Reimbursement

LTPAC HIT Summit: Leaders reveal goals, concerns for 2012-2014 and meaningful use

Today’s morning sessions at the LTPAC HIT Summit included the “Roadmap for 2012-2014” and the meaningful use keynote by Deputy National Coordinator for Programs and Policy Judy Murphy, RN. Both share how far we’ve come in the last two years, and how much further we need to go. Read More »

Medicaid fraud audits cost more than is recovered, CMS admits

Medicaid audit recovery is disappointing. A GAO report blames ineffective Medicaid Statistical Information System (MSIS) data. Read More »

U.S. healthcare spending to surge in 2014; overall spending to rise with or without the ACA, journal reports

A detailed economic forecast, released this week by Health Affairs, predicts national healthcare spending will experience “modest growth” during the next nine years, but will spike in 2014 when the Affordable Care Act (ACA) coverage expansions activate. Read More »

Ohio nursing homes take $30M hit

Although funding was approved in last year’s Ohio budget, Gov. John Kasich slashed bonuses to high-performing nursing homes by a line-item veto for the state’s midterm budget review. Read More »

AHCA to Congress: Don’t use Medicaid’s provider tax rates to bail out student loans

The American Health Care Association and the National Center for Assisted Living (AHCA/NCAL) tell Congress to stop eyeing Medicaid tax rates as rescue funds for student loans. Read More »

CMS launches data initiative

The Centers for Medicare & Medicaid Services creates the Office of Information Products and Data Analytics as part of a new initiative to collect, analyze and share healthcare information for use in care improvements. Read More »

Nursing home profits soar in Q1 2012, yet many facilities provide “lousy” care

Strong revenues may please corporate shareholders, but CMS data shows that many nursing homes are providing substandard care for residents. Read More »

Son billed $93K for mom’s nursing home care

In Pennsylvania, a nursing home, unwilling to wait for a woman's Medicaid approval and reimbursement, sues her son to recover the $93K debt. It's called the "filial responsibility law" and it's on the books in 30 states. Read More »

Medicare Fraud Strike Force charges 107 individuals for $452 million in false billing

The coordinated takedown involved the highest amount of false Medicare billings in a single takedown in Strike Force history. Read More »

Residents protest Medicaid cuts in Illinois budget

Residents rally across the Illinois to demonstrate to legislators how state Medicaid cuts will affect senior care Read More »

CMS forecasts near-term Medicare funding stability, long-term insolvency

The Affordable Care Act is projected to save Medicare more than $200 billion through 2016, according to The Medicare Trustees Report. But beyond 2024, Medicare’s solvency is in doubt. Read More »

OIG targets nursing homes in 2012

Many LTC facilities and hospices across the nation will be affected by the Office of the Inspector General’s (OIG’s) work plan underway for 2012. Here’s an overview of key initiatives. Read More »

Referral, liability implications of hospital readmissions from SNFs

Delayed hospital discharges mean potentially fewer acute patients and fewer days for the resident in the nursing home. But these are primarily revenue and business issues, so what are the legal issues for the nursing homes? 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 »

Defending against Medicare contractor audits

SNFs are an area of focus for audits by Medicare contractors. The OIG list of potential problem areas has become known as the OIG “hit list.” In fact, expect an even higher level of attention this year than in the past. 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 »

LTC industry generates $259 billion in revenue during 2011

Overall long-term care revenues, which grew 31 percent between 2006 and 2011, are forecasted to reach $352.8 billion by 2016, according to the Kalorama Information report. 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 »

Harness the power of your residents to promote legislative reform

LTC providers should be as proactive and savvy as the American Medical Association when it comes to lobbying Congress by convincing residents to go to war for them when necessary. 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 »

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 »

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 »

LTPAC providers need revamped performance measurement to improve quality

The Measures Application Partnership is recommending a coordinated performance measurement that promotes quality improvement across the industry. 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 »

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 »

MedPAC targets Medicare payments to SNFs

With margins averaging 18.5 percent in 2010, MedPAC contends SNFs are making a killing on Medicare. Under the proposed rebasing plan, there would be a zero update in 2013, followed by an initial reduction of four percent in 2014. Read More »

One-on-one with Craig T. Fukushima, NHA, Partner, The Fox Group

In this first of a regular monthly feature of conversations with LTC industry executives, Craig Fukushima of The Fox Group weighs in on the outlook for senior housing development, capital availability and the influence of baby boomers on senior care and marketing efforts. Read More »