Articles and Blogs

On August 1, 2011, the Centers for Medicare and Medicaid Services (CMS) issued its Fiscal Year (FY) 2012 Inpatient Prospective Payment System (IPPS) Final Rule clarifying which outpatient services are required to be bundled with inpatient services in submission of Medicare claims.  This billing policy is commonly known as the 3-Day Window Rule and is…Read More

While Congress was able to present the President with a compromised solution to cut Federal spending and raise the Government’s debt ceiling earlier this month, all long-term care providers should anticipate future reimbursement changes.  Under the current law, the Budget Control Act of 2011t , Medicare and Medicaid are unchanged. However, the Act requires for the…Read More

On August 1, 2011, the Centers for Medicare & Medicaid Services (CMS) published the Federal Fiscal Year (FFY) 2012 Final Rule for Inpatient Prospective Payment System (IPPS) and the Long-term Care Hospital Prospective Payment System on its website. For FFY 2012, Providers will receive a net total increase of 1% to the standardized amount.  This net…Read More

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 Medicare…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 for…Read More

SUMMARY On June 24, 2011, the United States Court of Appeals for the District of Columbia released a decision in Auburn Regional Medical Center v. Sebelius.  The decision reversed an unfavorable district court decision ruling that statutory deadlines to file appeals with the Provider Reimbursement Review Board (PRRB) were not subject to the doctrine of…Read More

Late last week, a wide-ranging initiative to update federal human research protection regulations was announced by the U.S. Department of Health and Human Services (HHS) and the White House Office for Science & Technology Policy (OSTP) through issuance of an Advance Notice of Proposed Rulemaking (ANPRM), which aims to catch the regulations up to technological…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 CFR…Read More

On May 4, 2011, we issued a bulletin alerting hospital clients that the Office of Inspector General (“OIG”) Office of Audit Services was in the process of sending numerous Contact Letters to hospitals across the country in an effort to verify their levels of compliance with Medicare billing requirements.  As part of this audit, the…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 $4.31…Read More