Articles and Blogs

The Centers for Medicare and Medicaid Services (“CMS”) announced today the contract suppliers for Round 2 and the national mail-order program of the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (“DMEPOS”) Competitive Bidding Program. As of April 9, 2013, there are 799 suppliers that have been awarded contracts in this round, and these contracts will affect... READ MORE

The Medicare Payment Advisory Commission’s (“MedPAC”) March 25th Report to Congress outlines inefficiencies they believe exist in the post-acute world and lead to excessive Medicare payments to providers. MedPAC recommendations include Congress evaluate post-acute provider reimbursement and encourage use of the lowest cost mix of services necessary to achieve the best outcomes. READ MORE

The Centers for Medicare & Medicaid Services (“CMS”), in the March 8, 2013 Memorandum, issued new guidance specifying those tasks that can and cannot be delegated in skilled nursing facilities (“SNFs”) and nursing facilities (“NFs”).  Physicians who improperly assign tasks to non-physician practitioners (“NPPs”) jeopardize the SNFs’ and NFs’ compliance with federal and state... READ MORE

In 2003, two fires in long-term care facilities resulted in 31 resident deaths. As a result of these two events, CMS analyzed the fire safety precautions in place in these facilities and determined that resident safety could be greatly improved by requiring that all long-term care facilities have automatic sprinkling systems installed throughout the... READ MORE

On December 19, 2012 the Department of Justice announced the owners and operators of two Miami health care agencies pleaded guilty for their participation in a $48 million home health Medicare fraud scheme.  According to plea documents, the owners conspired with patient recruiters for the purpose of billing the Medicare program for unnecessary home... READ MORE

On September 27, 2012, CMS issued an advance copy of the State Operations Manual (“SOM”) revisions to Appendix P of the SOM, which addresses Long-Term Care Facility survey protocol. The SOM guidance also makes changes to various survey forms resulting from the new quality measures reports. READ MORE

Centers for Medicare & Medicaid Services (“CMS”) has announced that registration is now open to all suppliers interested in participating in the Round 1 Recompete of the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) Competitive Bidding Program. In order to submit a bid for the Round 1 Recompete, suppliers will need to first... READ MORE

The Centers for Medicare & Medicaid Services (CMS) implemented changes to Internet-based PECOS to allow providers easier access to information. The following enhancements are now available: READ MORE

The 2% across-the-board cut in reimbursement for Medicare providers, the result of last summer’s “Super Committee” failure, is scheduled to take place January 1, 2013.  The President recently signed legislation requiring a report detailing how the sequestration process will affect Medicare providers.  Skilled nursing facilities (SNFs) have already seen significant cuts to reimbursement; an... READ MORE

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