Reimbursement

HHS launches revamped site for Health Insurance Marketplace

The Department of Health and Human Services launches a completely redesigned website ready to answer questions and assist in planning for this fall’s switch to the Health Insurance Marketplace (formerly Health Insurance Exchange). Read More »

CMS’ plans to reform payment to post-acute healthcare cause concern

CMS’ plans for payment reform designed  to cut costs in the post-acute sector for the FY2014 budget may be a cause of concern for the long-term care industry. Read More »

MDS Manual update brings welcome clarity

The RAI User's Manual received section revisions and clarifications on dental status (section L), skin conditions (section M) and other items in the May update release. Read More »

Medicare Part A fund to outlast predictions, remain solvent til 2026

The Medicare funds for hospital Part A could last two years longer than expected, notes today’s annual trustees report. Read More »

CMS clarifies confusing scoring for ADLs

AANAC's Judi Kulus explains the Centers for Medicare & Medicaid Services attempt to iron out the confusing rules for coding activities of daily living (ADLs) under the RAI User's Manual. Read More »

Hospitalists see new opportunities in LTC

Long-term care is a growing field for hospitalists to explore, which will enable them to fill the void in post-acute care as they do in the hospital setting. Read More »

Costs of stroke treatment may double by 2030

A new report predicts that the costs associated with strokes will double in the next 17 years, putting a strain on the healthcare system. Read More »

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 »

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 »

LTC property investors shirk SNFs as financial risks

Several of long-term care’s biggest property owners are shedding their interest in the financially challenged skilled nursing sector. 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 »

Leaders of Tomorrow: Phenelle Segal, RN, CIC

Congratulations to the fourth of our five 2013 Leaders of Tomorrow: Phenelle Segal, RN, CIC. After 30 years in acute care, Segal has dedicated herself to educating LTC facilities about infection control and prevention. 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 »

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 »

Technology reaches further into long-term and post-acute care policy

Health information technology and long-term care, once rarely found in the same conversation, are now topics of discussion within multiple policy-making bodies and workgroups. 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 »

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 »

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 »

Consistent nursing staff related to fewer rehospitalizations in SNFs

Licensed nurse retention seems to curb readmissions, and vice-versa. 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 »

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 »

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 »

Report details 10 states facing greatest impact from SNF Medicare cuts

With the clock ticking on March 1 Medicare cuts to nursing homes resulting from the onset of the federal Budget Relief Act's sequester provision, the Alliance for Quality Nursing Home Care on Wednesday released a state "Top Ten List" detailing the Medicare cut total to state nursing homes, their residents and their workforce. Read More »

OIG: Nursing homes provide ‘criminally poor care,’ fail on care plans

A new report from the Office of Inspector General accuses skilled nursing facilities (SNFs) of misusing their Medicare payments, since more than one-third of SNFs don’t fulfill—or even create—the care plans and discharge goals required for their residents. Read More »