Medicare/Medicaid

FDA approves, CMS proposes coverage for extensive cancer genomic test

The FoundationOne CDx (F1CDx) is a diagnostic test that can detect gene mutations for cancer, and its potential to help patients has spurred the Centers for Medicare & Medicaid Services to pay for qualifying beneficiaries to be screened.  Read More »

CMS adds online tool for quality measures

The web-accessible version of the CMS Measures Inventory Tool (CMIT) will make it easier for providers to track their quality measures across the care continuum. Read More »

LTC associations urge Congress to keep the medical expenses tax deduction

The tax deduction for medical expenses is on the chopping block in the Trump Administration’s new tax reform bill, an elimination that could seriously hurt all seniors, especially those with dementia. Read More »

Immediate jeopardy: True or false?

An immediate jeopardy deficiency can cost providers dearly in finances and reputation. But what if it’s not true? Legal expert Alan C. Horowitz discusses a recent case where the provider challenged CMS over nearly $1 million in fines—and won. Read More »

Price resigns from HHS: Now what?

As the head of the U.S. Department of Health and Human Services steps down amid scandal over the use of travel funds, how will it affect the swirl of unsolved healthcare issues? Read More »

Medicaid cuts could cause greater care gaps

An analysis of Nusing Home Compare shows cuts to Medicaid could harm the poorest residents and lowest-rated facilities that will have to do more with less. That could cost the government even more.  Read More »

Bye-bye, CMMI?

CMS Administrator Seema Verma has announced the dawn of big changes at the Center for Medicare and Medicaid Innovation (CMMI). What will happen to all the bundled payment projects? Read More »

CMS launches Hospice Compare site

Much like the Nursing Home Compare site for skilled nursing facilities, the new data comparison tool will allow consumers to see quality measures data on hospice and palliative care providers. Read More »

CMS raises reimbursement by 1%, pushes VBP

With the Value-Based Purchasing program due to begin in 2019, CMS is pushing SNFs to get on board with performance baselines now. Read More »

Senate says no to ‘skinny repeal’ healthcare bill version

The Senate has voted 51-49 to keep the Affordable Care Act law the way it is—for now. Majority Leader Mitch McConnell says it’s time to “move on.” Read More »

412 charged in largest-ever fraud bust

July has been a record-breaking month for the Department of Justice’s fraud squad, which orchestrated a 30-state takedown totaling $1.3 billion in fraudulent or illegal activities. Read More »

The new LTC bundle: housing and insurance

A few nursing home companies have begun selling their own private insurance policies on the Medicare Advantage market Read More »

Senate abandons second healthcare bill

The Senate GOP has pulled the plug on its most recent attempt to repeal and replace the Affordable Care Act. Read More »

Medicare Advantage plans murky on benefits

A recent report from the Government Accountability Office found one-quarter of reviewed plans had disproportionality high numbers of sicker people dropping out. Read More »

Senate GOP issues revisions to BCRA health bill

GOP senators make a few big changes to the BCRA bill but stick to their guns on tax repeals and cuts to Medicaid. Read More »

An open letter to Congress

Blogger Kathleen Mears writes legislators about how the proposed healthcare legislation would affect her and fellow nursing home residents. Read More »

How the Senate healthcare bill could affect seniors

The Senate’s proposed healthcare bill, the Better Care Reconciliation Act, calls for deep cuts to Medicaid. The program pays for about two-thirds of the 1.4 million seniors who live in nursing homes.  Read More »

CBO releases cost estimate, Senate delays vote on healthcare bill

The Senate’s version of healthcare reform would cut federal deficit, but also would make deep cuts to Medicaid at the federal and state levels. Read More »

Senate GOP bill calls for deep Medicaid cuts

Senate Republicans have finally revealed their bill to repeal and replace the Affordable Care Act. It is similar to the House version but key differences could make it a tough sell among Republicans with a razor-thin margin for passage. Read More »

Louisiana legislators limit long-term care competition

Lawmakers have successfully extended a moratorium to restrict assisted living facilities from entering the market. Read More »

Breaking down the CBO report: How AHCA could affect seniors

How could the proposed AHCA legislation affect older adults? What could happen to Medicaid and the ability to find insurance coverage? We explain the actual CBO report section by section. Read More »

Trump’s budget plan slashes Medicaid

The president’s 2018 budget includes a proposal for more than $610 billion in Medicaid cuts over the next decade.  Read More »

Helping Medicare beneficiaries with chronic conditions

The Senate Finance Committee unanimously approved the CHRONIC Care Act of 2017, which increases care delivery options for chronically ill Medicare beneficiaries. Read More »

CMS Final Rule: Compliance and ethics programs

SNF compliance and ethics programs aren’t optional anymore, and in some cases, may require additional staff roles. Are your programs survey-ready? Read More »

House passes AHCA bill by 4 votes

The promise of $8 billion for high-risk and pre-existing conditions pushed the bill in the GOP's favor. The bill now moves on to the Senate, where the margins for passage are predicted to be tougher. Read More »

CMS: SNF antipsychotic use at lowest level since 2011

The prevalence of antipsychotics in SNFs has dropped consistently since the CMS mandate to reduce unnecessary usage went into effect in 2012. Read More »

CMS funds nursing home for prisoners

A Connecticut nursing home will receive federal funding to help pay for and provide care to the state’s aging inmates.  Read More »

Congress to CMS: bolster oversight audits

Sen. Chuck Grassley asked Centers for Medicare and Medicaid Services Administrator Seema Verma to explain nearly $125 million in potential overcharges for Medicare Advantage plans.  Read More »

Parkinson’s disease awareness month shows unshakeable spirit

The American Parkinson Disease Association kicks off a new campaign to highlight the spirit and stories of those with Parkinson's disease to raise awareness of the illness. Read More »

The ACA and Medicaid

After months of political leverage on repealing the Affordable Care Act, the GOP decided to ditch its new House bill without voting on it. Now what? Read More »