month.
March 01, 2012
Federal researchers believe a common evaluation and payment model for three types of post-acute care could be up and running in the not-so-distant future. The key might be patient acuity measures that aren't currently used, they said.
Lower Medicaid federal matching rates will be in place for about 30 states in fiscal 2014, according to a report from the National Association of Medicaid Directors. Just a handful of states will see an increase, the report predicted.
February 01, 2012
Skilled nursing operators, apparently overwhelmed or defiant, have not been completing resident interviews as mandated by the new MDS 3.0 resident assessment tool, a top official with the Centers for Medicare & Medicaid Services said last month.
Authors of a new report recommend creating an integrated care model for dual-eligible Medicare and Medicaid beneficiaries. The result would be better coordinated care, and at a lower cost, they say.
January 03, 2012
It's no wonder long-term care providers prefer residents whose care is reimbursed by something other than Medicaid: The federal-state program was expected to underfund care by an average of nearly $20 per beneficiary day in 2011, according to a new analysis.
Medicaid beneficiaries are definitely taking notice — and making use — of federal funding intended to help move individuals from nursing homes to community residences. That's according to a new analysis from the Kaiser Family Foundation's Commission on Medicaid and the Uninsured.
October 01, 2011
Post-acute care providers will be among those affected under a new initiative that will provide bundled Medicare payments.
Providers may be getting their load lightened a bit with help from the Centers for Medicare & Medicaid Services. The agency has proposed covering intensive behavioral therapy for obese Medicare Part A and Part B beneficiaries.
September 01, 2011
When others were sweating out funding threats or declines, hospice providers were able to enjoy the announcement of a 2.5% rise in Medicare payments for fiscal 2012. The Center for Medicare & Medicaid Services released a final rule for it that was published in the Aug. 4 Federal Register.
Medicare's young prescription drug coverage program has brought down admissions to nursing homes and hospitals, thereby cutting healthcare costs by $12 billion, researchers say.
August 02, 2011
With federal lawmakers trying to figure out ways to cut expenditures, balance the budget and reduce the national deficit, funding to states — and healthcare providers in particular — has frequently been targeted.
In contrast to providers' preference, more Americans want an independent payment board to make decisions about Medicare spending, rather than leaving the current system as is.
July 01, 2011
The Centers for Medicare & Medicaid Services has issued a final rule that will deny Medicaid payments to providers that deliver services regarding preventable healthcare-acquired illnesses or injuries.
Officials say that some much-ballyhooed programs in the 2010 healthcare reform law aimed at nursing homes could go without funding.
May 02, 2011
Lawmakers in the U.S. House and Senate recently introduced proposals that would repeal payment caps for Medicare Part B therapy patients.
Federal regulators are undertaking major changes to the Nursing Home Compare website and will continue to do so for five more months, officials said.
April 01, 2011
Patricia Boyer, MSM, NHA, RN, President, Boyer & Associates, LLC
A new rule authorized under the Patient Protection and Affordable Healthcare Act sharply amends the notification-of-closure period for nursing homes, and significantly increases the stakes for potential penalties for administrators.
Health and Human Services Secretary Kathleen Sebelius recently announced additional funding to help expand home- and community-based services to 13 more states. The grants are part of the Money Follows the Person (MFP) program, which is designed to help move Medicaid beneficiaries out of nursing homes and institutional settings and into the community.
March 01, 2011
The U.S. Supreme Court has agreed to hear arguments in a controversial case that could allow states to significantly reduce Medicaid payments to long-term care operators—and leave providers all but powerless to stop them.
As budget shortfalls continue to hammer states, many governors have begun to explore the possibility of dropping Medicaid patients from state rolls through the use of Medicaid waivers.
