Medicare/Medicaid

MedPAC’s site-neutral payment recommendation draws criticism

Don’t count the Coalition to Preserve Rehabilitation or the American Medical Rehabilitation Providers Association among the fans of the Medicare Payment Advisory Commission recommendation of “site-neutral” payments for certain beneficiaries. Read More »

Managed care a growing force in post-acute care

Managed care is a growing force that will become far more prominent in post-acute care and will exert much influence over day-to-day operations. Read More »

Rebasing impact report concerns home health group

A rebasing impact report issued by the Medicare Payment Advisory Commission suffers from data and methodologic flaws, the Partnership for Quality Home Healthcare maintains. Read More »

Home care ruling draws cheers and jeers

A ruling by the U.S. District Court for the District of Columbia is being panned by organizations representing direct care workers and celebrated by those representing their employers. Additional action is expected Jan. 9. Read More »

Challenges to Medicare, Medicaid ahead

A recent congressional hearing is precursor as to what lies ahead for Medicare and Medicaid in reform efforts to reduce costs. Read More »

2015 Business Outlook: Important dates

Antipsychotic medications and therapy are just two aspects of care delivery that will be affected by deadlines in 2015. Read More »

Tennessee will use federal funding to experiment with LTSS

Tennessee will receive up to $65 million over the next two years to implement and test its State Health Care Innovation Plan, including the provision of long-term services and supports. Read More »

Nursing home care, rehab hospital care not equal, group maintains

The Medicare Payment Advisory Commission should reject a proposal to pay the same amount for rehabilitation care whether it occurs in an inpatient rehabilitation hospital or a nursing home, the American Medical Rehabilitation Providers Association says. Read More »

2015 Business Outlook: Payment

In the first installment of a multi-part series examining challenges in the new year, Long-Term Living explores why some government initiatives under testing or development give pause to many providers serving older adults. Read More »

Same-sex marriage recognition would be required under rule

Long-term care facilities that do not recognize residents’ same-sex marriages would be ineligible to receive Medicare or Medicaid funding under a rule proposed by the Centers for Medicare & Medicaid Services. Read More »

‘Site-neutral’ payment proposal pits rehab hospitals against nursing homes

A group representing providers of intensive rehabilitation is calling into question a proposal that potentially would divert patients to nursing homes for such care. Read More »

Reducing fraud goal of new CMS rule

The Centers for Medicare & Medicaid Services has announced a new rule that is says will help save more than $327 annually by increasing oversight of Medicare providers. Read More »

Spending on nursing facility, CCRC care was $155.8 billion in 2013, CMS says

Spending on care in nursing facilities and continuing care retirement communities totaled $155.8 billion in 2013, according to new data from the Centers for Medicare & Medicaid Services. This amount represents growth of 2.4 percent, compared with 2.0 percent in 2012. Read More »

CMS tweaks shared savings program to add more time, options for ACOs

The Centers for Medicare & Medicaid Services wants to ease the time lines for accountable care organizations participating in its shared savings program. Read More »

Payment for care after hip, knee replacement focus of AHCA comments to CMS

The American Health Care Association has suggested to CMS several changes to an outcome and efficiency measure that would affect payments to skilled nursing facilities for the care of those who have undergone total hip or knee arthroplasty. Read More »

Medicare co-payment for home healthcare bad idea, group says

Re-establishing a co-payment for the Medicare home health benefit would exacerbate the challenges facing U.S. seniors related to access, coordination and person-centered care, according to the Partnership for Quality Home Healthcare. Read More »

Wracked by RACs?

Sooner or later, most skilled nursing facilities encounter recovery audit contractors (RACs). A healthcare legal expert explains how to handle RAC visits and what to do when claims are denied. Read More »

White House Conference on Aging agenda items recommended by associations

Leaders in organizations representing seniors housing and services providers share with Long-Term Living their wish lists for the upcoming White House Conference on Aging. Do you agree with their picks? Read More »

SNFs, hospice and home health programs prominent in OIG work plan for 2015

The billing, hiring, care-provision and deficiency-correction practices of nursing homes, hospices and home health programs are among the areas to be targeted by the U.S. Department of Health and Human Services Office of Inspector General in 2015. Read More »

Older Americans have easy access to specialists, survey finds

A survey of older adults in 11 countries turns up interesting data on how efficiently people in industrialized nations can access and interact with their healthcare providers. Read More »

Ensuring care quality a challenge for HHS, OIG says

Ensuring quality in nursing home, hospice and home- and community-based settings is one of the top challenges facing the U.S. Department of Health and Human Services (HHS), according to a new report from the HHS Office of Inspector General. Read More »

The battle over immigration reform

One of the first political “hot potatoes” the new Congress must address is amnesty for illegal immigrants, which would present long-term care organizations a broader pool of potential caregivers. Read More »

CMS proposes to add annual lung cancer screening for high-risk seniors

CMS has followed the lead of a preventive services agency and proposed coverage of annual lung cancer screenings for certain older adults. But can Medicare afford it? Read More »

CMS updates Medicare COT assessment requirements

CMS recently updated the change of therapy requirements found in the RAI User’s Manual. Understanding the changes can ensure correct reimbursement and avoid miscalculations. Read More »

Jimmo settlement: Will effects be widespread?

The federal government has reached a settlement about one woman's Medicare claims for nursing and therapy services, but it remains to be seen how far its effects will reach. Read More »

CMS issues final rule with home health payment changes for 2015

Changes effective Jan. 1 will apply to face-to-face encounters, therapy reassessments, rate setting, home health quality reporting and speech-language pathologists' conditions of participation. Read More »

Leadership upheaval continues at ONC

This week’s departure of the top two executives at the Office of the National Coordinator for Health Information Technology are the latest in a series of leadership turnovers at ONC. What will it mean for IT initiatives for quality improvement and transitions of care? Read More »

Medicare challenge: When will Congress be up to the task?

Will members of Congress ever be able to cross the political divide and come up with a workable solution to Medicare funding? Read More »

Care quality, coordination is focus of new ACO model

A new model of accountable care organization will aim to improve care quality and coordination in rural and underserved areas through the use of health information technology. Read More »

Pioneer ACOs: Will positive effects last?

Pioneer ACOs have resulted in overall savings and quality improvements in the health system, according to new information released by CMS, but their effect going forward may be muted as participants dwindle. Read More »