-- "The Centers for Medicare & Medicaid Services has issued a call for additional providers to take part in a bundled payment program that involves post-acute care." - McKnight's -- "Despite some high-profile reports, nursing home staffing levels have not been definitively linked to better care, according to a recently published analysis of research on the topic." - McKnight's -- "Long-term care stakeholders are praising the government's decision to temporarily pause the recovery audit … [Read more...] about LTC News: Potential Medicare Reductions
LTC News: End of Dual Eligibles?
-- "In the post-acute care and long-term care performance measurement section of the report, [Measure Applications Partnership] identified 13 core measures in "high-leverage areas." These include long-term care providers examining advanced care planning as a goal, and evaluating safety issues for residents such as fall rate and pressure ulcers." - McKnight's -- "In the nearly 50 years since Medicaid and Medicare were enacted, the two health care programs – one for the poor and the other for … [Read more...] about LTC News: End of Dual Eligibles?
LTC News: NF Case, SNF Updates
-- "Post-acute providers are seeking deals that diversify their services and limit financial exposure related to Medicare reimbursement rates, according to an analysis from investment banking firm Triple Tree." - McKnight's -- "A state law to protect nursing home residents cannot be invoked to bring a suit against an assisted living provider, a federal judge recently ruled, reversing his earlier decision." - McKnight's -- "Skilled nursing operators can expect to see a new government report … [Read more...] about LTC News: NF Case, SNF Updates
LTC News: Home Health, SNF
-- "CMS recently updated the manual to make it clearer that Medicare may reimburse for skilled nursing services meant to maintain, not improve, a beneficiary's condition. The agency was required to make these updates per the settlement in the Jimmo v. Sebelius case." – McKnight's -- "Too many Medicare providers are receiving improper payments, and the Centers for Medicare & Medicaid Services should clamp down by doing a better job overseeing its contractors' error rate reduction plans, … [Read more...] about LTC News: Home Health, SNF
LTC News: Dual Eligibles, HSC Services Changes
-- "Dramatic Medicare cuts to skilled nursing facilities played a significant part in keeping healthcare spending low in 2012, the Centers for Medicare & Medicaid Services announced Monday." – McKnight's -- "In light of reports that Medicare Part D prescribing practices are endangering seniors — many of them in long-term care facilities — the Centers for Medicare & Medicaid Services has issued a proposed rule that would give the agency more power to oversee and control the … [Read more...] about LTC News: Dual Eligibles, HSC Services Changes
Risk Reduction and the Internal Investigation Policy
An essential element of an effective health care compliance plan is the internal investigations policy. Actions by employees, acting in the course and scope of their employment, can subject corporations to civil and criminal liability. Detecting, investigating and remedying such situations are crucial given the regulatory environment under which health care companies operate. The conduct of the investigation itself can exacerbate the situation. Employees subjected to discipline may … [Read more...] about Risk Reduction and the Internal Investigation Policy
DADS News Alert: Five Star Preview Reports
-- From the news alert page: The Five Star Preview Reports were available beginning December 11th. To access these reports, select the Certification and Survey Provider Enhanced Reports (CASPER) Reporting link located at the top of your MDS State Welcome page. For Texas, this web page is at: https://158.73.90.242:81/home.html (Staff might get a warning message, but should be able to select "proceed"). Once in the CASPER Reporting system, click on the 'Folders' button and access the Five … [Read more...] about DADS News Alert: Five Star Preview Reports
LTC News: MedPAC Calls for SNF Cuts
-- "The House of Representatives passed a 3-month patch late Thursday to stabilize physicians' Medicare payments -- delaying dramatic cuts scheduled for 2014 -- while Congress works on a permanent repeal of Medicare's sustainable growth rate (SGR) payment formula." - MedPageToday -- "Long-term care providers have lambasted the current [outpatient therapy payment] system, which requires Medicare contractors to manually review claims in excess of a set annual amount. Providers and government … [Read more...] about LTC News: MedPAC Calls for SNF Cuts
Alerts and News: Court Decision, STAR+PLUS Mistake
-- HHSC adopted amendments to §9.553, Definitions; §9.555, Definitions of TxHmL program service components; §9.567, Process for Enrollment; §9.578, Program Provider Certification Principles: Service Delivery; and §9.583, TxHmL program principles for local authorities, in Subchapter N, TxHmL Program, Chapter 9, Intellectual Disability Services--Medicaid State Operating Agency Responsibilities. -- From the news alert page: Some DADS waiver clients were enrolled in STAR+PLUS or got STAR+PLUS … [Read more...] about Alerts and News: Court Decision, STAR+PLUS Mistake
LTC News: CMS Rules, Provider Court Case
-- "After years of trying to clamp down on hospital spending, the federal government wants to get control over what Medicare spends on nursing homes, home health services and other medical care typically provided to patients after they have left the hospital." - Kaiser -- "In a rule issued today, [CMS] finalized payment rates and policies for 2014, including a major proposal to support care management outside the routine office interaction as well as other policies to promote high quality … [Read more...] about LTC News: CMS Rules, Provider Court Case
