Reimbursement

Are SNFs causing their own headaches?

MedPAC proposes more cuts for 2014, and the skilled nursing industry objects. But the GAO issues a report that can only make the industry’s case more difficult. Read More »

AHCA: Medicaid payment shortfalls projected at $7 billion for 2012

A new report released today by the American Health Care Association shows historic shortfalls in what Medicaid pays and what skilled nursing care actually costs. Read More »

5 tips for increasing LTC resident pay and reducing collections

As the resident pay portion in long-term care has increased over the last several years, many facilities are finding it difficult to collect the resident’s entire portion when the resident doesn't have the resources to pay all at once. Here are five key tips for increasing the collection of the resident pay portion, thus reducing the account receivables that end up in collections. Read More »

ONC releases final EMR testing specs for 2014

No more guessing: After months of drafting and reviewing, the Final Testing Method for electronic medical records (EMRs) has been published by the Office of the National Coordinator for Health Information Technology (ONC). Read More »

Medicare policies complicate aging-in-place strategies

If aging-in-place is on the rise, why is it becoming more difficult for stay-at-home seniors to get mobility equipment? Read More »

HHS says no to full funding for partial Medicaid expansions

The Department of Health & Human Services clarified its position Monday on funding ratios for state Medicaid expansions and published an extensive FAQ list on state health insurance exchanges. Read More »

Washington Update: Medicare, ‘doc-fix’ and the ‘fiscal cliff’

Healthcare policy expert Blair Childs, vice president for public affairs at Premier healthcare alliance, gives his "insider impressions" of what’s happening on the Hill regarding a possible "doc-fix," Medicare funding, and possible Affordable Care Act policy changes as the deadline clock ticks down on the fiscal cliff. Read More »

Drug company must repay Medicare up to $48M for selling unapproved Xenaderm cream

The Healthpoint pharmaceutical company has to give back millions in Medicare reimbursements for false marketing of a skin ointment cream. Read More »

Therapy cap would jeopardize seniors with Parkinson’s, stroke

Healthcare associations appeal to Congress to keep the therapy cap off the calendar for another year, as the clock ticks toward the December 31 Congressional deadline. Read More »

Time to review the 2013 OIG work plan

The Office of Inspector General (OIG) is continuing its aggressive efforts to identify fraud among healthcare providers. In October, the OIG released its 2013 work plan, which outlines the audit and enforcement initiatives for Medicare and Medicaid providers in the coming year. Let's take a look at the Nursing Homes section of the work plan. Read More »

Survey: Voters want nursing homes off the ‘cliff’

Legislators may have a bitter pill to swallow at election time if Medicare cuts become part of the fiscal cliff deal. Read More »

A cliffhanger for long-term care

A year ago, who would have thought such terms as “sequestration” and “fiscal cliff” would roll off our tongues so easily (even as some of us still grapple with comprehending the full impact of these concepts on our lives and industry). Read More »

OIG to CMS: Get tougher on EHR incentive verifications

There are plenty of potential holes in the Meaningful Use incentives programs for electronic health records—and too many temptations for cheating, says a new OIG report. Read More »

DOJ orders repayment of improper Medicare reimbursements

In the wake of federal reports of rampant fraudulence Medicare billing, the letters begin arriving at hospitals and other healthcare sites: Medicare wants its money back. Read More »

Short-term rehab soars to No. 1 service in SNFs

Still think the majority of residents at skilled nursing facilities (SNFs) are grannies? Not anymore. Check out the fastest-growing demographic in today’s LTC market. Read More »

BREAKING: HHS releases proposed rules for state insurance premiums, workplace wellness programs

The release of today's proposed rules brings the Department of Health & Human Services a few steps closer in building the rules for state health exchanges (HIX). Read More »

Top 10 nursing home deficiencies, top 10 trouble states

The latest version of the Nursing Home Inspect tool includes more ways to search nursing home survey data and to assess the historial track record of a skilled nursing facility. Read More »

OIG alleges rampant skilled nursing billing errors

The Wall Street Journal reported that the OIG is using the term “Operation Vacuum Cleaner” to refer to its review of nursing home billing issues. This term is perhaps even more foreboding than the report itself. With the fiscal cliff looming and sharp negotiations set to begin over the future of Medicare reimbursement, the timing and substance of this report are less than ideal for an industry already under fire. Read More »

BREAKING: Health exchanges: Holdout states get last-minute reprieve

Today was to be decision day for states on whether they intend to participate in the new state health exchange program, but an eleventh-hour extension from Health and Human Services Secretary Sebelius gives the remaining eight states another few weeks to decide. Read More »

Senior care planning takes a woman’s touch, men better at LTC’s financial aspects

When it comes to long-term care planning, it takes a village—or at least the input of both men and women. Read More »

SNFs erred on 25% of claims in 2009; $1.5 billion in overpayments

The Office of Inspector General continues to unearth massive misreporting and over-billing in nursing home claims, especially where therapy is involved. Read More »

Brookdale mulls restructuring options amid Medicare reductions

Brookdale Senior Living is considering several financial options to refit its operations in an era of Medicare reductions, announced Brookdale's CFO and co-president Mark Ohlendorf today at the Stephens Fall Investment Conference. Read More »

SNFs: Be nimble, resourceful and ready to fight

The clarion call to action grows ever louder: In addition to lobbying their local lawmakers, long-term care providers must best position their organizations to serve a rapidly changing healthcare system or face demise. Read More »

HHS submits rules for state insurance exchange benefits

The Department of Health and Human Services has submitted another rulemaking piece on state health insurance exchanges to the Office of Management and Budget—the last step before publication. Read More »

AHCA launches Ad firestorm at Congress: No Medicare/Medicaid cuts

Long-term care organizations are using an aggressive advertising campaign to tell Congress to end the deep cuts to Medicare and Medicaid reimbursements. Read More »

Providers get $8.36 billion in Meaningful Use payouts for EHR goals

Under the Centers for Medicare & Medicaid Meaningful Use incentive program for the use of electronic health records, eligible providers have received more than $8 billion in incentive payouts since the program began in early 2011, according to this week's report. Read More »

Post-acute care market awaits Allscripts’ fate

Just as documentation requirements begin to heat up, healthcare technology circles are abuzz as executives confirm that electronic medical record system vendor Allscripts Healthcare Solutions may be up for sale. Read More »

What President Obama’s re-election means for the future of long-term care

The votes are in: The Obama Administration now has four more years to further the healthcare initiatives begun under the 2010 Affordable Care Act. So, what happens next? Long-term care leaders, providers and industry experts weigh in on the implications of President Obama's reelection for the U.S. healthcare system and, specifically, the LTC industry. Read More »

Blanket waivers issued for New York and New Jersey in Hurricane Sandy’s wake

The Centers for Medicare & Medicaid Services has granted blanket waivers for New York and New Jersey after Hurricane Sandy, easing the regulations required of long-term care and other health providers. Read More »

CMS: Waiver status issued for New York state in Sandy’s wake

An emergency response meeting held by the Centers for Medicare & Medicaid Services answers some questions on coping with the aftermath of Hurricane Sandy in New York, but many issues remain for long-term and acute care facilities in other states. Read More »