Articles and Blogs

Data collected and analyzed by the Office of Inspector General (OIG) since 2010, indicate that home health agencies (HHAs) are predisposed to commit Medicare fraud, waste and abuse. In 2010, Medicare inappropriately paid $5 million for erroneous claims submitted by HHAs. With one in four claims being suspect, the OIG established six (6) criteria... READ MORE

The Alliance for Quality Nursing Home Care (AQNHC) released the results of a study conducted concerning the future of skilled nursing facility (SNF) reimbursement.  While SNF providers have recently seen their reimbursement rates improve, the study report projects SNF providers are facing $65 billion in reimbursement cuts over the next ten years. The reimbursement... READ MORE

After facing significant reimbursement cuts last year, skilled nursing facility (SNF) providers have reason to celebrate after the Centers for Medicare and Medicaid Services (CMS) released the FY 2013 SNF Prospective Payment System (PPS) schedule.  Effective October 1st of this year, SNF providers can expect a 1.8% increase in their PPS reimbursement.  While a modest bump,... READ MORE

This afternoon, the Centers for Medicare & Medicaid Services (CMS) issued a notice updating the Medicare Hospice Wage Index with an estimated 0.9% increase in payments for FY 2013. The payment increase is the net result of a 1.6 percent increase in the hospital market basket update, which is offset by a 0.7 percentage point decrease... READ MORE

In the near future, Regional Home Health Intermediaries (RHHIs) and Parts A and B Medicare Administrative Contractors (A/B MACs) will be contacting home health agencies (HHAs) that have previously submitted claims for ordered or referred services using a group name and national provider identifier (NPI).  HHAs will be informed they should begin submitting such... READ MORE

Since 2005, a group of associations, such as LeadingAge, AHCA, AMDA, and many others, has hosted an annual summit to discuss the information technology (IT) issues long term care and post acute care providers face.  The group, known as the Long Term and Post Acute Care (LTPAC)  Collaborative, publishes a Road Map for LTPAC providers to... READ MORE

The Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) Competitive Bidding Program Round 1 Recompete will begin later this year.  Below is the schedule the Centers for Medicare & Medicaid Services (“CMS”) has announced so far: READ MORE

The Office of Inspector General (OIG) released a report this morning detailing issues found in the use of antipsychotics in nursing facilities.  Utilizing a sample of records from January through June of 2007, the OIG found over 99% of records reviewed failed to meet one or more Federal requirements.   READ MORE

The Centers for Medicare & Medicaid Services (CMS) just released the 2012 Nursing Home Action Plan; a guide for CMS’ efforts to continue to improve nursing home safety and quality.  The plan features 5 actionable strategies, including: enhance consumer engagement; strengthen survey processes, standards, and enforcement; promote quality improvement; create strategic approaches through partnerships; and... READ MORE

In an on-going push to regulate the use of antipsychotic medications in nursing facilities, another piece of legislation has failed to pass Congress.  The Senate did not pass a proposed regulation that would have standardized protocols for obtaining informed consent before administering antipsychotics for off-label use.   READ MORE