Medicare/Medicaid

New federal rules for home health agencies

Federal regulations, set to go into effect in July, would require the more than 12,000 home health agencies participating in Medicare and Medicaid be more responsive--and responsible--for patients and caregivers.  Read More »

Price confirmed to head HHS

The Senate has approved the president’s nomination of Representative Tom Price as the new secretary of the Department of Health and Human Services. Read More »

Re-examining CMS’ 5-star rating system

A new GAO report highlights why experts say the next addition to the Nursing Home Compare five-star ratings should be customer service. Read More »

Providers, Medicare renew battle over therapy services

Four years after the Jimmo court case, Medicare officials, providers and senior advocates still can't agree on how to handle ongoing therapy services for patients who aren't improving. Read More »

PointRight, Pathway launch 5-star ratings solution

The product will help skilled nursing facilities maximize their 5-star ratings under the CMS's Nursing Home Compare system. Read More »

Fighting superbugs with genetic warfare

As antibiotic resistance grows, scientists are learning how to attack killer bacteria at the genetic level. Read More »

Judge says no to Aetna/Humana merger

The risks to pricing and competition among Medicare plans were key factors in the denial, the court says. Read More »

CMS applauds readmission reduction

The Centers for Medicare & Medicaid Services has seen a substantial decline in hospitalization admissions among Medicare beneficiaries in long-term care.  Read More »

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 »