Medicare/Medicaid

Therapy billing fraud: When will LTC learn?

Providers who overbill or fudge their therapy services are on the DOJ’s radar more than ever. So why is there still so much therapy billing fraud? Read More »

CMS releases home health agency rules

Home health agencies that receive Medicare or Medicaid funds must now comply with a new set of rules designed to close the gaps in care documentation. Read More »

Medicaid Qualified Income Trust a trying process

Resident blogger Kathleen Mears details her lengthy—and frustrating—journey of setting up a Qualified Income Trust (QIT/Miller trust) to meet Ohio’s changing Medicaid eligibility requirements. Read More »

CMS issues final rule for cardiac bundled payments

CMS released its latest episodic care models Tuesday, including the 90-day bundles for heart and bypass patients. Read More »

CMS offers compliance guidelines to HCBS settings on wandering

The Centers for Medicare and Medicaid Services has released compliance guideline fact sheet for home- and community-based providers who care for people who exhibit wandering or exit-seeking. Read More »

Medicare Part B outpatient drug payment cancelled

The Centers for Medicare and Medicaid Services will not move forward with a mandatory five-year Medicare initiative that would have tested new ways to pay for outpatient drugs under Medicare Part B. Read More »

CMS to test new ACO model for dual-eligibles

The pilot will let accountable care organizations manage the Medicaid claims for beneficiaries who receive both Medicare and Medicaid benefits. Read More »

LTC industry: Get back to basics ahead of Trump Adminstration

There may be regulatory changes ahead for the long-term care industry under a Trump Administration and Republican-led Congress, but Cynthia Morton says the best thing long-term care facilities can do is to keep doing what they've always done: take care of people. Read More »

GOP, Trump regime met with optimism

AHCA/NCAL anticipates—and looks forward to—expected regulatory relief and repeal under the new Republican-led White House and Congress. Read More »

Home health pushes for more thought on CMS pre-claim policy

A coalition of home health providers is encouraging Congress to give Medicare more time to iron out its home health pre-claim policy before pilots begin. Read More »

Medicare crunch time with Trump administration, Part II

Contributor Robert Gatty ponders whether sweeping reforms are ahead as President-elect Donald Trump fills out his Cabinet and Republicans retain majority in Congress.  Read More »

AHCA ‘excited’ about Trump’s HHS, CMS appointments

The American Health Care Association (AHCA) is looking forward to working with President-elect Donald Trump’s nominees and possible changes to the long-term/post-acute care industry, a vice president said in a call with reporters. Read More »

Trump names new CMS administrator

President-elect Donald Trump has nominated Seema Verma, Indiana-based health policy consultant, to serve as Administrator of the Centers for Medicare and Medicaid Services. Verma worked with Vice President-elect Mike Pence on state health care reform. Read More »

One-on-one with…Cynthia Morton

What's in store for long-term care in 2017? Cynthia Morton, Executive Vice President of NASL, talks about coming regulations and policy changes, including how a Trump administration could affect Medicaid. Read More »

Trump picks healthcare leader, plans for healthcare reform

Three days after the U.S. election, President-elect Trump has announced his choice to lead the healthcare segment of his transition team. Read More »

Medicare crunch time with Trump administration?

The next administration will have to cut back on Medicare spending and fraud. Contributor Robert Gatty speculates whether lawmakers will crack down on avoidable hospital admissions. Read More »

What impact will Trump’s victory have on value-based healthcare?

As Republicans take control of the executive and legislative branches, how will the new Administration impact healthcare's initiatives and priorities? Healthcare information technology experts weigh in on key policy issues moving forward. Read More »

Federal judge blocks CMS ban on arbitration

A federal judge has issued a temporary halt on CMS’ final rule ordering LTC facilities to remove all arbitration agreements from their admissions materials. Read More »

CMS finalizes site-neutral payment policies

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. Read More »

The CMS final rule: Twist and shout, but we can work it out

The long-term/post-acute care industry knew some groundbreaking changes were coming in the final rule from the Centers for Medicare and Medicaid Services, and Long-Term Living’s legal expert Alan C. Horowitz explains what all the fuss is about. Read More »

CMS proposes new payment models for diabetes prevention and wellness

National Diabetes Awareness month takes on extra meaning as Andy Slavitt, Acting Administrator of CMS, pushes for better diabetes care. Read More »

The changing season of CMS

As the season shifts into fall, the Centers for Medicare and Medicaid Services (CMS) is launching a new season of regulations for long-term and post-acute care. Read More »

How the RAI Manual changes encourage collaboration

AANAC's Judi Kulus, RN breaks down the impacts of the new RAI Manual changes and why SNF needs to collaborate better among their care teams and with their outside partners—including therapy providers and home health. Read More »

NASL elects new board officers

MatrixCare’s John Damgaard will head up the association’s new board of directors, along with four other officer electees. Read More »

The psychology of rehab

Fretting about CJR and rehab outcomes? Here’s why one of the best additions to your rehabilitation service line might be a psychologist. Read More »

AHCA seeks injunction of CMS final rule

The American Health Care Association filed a complaint that the arbitration provision in CMS’ final Requirements of Participation rule is unlawful.  Read More »

2016 OPTIMA Award: An honored memory

What happens when dementia and post-traumatic stress intersect in the nursing home environment? The winner of the 2016 Long-Term Living OPTIMA Award has spent three years developing a program to train caregivers how to interact with veterans—and how to document their positive and negative behavioral interventions to increase everyone’s ability to provide better person-centered care.   Read More »

Admissions, discharges and data-sharing

Will hospitals and nursing homes ever be able to agree on a standard set of data to share during patient transfers? Thought leaders at the annual NASL meeting discuss the current regs—and what needs to happen next. Read More »

Is senior care going to pot?

As more states pass laws legalizing medical marijuana, how will federal lawmakers react to the new climate? Read More »

BPCI Model 3: Bonanza or boondoggle?

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. Read More »