Effective July 1, the Centers for Medicare & Medicaid Services will begin rejecting claims received for Medicare Part B patients that do not include the new requirement of G-coding. That really means providers need to be ready by June 1.
How do skilled nursing facilities, clinics and hospitals think about therapy? Focusing on patient satisfaction and revenue is a good start, but it is not enough. As therapy continues to be scrutinized by the government and insurance companies, it's a good idea for administrators, directors of nursing and compliance staff to become more familiar with therapy operations.
As we've been predicting here for some time, allegations of mismanaged therapy care are starting to land nursing homes in some seriously hot water.
While CMS tries to figure out how to proceed with the manual medical review process, we continue to track our caps and apply our modifiers. In the meantime, has anyone noticed how our typical Medicare Part B patients have become more medically complex than just a few years ago?
Government agencies and lobbyists are famous for conducting studies that prove a point — theirs, namely. That's why I'll be very interested to see who will have the courage to conduct one of the most important long-term care-related studies that should be completed over the coming year.
Here's the good news for providers: new analytics are making it possible to understand and bill your care in ways that would have been impossible just a few years ago. Here's the bad news: The government is quite aware of these new options.
A False Claims Act lawsuit involving a nursing home chain and therapy providers in Missouri can move forward, a federal judge has ruled. The case originated when a whistleblower alleged that a therapy company received more than $10 million in kickbacks as part of a scheme to overbill Medicare and Medicaid.
Tennessee-based nursing home operator Grace Healthcare LLC will pay the federal government more than $2.7 million, settling charges that Grace violated the False Claims Act by billing Medicare for unnecessary rehabilitation therapy.
Each time I visited a restroom during a routine site visit, I noticed a very pretty toilet-paper flower there. It was made of toilet paper and folded into a flower, including the stem. It was then sitting in an unused toilet paper roll to serve the purpose of the vase. It was such a clever and creative idea, I wanted to know who was behind this craft.
It's official: A federal judge approved a settlement agreement the last week of January that will allow Medicare patients to continue receiving therapy services even if they are not making measurable improvement.
Fairhaven Manor's Amy Kotterman wasn't sure her incoming graduate student intern was the Katie Smith until receiving an unusual voicemail. Smith called to say she would miss a day of her upcoming rotation to attend a USA Basketball board meeting.
A new U.S. Senate bill would change a Medicare provision preventing many seniors from getting coverage for skilled nursing therapy after hospital "observation stays."
The Centers for Medicare & Medicaid Services is encouraging provider input as it seeks to change the payment system for therapy provided by skilled nursing facilities.
A keynote address by Farzad Mostashari, MD, ScM, the National Coordinator for Health Information Technology, will highlight opening day of the annual winter Legislative and Regulatory Conference of the National Association for the Support of Long-Term Care.
Instead of spending more time doing hands-on patient care, therapists who work with Medicare beneficiaries have been strapped with increased administrative tasks, sometimes leading to delayed services, or worse.
When Grancare Nursing Center owner and administrator Donna Zunker began envisioning a new rehab wing, she wanted more than a new addition.
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?
Aggressive therapy can improve language function and general cognition for seniors who have had aphasia for years, according to a study recently published in Brain and Language.
The Office of the Inspector General's recent report about what it calls $1.5 billion in inappropriate Medicare payments to skilled nursing facilities should be yet another wake-up call to providers.
It's no secret health care is changing and that we, as professionals, need to be a part of that change to improve the overall system. Part of this improvement involves helping patients quickly return home after a visit to the hospital, and doing all we can so they do not have to return. Therapy can help with both of these goals.
Well, we didn't completely go off the "fiscal cliff," but we're definitely heading for a downward slope.
It's hard to believe the holidays are already here. As I have frantically baked cookies, mailed holiday cards and waited in long lines for the perfect gift, I couldn't help but people-watch. I've encountered my share of fellow shoppers that should be posted on various websites for their holiday spirit, or lack thereof.
What happens when delegation without accountability takes place? We saw a good example last week, when the Office of Inspector General released a damning report about excessive Medicare charges from nursing homes.
Hospitalizations of frail nursing home residents can result in higher costs, complications, and death. Fifteen percent of long-term nursing home residents are hospitalized in any given six-month period, and 40% of these admissions are considered inappropriate
Are we being replaced by computers? Most likely the answer is no, but ... computers have made our jobs more efficient, right? Right?
Therapy services can be a tricky business when working with residents with a history of "behavioral issues."
Nursing home administrators who can't substantiate every minute of rehab therapy delivered in their building leave themselves open to increasingly common audits and surveys, a top MDS 3.0 expert said Tuesday.
Nursing home administrators who can't back up every minute of rehab therapy delivered in their building leave themselves open to auditing, warns an MDS 3.0 expert during the July 10 McKnight's Super Tuesday webcast. Every skilled nursing facility billing minutes to rehab services must be able to verify that he or she has read all of the updates to the RAI Manual, as well as all of the changes that took effect April 1, adds Leah Klusch, RN, BSN, FACHA. That and much more was discussed during the free webcast, which remains available for viewing in an online archive for a year.
Have you heard? Yes, it's true. We can now provide therapy co-treatment with another discipline WITHOUT splitting our treatment time. But, not so fast ...
The bundling of payments to post-acute providers and an overhaul of the therapy caps exception process were just two of the Medicare changes that the Medicare Payment Advisory Commission (MedPAC) floated last week.