Articles and Blogs

This week, the Centers for Medicare & Medicaid Services (CMS) updated Section 40.1 of Publication 100-1, the Medicare General Information, Eligibility and Entitlement Manual, to reflect Section 3108 of the Patient Protection and Affordable Care Act (PPACA).  This update permits physician assistants to perform the initial certifications and recertifications of a beneficiary’s need for skilled... READ MORE

So-called “superbugs”, those bacteria strains that have developed resistance to antibiotics, have long generated high levels of concern for hospitals and long-term care facilities.  These infections are difficult to treat, and often generate serious complications for individuals with already impaired immune systems.  The Wall Street Journal (WSJ) today published a note detailing efforts by researchers... READ MORE

The Medicare Payment Advisory Commission (MedPAC) voted on Wednesday of this week to recommend to Congress a significant change in the way skilled nursing facilities (SNFs) are reimbursed under the Medicare program within the next two years.  READ MORE

Under the Patient Protection and Affordable Care Act (PPACA), skilled nursing facilities (SNFs) are required to seperately report expenditures for wages and benefits for direct care staff (breaking out (at a minimum) registered nurses, licensed professional nurses, certified nurse assistants, and other medical and therapy staff).  CMS recently posted updates to the Provider Reimbursement Manual... READ MORE

Effective January 1, 2012, all standard and/or complaint surveys initiated on or after January 1, 2012, that generate an enforcement action, will be subject to the new Federal requirements governing the Independent IDR process.  The State survey agency must develop a written process that will then be approved by the Centers for Medicare &... READ MORE

In December, the Office of the Inspector General (OIG) released an initial series of videos aimed at providers that focus on compliance issues.  These videos are part of the Health Care Fraud Prevention and Enforcement Action Team (HEAT) Provider Compliance Training initiative.  Health & Human Services Inspector General Daniel Levinson stated the videos are... READ MORE

The Centers for Medicare & Medicaid Services (CMS) has issued revisions to the process Home Health Agencies (HHA) must undergo prior to initial certification.  The revised process adds an additional review of enrollment criteria performed by the Regional Home Health Intermediary (RHHI) or Medicare Administrative Contractor (MAC).   READ MORE

The Department of Labor published a Notice of Proposed Rulemaking in late December aimed at giving the nation’s nearly two million home care workers minimum wage and overtime protections.  These workers have long been working  under an exemption from the Fair Labor Standards Act (FLSA) as “companion” employees.   READ MORE

The National Labor Relations Board (NLRB) has again postponed the requirement for private employers to post notice of employee rights under the Nation Labor Relations Act (NLRA). See our previous analysis here, here, and here. Employers now have until April 30,2012 to post the required notice.  The board said it “has determined that postponing... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) has recently instructed contractors to reopen certain claims that were previously denied for failure to meet the “face-to-face” requirements in certain circumstances and assuming all content requirements of the certification and the face-to-face documentation are otherwise met.  It came to CMS’ attention that certain claims were... READ MORE