Accountable Care Organizations (ACOs)

CMS proposal: Ditch “coding levels” for outpatient services

A new payment proposal from the Centers for Medicare & Medicaid Services (CMS) could impact the reimbursements for long-term care hospitals, post-acute care and rehab facilities. Read More »

CMS limits Medicare coverage of exorbitant brain test to specific cases

There’s a brand-new imaging test available to diagnose Alzheimer’s disease, but it’s so expensive that CMS is limiting the Medicare coverage of the test to two circumstances. Read More »

CMS revises discharge planning guidelines

New CMS guidelines take a deeper look at discharge planning, clarifying who is responsible for what at the time of discharge and why discharge planning is a key to reducing 30-day readmissions. Read More »

CMMI rethinks its innovation program, sharpens focus for Round 2 funding

CMS’ Center for Medicare and Medicaid Innovation (CMMI) announces a significantly smaller and more-focused project list for Round Two of the funding awards. Read More »

CMS proposes $180 million increase in hospice reimbursements

CMS has proposed a new rule that would raise hospice payments under Medicare by $180 million next year. Read More »

CMS sweetens the deal for fraud whistleblowers

Know about someone conducting sneaky Medicare billing practices? CMS’ new whistleblower proposal might pay you more than your boss does. Read More »

Senate committee approves Tavenner for CMS helm

Marilyn Tavenner has obtained a vote of confidence from a Senate committee in her bid to become the first confirmed administrator of the Centers for Medicare & Medicaid Services in seven years. Read More »

Industry leaders weigh in on President Obama’s FY2014 budget proposal

This summer will be a busy one as Congress deliberates the 2014 budget and how, without revisions, its proposed cuts to Medicare may affect the physicians, hospitals and long-term care providers. Read More »

The pros and cons of per capita caps for Medicaid

Federal agencies and lawmakers keep revising one possible way to curb Medicaid spending growth: Per capita caps. Read More »

Obama budget will cut Medicare but boost Medicaid and mental health

President Obama's new budget, released by the White House Wednesday, includes plenty of cuts, but also contains a few surprising increases. Read More »

CMS releases guidelines on delegated nursing roles in SNFs

A new Centers for Medicare & Medicaid Services document clarifies what tasks physicians may delegate to nurses within nursing homes serving Medicare and Medicaid residents. Read More »

One-on-one with…. Ruta Kadonoff

Senior Editor Pamela Tabar talks with Ruta Kadonoff, vice president of quality and regulatory affairs for the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), about quality in long-term care—and why being able to measure it will be important for business. Read More »

2% Medicare payment reductions begin today

The waiting is over. No resolution to the budget crisis means that sequestration begins—today. Long-term care facilities will feel the effects upfront, but a quieter casuality might be healthcare's information technology and data-sharing initiatives. Read More »

White House, Congress might consider combining Medicare Parts A and B

Sweeping changes may be on the horizon for the way Medicare billing is divided, as President Obama and Republicans put the idea of combining Medicare Parts A and B back on the discussion table, the New York Times reports today. Read More »

CMMI, Senate committee lock horns over innovation projects

The Center for Medicare and Medicaid Innovation (CMMI) got a tongue-lashing from the Senate Finance Committee, while CMMI’s director explains that testing new models takes time before payment reforms can be put into action. Read More »

MedPAC to Congress: Reduce SNF payments by 4% in 2014

Skilled nursing facilities and home health agencies face payment reductions, but hospices and long-term care hospitals get a first-round bye in MedPAC's latest Medicare payment recommendations to Congress. Read More »

Final 3 members appointed to LTC commission

President Obama adds the last three names to the Long Term Care Commission, completing the group's bipartisan membership. Read More »

Social services key to delivering senior healthcare at lower cost

Improving healthcare delivery for seniors might take greater investment in an often-ignored component: Social services. Read More »

SNF surveys: Do they tell the whole story?

Nursing home consumers—residents and their families—say the survey process has flaws that need to be addressed, according to a new report from the Coalition for Quality Care. Read More »

CMS: Penalties are working to reduce hospital readmissions

New data on hospital readmission shows that healthcare reform is making an impact--changing the rates for the first time in five years, says CMS. Read More »

Calif. plans 85% increase in LTC insurance rates for public employees

The California Public Employees’ Retirement System, the country's third-largest health benefits purchaser,  dropped a bombshell on its long-term care policyholders—switch LTC policies or deal with a massive rate increase. Read More »

OIG: Nursing homes provide ‘criminally poor care,’ fail on care plans

A new report from the Office of Inspector General accuses skilled nursing facilities (SNFs) of misusing their Medicare payments, since more than one-third of SNFs don’t fulfill—or even create—the care plans and discharge goals required for their residents. Read More »

N.J.’s Gov. Christie joins GOPs reconsidering Medicaid expansion

N.J.’s Gov. Chris Christie is the latest republican governor to change his mind about expanding the state Medicaid program. Read More »

C. Everett Koop dies at 96

Widely recognized by his bushy beard and somber uniform, former U.S. Surgeon General C. Everett Koop became a household name for his anti-smoking campaign. Read More »

The SCOOTER Store is back on the hot seat

A popular provider of power chairs gets a visit from federal agents in a new Medicare fraud investigation. Read More »

Therapy caps: Unraveling the spider’s web for long-term care

How many of your residents are on track to exceed the $1,900 payment cap on physical or occupational therapies? We examine the current therapy cap situation, and why it's such a challenge for long-term and post-acute care. Read More »

Fla. governor reverses stance, now supports Medicaid expansion

Florida’s governor, once one of the loudest voices against “ObamaCare,” has done a policy about-face and now supports limited Medicaid expansion in the state. Read More »

CMS proposes lower Part D deductibles, slashed insurer payments for Medicare Advantage plans

The Centers for Medicare & Medicaid Services has released its proposals for rate and payment changes for 2014. Seniors may be happy about the Part D drug changes, but insurers aren't as pleased with their end of deal. Read More »

GOP appoints first members to LTC commission

The new congressional commission on long-term care is slowly forming, as Republicans add two members to the bipartisan group. Read More »

Report: Location plays a role in readmission rates

Hospitals made little progress on hospital readmission rates between 2008 and 2010, and some regions have far more readmissions than the national average. Read More »