Reimbursement - McKnight's Long Term Care News


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

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.

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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.

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