Articles and Blogs

Effective fiscal year (FY) 2012, The Centers for Medicare & Medicaid Services (CMS) final rule on Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2012, released July 29, reduces Medicare skilled nursing facility (SNF) Prospective Payment System (PPS) payments by 11.1%. CMS states this action was taken to “better align... READ MORE

The Centers for Medicare & Medicaid Services (CMS) increased fiscal year (FY) 2012 Medicare payments by 2.5% for hospice providers in a final regulation released July 29.  Also included in the final regulation are requirements for hospice providers to start collecting quality of care data and changes to the way CMS counts hospice patients... READ MORE

As record-breaking temperatures scorch the Midwest, long-term care providers are reminded to evaluate their emergency preparation plans. Proper planning can mitigate a situation from a potential disaster to a mere inconvenience. CMS provides a checklist, Emergency Preparedness for Every Emergency, for providers to use to evaluate their current emergency plans. Federal regulations at 42... READ MORE

Recently, the Office of Inspector General (“OIG”) published a report of its findings pertaining to the nearly 70% growth of Medicare spending for hospice care provided to nursing facility (“NF”) residents from 2005 – 2009.  During that time, Medicare spending on hospice care for residents in NFs increased sixty-nine percent (69%) from $2.55 billion to... READ MORE

Effective August 1, 2011, the Centers for Medicare & Medicaid Services (CMS) is implementing two (2) significant changes affecting skilled nursing facilities (SNFs) and hospital swing-bed providers billing for Part A claims.  The changes include the following: 1.         Any Part A claim reporting an End of Therapy Other Medicare Required Assessment must include Occurrence... READ MORE

Michigan’s Department of Community Health will enforce Michigan’s Medicaid Asset Recovery Act (MCL Sec. 400.112g) with efforts starting July 1, 2011.  Michigan may file claims in the probate estates of individuals age 55 or older who received Medicaid benefits that paid for long term care services after September 30, 2007.   Michigan’s claim would seek... READ MORE

Effective July 2011, the Centers for Medicare & Medicaid Services (CMS) adopted a revised Medicare Enrollment Application – Institutional Providers CMS-855A (CMS-855A).  Some of the more significant changes include a couple of additonal documentation requirements, significant changes to the ownership disclosure requirements, and an attachment for Physician-Owned Hospitals. The CMS-855A has been significantly reformatted which... READ MORE

When the new hospice Conditions of Participation (CoPs) became effective in Decmeber of 2008 there was a provision in the CoPs stating a hospice must have an agreement with a nursing home if the hospice provides services in the nursing home.  While it was a standard business practice for hospices to have agreements with nursing homes prior... READ MORE

The Motion Picture License Corporation (MPLC) has reached an agreement with long-term care advocacy groups to exempt certain facilities from licensing fees when showing movies for residents. Under the United States Copyright Act, a “public performance” of copyrighted materials, including movies, traditionally requires a separate license.  The MPLC has reached an agreement with the... READ MORE

In response to the changes contained in the Patient Protection and Affordable Care Act (ACA) designed to address increasing lengths of stay in hospice programs, CMS added a “face-to-face encounter” requirement to the hospice certification requirements. Effective January 1, 2011, a hospice physician or nurse practitioner must have a “face-to-face” encounter with each hospice... READ MORE