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Reimbursement

Take advantage of the changing long-term care marketplace, top execs urge

Elizabeth Newman May 08, 2012

Long-term care providers should hone in on the changing needs of their market by embracing what customers want and will pay for, and by working to change the profession's image problem, LTC executives said Monday.

LeadingAge gets a 911 call

Elizabeth Newman April 24, 2012

You could soak up plenty of what you'd want to hear at a conference Monday at the LeadingAge PEAK Leadership Summit: discussions ranging from leadership and policy to payments.

In limbo with underwhelming pay proposal

James M. Berklan April 18, 2012

First, it was the U.S. Supreme Court's turn to leave providers in suspense. Now, it's a group of decision-makers without robes who have operators holding their breath.

Analysts disagree whether death of healthcare reform could mean recoupment of provider funding

McKnight's Staff April 13, 2012

Healthcare analysts are proposing that Medicare providers, including nursing homes, could recoup millions of dollars if the Supreme Court strikes down the Affordable Care Act.

So this is what hope feels like?

James M. Berklan February 29, 2012

I don't know when I've ever heard louder joyful shouts of, "We didn't lose!"

'Doc fix' moves on to White House

February 17, 2012

A bill that contains legislation cancelling a scheduled Medicare reimbursement cut to physicians has passed the House and Senate.

RAC reviews and the long-term care provider

David Centafont February 10, 2012

Recently, claims for hospital patients discharged to skilled nursing homes have come under increased review, particularly by various recovery audit contractors. If you know some background and better understand the situation, it can only help.

Nursing homes more likely to send Medicaid recipients to hospital, study says

October 04, 2011

Medicaid beneficiaries in a nursing home are 27% more likely than private pay residents to be sent to a hospital rather than be treated on-site, according to a new study.

Nursing home operators anxious as new assessment, reimbursement changes take hold

September 29, 2011

Saturday marks the much-awaited — if not eagerly anticipated — Oct. 1 start date for a sweeping new set of changes to the MDS 3.0 resident assessment tool. Nursing home operators believe this could be the start of a new era of austerity. Among other challenges: The Centers for Medicare & Medicaid Services is enacting changes to reclaim billions of dollars in "overpayments" made over the last 12 months. Federal regulators have released hundreds of changes to the operations manual during the last several weeks alone. Experts caution that coding during the first transition month, which begins tomorrow, must be spot-on in order to avert missed payments, penalties or both.

Medicare SNF Final Rule: An analytics- based perspective

Cheryl Field, RN, MSN, CRRN and Nancy Augustine, RN, MSN, NHA September 26, 2011

While the changes to the new SNF PPS rule have been summarized as a simple number reflecting an overall revenue decrease of 11.1%, there are many details in the rulemaking that result in a disproportionate impact upon individual providers.

Irene's nursing home evacuations leave paperwork headaches behind

August 31, 2011

Hurricane Irene evacuations have some East Coast nursing home operators nervous that reimbursement payments will be late or inadequate.

CMS did more than 'just' cut Medicare pay by 11.1%

Shelly Mesure, MS, OTR/L August 19, 2011

Have you started your COT trending analysis? On Aug. 8, the Centers for Medicare & Medicaid Services released the final ruling and commentary for the new implementation of the MDS changes set to take effect on Oct. 1. Of these many changes, I believe the most significant will be with the Change of Therapy OMRA.

Top therapy reimbursement for everyone: here's how

Shelly Mesure, MS, OTR/L July 18, 2011

If the Ultra High is the highest level of allowable treatment we may seek, it's our professional obligation to clinically provide these levels of service to every patient.

Care transitions becoming more crucial

James M. Berklan June 17, 2011

It seems the Hebrew Rehabilitation Center in Boston ought to be getting a lot more attention from its peers. The center has successfully implemented a multi-pronged approach to lower rehospitalizations.

Providers grapple with CMS 'rule'

James M. Berklan May 03, 2011

The Centers for Medicare & Medicaid Services has a lot of long-term care providers shaking their heads. They're not sure they heard one of CMS's latest proposed rules right.

SIX DAYS TO GO: McKnight's 5th Annual Online Expo

March 17, 2011

Two federal courts recently issued nearly identical rulings declaring the Medicare cap on hospice reimbursements to be invalid. They continue an unbroken series of rejections of the Department of Health and Human Services' payment rule.

MedPAC recommendation of 0% pay increase for 2012 leaves long-term care providers fuming

March 16, 2011

Long-term care groups on Tuesday strongly criticized the latest round of recommendations to Congress from the Medicare Payment Advisory Commission.

A reason to hide

James M. Berklan February 17, 2011

Given recent flaps about hospice care in nursing homes, one has to wonder if long-term care providers are always going to be subjected to the "one step forward, one step back" syndrome.

Hospice provider wins injunction against HHS efforts to enforce 'capricious' reimbursement cap

August 24, 2010

An Arkansas hospice provider has been granted a temporary reprieve from efforts by the Department of Health and Human Services to recoup reimbursement the federal agency says exceeds the annual Medicare reimbursement cap for hospice services.

Doc pay fix temporary resolves nursing home therapy reimbursement rates

June 30, 2010

The recent temporary physician pay fix also decides certain nursing home therapy reimbursement rates.

Vermont to seniors: Give me your $250 Medicare Part D checks

June 14, 2010

Many seniors across the country are gearing up to receive $250 reimbursement checks for costs associated with the Medicare Part D coverage gap. But Vermont is telling some seniors to hand that money over to the state.

Report: 'Episode of care' reimbursement model filled with promise, problems

September 30, 2009

Reimbursing physicians and providers using an "episode of care" model has been discussed as a way to potentially curb medical expenses and improve quality of care, but a number of logistical concerns stand in the way of implementing such a system, according to new research from the RAND Corporation.