Independent pharmacies supplying LTC could drop lower-priced drugs in new Medicare program
By
Kimberly Marselas
Oct 23, 2024
More than half of independent pharmacies are warning that they might no longer stock the first 10 drugs subject to new lower, Medicare-negotiated prices once the program starts in 2026.
‘Enormous’ MDS implications, the next version, and more
By
Foster Stubbs
Oct 22, 2024
Consider MDS processes another example of high-risk management, and it shouldn’t be taken lightly. That’s the view of Leah Klusch, the executive director of The Alliance Training Center, who sat down...
‘Discovered authority’ for nursing home staffing rule can’t stand: latest AHCA legal challenge
By
Kimberly Marselas
Oct 21, 2024
The American Health Care Association, LeadingAge and other plaintiffs on Friday formally asked a federal court to issue a quick judgment in their favor in their case opposing a national nursing home staffing...
New CMS final rule enables quicker ‘observation stay’ challenges
By
James M. Berklan
Oct 21, 2024
Long-term care stakeholders and Medicare beneficiaries are applauding a new federal rule that makes it easier for patients to appeal hospital recoding that leaves them ineligible for Medicare skilled nursing...
Senate report hits top 3 Medicare Advantage insurers over ‘refusal’ of skilled nursing, other coverage
By
Kimberly Marselas
Oct 18, 2024
A Senate report published Thursday blasts the nation’s three largest Medicare Advantage insurers for increasingly limiting access to post-acute care and forcing vulnerable patients into “impossible...
CMS: ‘Constant’ guidance updates expected for Medicare revalidation process
By
James M. Berklan
Oct 18, 2024
Skilled nursing operators unnerved by what they see as excessive information demands for a new, off-cycle Medicare revalidation process were assured Thursday that current guidance will be updated frequently...
Rushing roulette: Nursing homes want relief from hasty CMS Medicare revalidation demands
By
James M. Berklan
Kimberly Marselas
Oct 17, 2024
Nursing homes are crying foul over what they call excessive and hurried federal demands for ownership and related-party information that were sent with atypically short notice and relatively little guidance,...
Lawmakers want 2 more years for ‘life-saving’ telehealth benefits as DEA threat looms
By
Zee Johnson
Oct 17, 2024
Members of Congress are calling for a two-year extension of pandemic-era telemedicine benefits that are set to expire at the end of the year. A proposed DEA rule, however, could halt many of those flexibilities.
False Claims Act likely to face Supreme Court review after ruling against use of whistleblowers
By
Kimberly Marselas
Oct 16, 2024
A recent ruling in a Florida False Claims Act case may give the Supreme Court the opening it has wanted to review whether whistleblowers can act on behalf of the government to bring lawsuits against healthcare...
Report reveals how Medicaid payments stack up against nursing homes’ cost of care
By
Zee Johnson
Oct 16, 2024
A new government survey of 13,285 US nursing homes has found that the average provider received 82 cents on the dollar from Medicaid for the costs accrued while caring for beneficiaries.