MACRA now in its first year of implementation in 2017, has established a new framework for physician payment focused on quality and value using two distinct payment paths. The Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP) includes the following pathways: the Merit-Based Incentive Payment System (MIPS) and the Alternative Payment Model (APM) Incentive program. MACRA replaced the Sustainable Growth Rate (SGR) formula that gave the ability to determine Medicare … [Read more...] about Major Health Groups Chime in on Medicare Access and CHIP Reauthorization Act (MACRA) Payment System
CMS Launches New Hospice Care Website for Families, Physicians and their Patients.
In a new press release, Centers for Medicare & Medicaid Services (CMS) officially announced the opening of their Hospice Compare website. The website which focuses on palliative and end of life care was designed to improve transparency, the consumer experience and empower patients. giving families, patients and the physicians who care for them a reliable resource and "snapshot" of the quality of care a hospice facility provides, as well as information related to health care decisions. The … [Read more...] about CMS Launches New Hospice Care Website for Families, Physicians and their Patients.
Hospice Care To Increase For U.S. Veterans via Initiatives to Improve Care at the End of Life.
Recently, a Texas home hospice care patient went viral online after hundreds of inspired and sympathetic people called and sent well-wishes to terminally ill army veteran, Lee. As the story is reported in the news; the influx of support came after his wife told a friend that the Lee had asked to hold his phone and when she asked why he said, 'in case someone calls but after a couple hours and no calls he told his wife, 'I guess no one wants to talk to me.' In recent reports, A 2009 initiative … [Read more...] about Hospice Care To Increase For U.S. Veterans via Initiatives to Improve Care at the End of Life.
CMS & CBO Report different numbers on possible effect of AHCA in the healthcare market
The Republican led U.S. House of Representatives approved the American Health Care Act of 2017 last may and now the Office of the Chief Actuary of the Centers for Medicare and Medicaid Services released its report on the Estimated Financial Effect of the “AHCA .” According to reports from the Health Affairs Organization:"The headline from the Actuary’s report that is likely to receive the most attention is that the CMS Actuary sees the AHCA as increasing the uninsured by 4 million for 2018/2019 … [Read more...] about CMS & CBO Report different numbers on possible effect of AHCA in the healthcare market
Challenges Continue for LTC Regarding Change of Therapy Documentation
Nursing facilities continue to battle Medicare denials because of documentation issues:Untimely certifications, missed or incorrectly billed Change of Therapy documentation, and lack of documentation supporting a signed physician order for skilled therapy are among the top reasons facilities are battling Medicare claims denials, an expert said in late April.Check your systems for communication between your MDS people and the therapy providers. … [Read more...] about Challenges Continue for LTC Regarding Change of Therapy Documentation
Nursing Facility Providers Must Allow (DADS) surveyors complete access to their records
Provider Letter No. 17-20 – Electronic Health RecordsNursing Facilities may use the system of medical records that best suits their needs whether it is paper or an electronic system. As directed in the DADS released provider letter, a provider must grant access to any EHR when requested by the surveyor. During the entrance conference, surveyors will verify with the provider the process they will follow in order to have unrestricted access to a resident’s medical records. Please note that … [Read more...] about Nursing Facility Providers Must Allow (DADS) surveyors complete access to their records
Interpretation of Medical Assistance Only Codes
DADS published an information letter to provide assistance to service coordinators, case managers, and program providers on how to identify an individual’s Medicaid type program (TP) and to identify if a certified Medicaid TP is categorized as Medical Assistance Only (MAO).Individuals certified for MAO Medicaid by the Health and Human Services Commission (HHSC) receiving Community First Choice (CFC) services through a 1915(c) Waiver Program must meet eligibility requirements stated in 42 Code … [Read more...] about Interpretation of Medical Assistance Only Codes
Information on Ebola Virus for Providers of Services to Individuals in the Department of Aging and Disability Services Programs
DADS information letter provides information on the Ebola virus that providers may use to help ensure the health and safety of staff members and individuals receiving services. The Department of Aging and Disability Services encourages its providers to take reasonable precautions to ensure their employees are not exposed to a symptomatic person by knowing how Ebola is transmitted and its symptoms. An individual will not contract Ebola if he has not had exposure to an individual with Ebola or … [Read more...] about Information on Ebola Virus for Providers of Services to Individuals in the Department of Aging and Disability Services Programs
LTC News: Court Reverses Medicaid Ruling
"The Arkansas Supreme Court tossed out a $1.2 billion judgment against Johnson & Johnson on Thursday, reversing a lower court verdict that found the drug maker engaged in fraudulent tactics when marketing the antipsychotic drug Risperdal." - Associated Press "Lawmakers in both houses of Congress have unveiled a draft bill calling for post-acute care providers to furnish standard assessment data, with the goals of enabling better quality oversight and driving Medicare payment reform." - … [Read more...] about LTC News: Court Reverses Medicaid Ruling
LTC News: NF Inspections, Post-acute Care
-- "Federal efforts to strengthen inspections of the nation's nursing homes are gaining momentum after a government probe uncovered instances of substandard care." - Kaiser News -- "The Centers for Medicare & Medicaid Services sees the upcoming Quality Assurance & Performance Improvement guidelines, not harsher penalties, as the way to reduce adverse events in post-acute care, officials said on an Open Door Forum call Thursday [March 6]." - McKnight's -- "About 22% of Medicare … [Read more...] about LTC News: NF Inspections, Post-acute Care
