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Reimbursement

The best of 2016

December 29, 2016  |  The Long-Term Living editors
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CMS mandates, dementia care strategies, cross-team collaboration and ageism culture change—We checked our web visits and social media stats to see which in-depth articles were the most popular among our readers in 2016. Did you miss any of these?

CMS issues final rule for cardiac bundled payments

December 27, 2016  |  Pamela Tabar, Editor-in-Chief
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CMS released its latest episodic care models Tuesday, including the 90-day bundles for heart and bypass patients.

CMS to test new ACO model for dual-eligibles

December 18, 2016  |  Pamela Tabar, Editor-in-Chief
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The pilot will let accountable care organizations manage the Medicaid claims for beneficiaries who receive both Medicare and Medicaid benefits.

OIG scrutinizes SNFs and therapy reimbursement

November 14, 2016  |  Pamela Tabar, Editor-in-chief
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The office’s 2017 workplan targets rehabilitation, hospice and hyperbaric oxygen therapy services, in addition to SNF billing.

A Place For Mom joins effort to promote veterans' LTC resources

November 10, 2016  |  Pamela Tabar, Editor-in-Chief
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A Place For Mom is partnering with a veterans resource organization to spread the word about the Veterans Aid and Attendance Pension, which can help pay the costs for assistance for those who qualify.

CMS finalizes site-neutral payment policies

November 4, 2016  |  Pamela Tabar, Editor-in-Chief
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The Centers for Medicare and Medicaid Services has finalized a rule that will change the way services are reimbursed in off-campus and on-campus settings.

Life Care Centers reaches $145M settlement

October 26, 2016  |  Nicole Stempak, Senior Editor
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The nation’s largest private nursing home company will pay $145 million to settle claims it overcharged the government for therapy treatments. 

BPCI Model 3: Bonanza or boondoggle?

October 6, 2016  |  Kevin R. McMahon
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There’s an argument to be made for being an early adopter with Bundled Payments for Care Improvement (BPCI) Model 3, but there are also questions about how much participants will ultimately save.

Patients must be notified of hospital 'observation status'

August 8, 2016  |  Nicole Stempak, Senior Editor
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The Notice Act, which went into effect Saturday, would requires hospitals to notify patients of their outpatient status to warn them of potential out-of-pocket hospital expenses and impact on possible nursing home stays funded by Medicare.

DOJ shuts down $1B Miami nursing home fraud scheme

July 22, 2016  |  Pamela Tabar, Editor-in-Chief
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The largest-ever fraud case involved the owner of more than 30 skilled nursing facilities and two others accused of kickbacks and false billing, the Department of Justice indictment says.

Medicare proposes changes to primary care payment

July 13, 2016  |  Nicole Stempak, Senior Editor
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The Centers for Medicare and Medicaid Services has proposed changes to the Physician Fee Schedule to change how Medicare pays for primary care with an emphasis on care management and behavioral health.

MedPAC launches plan for new payment system

June 30, 2016  |  Robert Gatty
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The Medicare Payment Advisory Commission (MedPAC) submits it recommendations to Congress for how to establish a unified, cross-setting post-acute care payment system. The plan would redistribute payments among types of stays, making profits more uniform and...

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