Medicare/Medicaid

Researchers identify risk factors of rehospitalization for post-acute stroke patients

Of the nearly 700 stoke patients studied, 18 percent were rehospitalized during the three months following discharge. Patients with better motor and cognitive abilities at rehabilitation discharge were less likely to be rehospitalized. Read More »

Back to the future through MDS

Determining what is “less institutional” may not be a foregone conclusion. Making assumptions about residents’ preferences is dangerous business, and when we simply ask residents what they want, they surprise us more often than not. Read More »

‘Bad debt’ cuts to hit SNFs hard in 10 states

Florida, Ohio, Illinois, Pennsylvania, North Carolina, Louisiana, Indiana, Tennessee, Georgia and New Jersey will absorb the largest Medicare funding cuts from bad debt provisions, a new Avalere Health analysis found. Read More »

CMS memo clarifies PPS billing, assessment policies

The memo also introduced a new policy, effective April 1, 2012, for how providers should handle interviews on unscheduled PPS assessments. Read More »

Cumulative Medicare, Medicaid cuts are hurting SNFs

A policy paper addresses the potential impact of payment reductions including the loss of at least 20,000 jobs industry-wide and cancellation of facility expansions or renovations that would have generated 20,000-25,000 new jobs. Read More »

House votes to kill Medicare payment advisory board

Under the new healthcare law, the 15-member board would have had the authority to cut $575 billion from Medicare over 10 years through rationing and price controls. Read More »

Limit on Medicare RAC records requests increased; SNFs to provide more documentation

RACs are now allowed to request a maximum of 400 medical records in a 45-day period, while SNFs must provide documentation for Medicare beneficiaries’ entire episodes of care. Read More »

HHS announces final rule on Medicaid expansion

Final rule implements provisions of the Affordable Care Act that terminated several eligibility categories for Medicaid in favor of an income-based standard of 133 percent of the federal poverty level. Read More »

MedPAC’s latest report urges SNF payment cuts

The Medicare Payment Advisory Commission recommends SNF payments rebasing in 2014 with an initial reduction of 4 percent and reduced payments to SNFs with higher rates of rehospitalization. Read More »

CMS initiative seeks to reduce avoidable nursing home hospitalizations

The initiative aims to fund organizations that would partner with nursing facilities to provide enhanced on-site services to residents through evidence-based interventions. Read More »

AHCA applauds CMS promise to reduce frequency of RAI changes

CMS announced multiple changes at the 2012 MDS National Conference that will directly impact long-term and post-acute care providers. Read More »

Alzheimer’s to cost U.S. $200 billion in 2012

The total cost of caring for people with Alzheimer's disease and dementia includes $140 billion paid by Medicare and Medicaid, according to “2012 Alzheimer’s Disease Facts and Figures.” Read More »

House committee votes to repeal ACA’s Independent Payment Advisory Board

The bipartisan bill would eliminate the Independent Payment Advisory Board (IPAB) from the Affordable Care Act. The bill will now go the House floor for a vote. Read More »

Report argues CMS must monitor progress of Quality Indicator Survey

The Government Accountability Office report says the QIS was intended to improve the nursing home survey process, but CMS is not routinely monitoring the extent to which objectives are being met. Read More »

New Hampshire first state to get Medicaid funds to keep people out of SNFs

States are eligible for the Medicaid grants if they currently spend less than 50 percent of their total long-term care costs on community-based options. Read More »

Arrests made in ‘largest ever’ home health fraud scheme

Between January 2006 and November 2011, Medistat Group Associates P.A. certified more Medicare beneficiaries for home health services and had more purported patients than any other medical practice in the United States, according to the indictment. Read More »

Boomers reveal ignorance about Medicare

A new study shows that most boomers are ignorant about Medicare and its provisions including long-term care coverage, monthly premiums, co-pays and deductibles. Read More »

Revising the five-star quality rating system: What stays, what goes?

As the fruits of this system are borne each winter to national attention, so too are its faults—to the providers who are affected, and those who remember the recent past. AHCA and LeadingAge offer up areas for improvement. Read More »

What MDS 3.0 gets right

Nurse assessment coordinators report lower job satisfaction and general frustration managing and administrating the new tool. Additionally, constant changes have made it difficult to keep up with the new rules. That said, CMS got some important things right with 3.0. Read More »

CMS proposed rule would force providers to report overpayments in 60 days

The CMS announcement followed a separate HHS report finding that the government had recovered nearly $4.1 billion in healthcare fraud cases during FY2011. Read More »

Skilled nursing provider groups blast Obama’s 2013 budget

The Alliance for Quality Nursing Home Care called Obama’s approach to achieving the proposed $4 trillion in deficit reductions a “strategy of ‘cuts only’ without reforms.” Read More »

Obama’s proposed budget calls for Medicare/Medicaid cuts

The 2013 budget includes proposals to cut approximately $248 billion on Medicare and $72 billion on Medicaid and to lower payments to nursing homes. Read More »

Most states to see Medicaid matching rates decline in 2014

Only a handful of states are expected to see an increase in Federal Medical Assistance Percentage, according to projections by the National Association of Medicaid Directors. Read More »

Poll: Most voters oppose reducing Medicare funding for SNF care

The Alliance for Quality Nursing Home Care, which announced the poll's findings, intends to broadcast the results “on Capitol Hill and in states across the nation.” Read More »

The impact of ‘never events’ on post-acute care

The current Medicare payment policy for hospital “never events” has created risks for unassuming post-acute providers. Nursing homes, assisted living facilities and CCRCs need to prepare for the coming impact. Read More »

CBO: 10-year repeal of sustainable growth rate would cost $316 billion

The CBO said outlays for Medicare would be $9 billion higher in 2012 alone if Congress overrides a scheduled 27 percent reduction under the SGR, which would take effect March 1. Read More »

Pork gets political for nursing homes

"Don’t mess with residents’ dietary requirements" is the rallying cry of Jewish nursing home advocates after a past veto by Mitt Romney for funding kosher meals garners renewed attention. Read More »

CMS rule would increase Medicaid drug pricing transparency, save $17.7 billion

The CMS rule, which implements prescription drug provisions of the Affordable Care Act, would increase transparency in drug pricing to ensure states are not overpaying for prescription drugs. Read More »

In face of fiscal meltdown, Illinois funds nursing home safety

Gov. Quinn has boosted nursing home funding by millions of dollars to help carry out safety reforms passed in 2010. This is because the state won’t have to touch its own coffers to distribute the cash. Read More »

AHCA finds providers commit to quality in 2011 despite threat of cuts

The industry is focused on reducing hospital readmissions and improving patient and staff satisfaction, AHCA/NCAL said. However, those goals may be in jeopardy with the likelihood of diminishing reimbursement. Read More »