The predominance of fee-for-service payment methods is the greatest barrier to improving efficiency in the nation's healthcare system, according to a May 29 report from a panel of White House advisors. The President's Council of Advisors on Science and Technology criticized the FFS payment model because it focuses on the volume of services provided rather than on better outcomes.
Government health programs could save money and health outcomes could improve if more dual-eligible beneficiaries were to go from hospitals to well-staffed long-term and post-acute facilities, according to research from Brown and Harvard universities.
Medicare would increase hospice reimbursements by 1.3% in fiscal year 2015 under a payment rate proposed in May. This would be a $230 million boost, according to the Centers for Medicare & Medicaid Services.
Healthcare providers face unfairly reduced reimbursements if they serve economically disadvantaged patients, according to a recent National Quality Forum draft report. The government rejected recommendations to address this problem.
A long-term care facility that has been slapped with a civil monetary penalty has 10 days to file for an independent informal dispute resolution process, according to a recent manual update from the Centers for Medicare & Medicaid Services.
Seniors will not have to stop curative care to receive hospice benefits under a new demonstration program, the Centers for Medicare & Medicaid Services recently announced.
Long-term care staffers' understanding of the Minimum Data Set and its Quality Indicators is "mediocre at best," according to recent survey results. Lack of exposure and involvement are key reasons why nurse aides especially feel they are out of the loop.
Federal investigators recovered more than $10 million in incorrect Medicaid payments made to nursing homes in 2013, an annual review shows.
A long-term care provider that requested clearance for a system of paying an agency to refer patients is in the clear.
Providers who want to have an administrative law judge consider a Medicare claim appeal can save their breath and memos for now.
The Department of Health and Human Services' watchdog arm recently said hospice providers need stronger oversight measures. It also noted more than $5.8 billion in recoveries in fiscal 2013.
The Centers for Medicare & Medicaid Services has seen enough and wants to gain more control over drug-prescribing practices for the Medicare Part D program.
So far, some providers have been put through a wringer without enough verification that it's been worth it, according to a new Government Accountability Office report.
A provider-sponsored survey recently uncovered huge backlogs of therapy claim reviews for beneficiaries who exceeded the Medicare Part B caps limits.
The Medicare Payment Advisory Commission could be getting closer to formally recommending more uniform payments to skilled nursing facilities and inpatient rehabilitation facilities.
Federal regulators have come out strongly against facility-wide policies that prohibit cardiopulmonary resuscitation for residents in distress.
A second group of contracts in a competitive bidding program for durable medical equipment items showed savings of more than one-third, according to the Centers for Medicare & Medicaid Services.
Earlier this year, the Department of Health and Human Services released an action plan for tackling Alzheimer's diagnostics, treatment and funding.
Federal regulators have expanded the use of escrow accounts so that as of this month, providers will be subject to their use for any kind of deficiency from a standard or complaint survey that draws a civil monetary penalty.
Federal regulators say surveyors need to prevent providers from possibly "gaming" the system when it comes to the timing of surveys and sales.
Federal regulators have added another layer of bureaucracy for hospice providers operating within skilled nursing facilities.
Long-term care groups are among those hailing a federal study that raises critical questions about hospitals' apparent over-use of "observation stay" designations for patients.
Organizations may serve as authorized representatives for nursing home residents in the Medicaid application and enrollment process, according to a final rule issued by the Centers for Medicare & Medicaid Services.
The Centers for Medicare & Medicaid Services should consider a higher market basket update for nursing homes due to improper calculations that could be costing providers, the American Health Care Association maintains.
Independent Medicare auditors are criticizing two measures that would put stricter controls on Recovery Audit Contractors.
States have run their respective long-term care ombudsman programs in differing ways for nearly 20 years, but that would change if a new proposal advances.
Large-scale bundling of government reimbursements is needed, say researchers who have studied the topic. Post-acute care was the fastest growing major healthcare spending category for government programs between 1994-2009, according to Harvard University researcher Amitabh Chandra, Ph.D., and co-authors.
The Centers for Medicare & Medicaid Services has increased its scrutiny of Medicare Part A filings recently and as a result, has reclaimed more funds than ever from providers, a long-term care compliance expert noted at a recent McKnight's Super Tuesday webcast.
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.
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.
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.
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?
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.
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.
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.
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.
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.
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.