Medicare/Medicaid

CMMI rethinks its innovation program, sharpens focus for Round 2 funding

CMS’ Center for Medicare and Medicaid Innovation (CMMI) announces a significantly smaller and more-focused project list for Round Two of the funding awards. Read More »

Senate confirms Marilyn Tavenner as permanent administrator of CMS

 Tavenner is the first permanent administrator of that federal agency to be confirmed in nearly a decade. Read More »

Medicare fraudsters nabbed in $223 million nationwide bust

This week’s Medicare fraud sting operation involved nearly 100 people across multiple states, including physicians, nurses and therapists. Read More »

Skilled care in the south of France

Every country in the world--from Argentina to Zimbabwe--is confronted with the problem of caring for its elderly and paying for that care. Here's a firsthand look at how senior care is provided at a facility in France. Read More »

CMS Publishes FY 2014 Proposed Payment Guidance

CMS publishes proposals for changes to FY 2014 payment rates, quality data collection and reporting requirements, and qualification criteria for long-term care providers in the Federal Register.  Read More »

National hospice provider charged with false claims submissions

Vitas Hospice Services is charged by DOJ with engaging in business practices that resulted in inappropriate patient admissions and upcoded claims submissions to Medicare. Read More »

CMS proposes $180 million increase in hospice reimbursements

CMS has proposed a new rule that would raise hospice payments under Medicare by $180 million next year. Read More »

A resurgence of fraud cases based on quality allegations

Alleged poor quality charges are landing providers in the poorhouse. A look at cases based on poor quality of care and the subsequent verdicts handed down. Read More »

CMS sweetens the deal for fraud whistleblowers

Know about someone conducting sneaky Medicare billing practices? CMS’ new whistleblower proposal might pay you more than your boss does. Read More »

Senate committee approves Tavenner for CMS helm

Marilyn Tavenner has obtained a vote of confidence from a Senate committee in her bid to become the first confirmed administrator of the Centers for Medicare & Medicaid Services in seven years. Read More »

Industry leaders weigh in on President Obama’s FY2014 budget proposal

This summer will be a busy one as Congress deliberates the 2014 budget and how, without revisions, its proposed cuts to Medicare may affect the physicians, hospitals and long-term care providers. Read More »

The pros and cons of per capita caps for Medicaid

Federal agencies and lawmakers keep revising one possible way to curb Medicaid spending growth: Per capita caps. Read More »

SNFs soon may face penalties for avoidable readmissions

Next year, in an effort to improve quality of care, skilled nursing facilities may share the penalties already levied to hospitals for 30-day Medicare hospital readmissions. Read More »

Obama budget will cut Medicare but boost Medicaid and mental health

President Obama's new budget, released by the White House Wednesday, includes plenty of cuts, but also contains a few surprising increases. Read More »

CMS releases guidelines on delegated nursing roles in SNFs

A new Centers for Medicare & Medicaid Services document clarifies what tasks physicians may delegate to nurses within nursing homes serving Medicare and Medicaid residents. Read More »

One-on-one with…. Ruta Kadonoff

Senior Editor Pamela Tabar talks with Ruta Kadonoff, vice president of quality and regulatory affairs for the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), about quality in long-term care—and why being able to measure it will be important for business. Read More »

2% Medicare payment reductions begin today

The waiting is over. No resolution to the budget crisis means that sequestration begins—today. Long-term care facilities will feel the effects upfront, but a quieter casuality might be healthcare's information technology and data-sharing initiatives. Read More »

Fla insurance shutdown hits 100,000 Medicare/Medicaid beneficiaries

Florida’s Universal Health Care Insurance suddenly closed its doors last week, giving beneficiaries three days to choose another insurance provider. Read More »

HHS finalizes rule on funding payment rates for new Medicaid beneficiaries

The federal government last Friday announced a final rule that provides 100 percent payment of the cost of certain newly eligible adult Medicaid beneficiaries. Read More »

White House, Congress might consider combining Medicare Parts A and B

Sweeping changes may be on the horizon for the way Medicare billing is divided, as President Obama and Republicans put the idea of combining Medicare Parts A and B back on the discussion table, the New York Times reports today. Read More »

Pressure ulcers: What we don’t know can hurt us

Knowledge about the prevention and treatment of pressure ulcers has come a long way, but has it come far enough to prevent and reduce the incidence of this problem in long-term care? Read More »

DOJ nabs more home health, therapy fraudsters

The Department of Justice and Medicare fraud teams continue to look hard at therapy and home care billing. Read More »

CMMI, Senate committee lock horns over innovation projects

The Center for Medicare and Medicaid Innovation (CMMI) got a tongue-lashing from the Senate Finance Committee, while CMMI’s director explains that testing new models takes time before payment reforms can be put into action. Read More »

LTC industry applauds legislation to roll back therapy caps

Legislation that would roll back caps on therapy services to seniors in skilled nursing centers has been introduced in both the House and Senate and is being applauded by an industry reeling from one payment reduction after another. Read More »

MedPAC to Congress: Reduce SNF payments by 4% in 2014

Skilled nursing facilities and home health agencies face payment reductions, but hospices and long-term care hospitals get a first-round bye in MedPAC's latest Medicare payment recommendations to Congress. Read More »

Final 3 members appointed to LTC commission

President Obama adds the last three names to the Long Term Care Commission, completing the group's bipartisan membership. Read More »

Texas SNF survey: Funding cuts portend staff layoffs, deferred tech investment, facility closures

A new survey of Texas nursing homes finds the series of state and federal funding cuts to seniors’ skilled nursing facility care is creating a dangerous strain on facilities’ ability to care for growing numbers of older, more medically complex residents. Read More »

New dementia quality measures approved for LTC

Many health professionals feel that dementia is under-diagnosed in nursing home residents, which may lead to poorly coordinated care or inappropriate care. Read More »

Social services key to delivering senior healthcare at lower cost

Improving healthcare delivery for seniors might take greater investment in an often-ignored component: Social services. Read More »

SNF surveys: Do they tell the whole story?

Nursing home consumers—residents and their families—say the survey process has flaws that need to be addressed, according to a new report from the Coalition for Quality Care. Read More »