Medicare/Medicaid

Patients must be notified of hospital ‘observation status’

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. Read More »

Medical marijuana: Hashing out the legal issues

Many states have legalized medical marijuana, but when it comes to Medicare participants, it’s federal law that matters. Read More »

CMS saved $42B by preventing fraud and improper payment

The Centers for Medicare and Medicaid Services has saved $42 billion in fiscal years 2013 and 2014 by proactively preventing potential fraud and dispersing improper payments. Additional savings are expected for fiscal year 2015.  Read More »

Ohio Medicaid Qualified Income Trust

Setting up a Qualified Income Trust/Miller Trust to fulfill the Medicaid requirements can be tricky business, so Ohio's Medicaid recipients shouldn't wait to get started on the process, says SNF resident blogger Kathleen Mears. Read More »

Medicare proposes changes to primary care payment

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. Read More »

CMS ranks Texas 48th in nation for antipsychotic misuse in nursing home

The Centers for Medicare and Medicaid Services Nursing Home Enforcement Report has found one in five Texas nursing home residents are improperly given antipsychotic drugs as a means of restraint.  Read More »

Whistleblower: hospice provider rigged documentation to raise census

A civil lawsuit filed by a whistleblower claims Caris Healthcare, which provides hospice services in five states, deliberately documented any illness that could be considered terminal in order to keep its hospice beds occupied. Read More »

MedPAC launches plan for new payment system

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 hopefully reducing unnecessary services and admission preferences.  Read More »

House Republicans propose healthcare system overhaul

Republicans from the U.S. House of Representatives announced a healthcare reform proposal that would challenge parts of the Affordable Care Act but retain some of the Act’s more popular provisions. Read More »

Unified PAC payment feasible, MedPAC says

The Medicare Payment Advisory Commission (MedPAC) has issued its annual report on refinements to Medicare payment systems and on issues affecting the medicare program Read More »

CMS gives hospitals extension to meet new fire safety codes

The Centers for Medicare & Medicaid Services announced it will not begin surveying for compliance with the 2012 fire safety codes until November. The July 5 ruling still applies when considering which code chapters facilities must comply with.  Read More »

GAO report: Provider Medicare appeals still in logjam

Despite efforts to ease the backlog of appeals, no relief is in sight for the backlog of appeals from facilities that choose to appeal Medicare claims denials and deficiency citations. Read More »

Medicare could cover comprehensive Alzheimer’s care plan

Congressional subcommittees have proposed changes to the Social Security Act to cover an initial care plan for Medicare beneficiaries newly diagnosed with Alzheimer’s disease and related dementias to help them understand the disease and treatment options. Read More »

How chart audits affect your reimbursement

The pressure is on for skilled nursing facilities: Compliance for CMS reimbursement means proper charting, documentation of therapy minutes and shaking out those RUGs. Read More »

Getting stiff

Getting that handy touchpad laptop made life seem easier, but it wasn't so great for her hand's range of motion, says SNF resident blogger Kathleen Mears. Read More »

CMS to Allow ACOs to Join Forthcoming CPC+ Model

The Centers for Medicare & Medicaid Services (CMS) has opened up its new Comprehensive Primary Care Plus (CPC+) initiative to 1,500 eligible primary care practices currently in the Medicare Shared Savings Program (MSSP). Read More »

Extreme honesty: Medical errors and full disclosure

Mistakes and “near misses” can and will happen. But, how a facility discloses an error can affect everything from the CMS response to the family’s reaction. Read More »

“We are the solution,” industry execs tell Congress

A two-day AHCA/NCAL congressional briefing brings 450 long-term interests to Capitol Hill. Read More »

Couples become more similar as they age

New research suggests people who have been in relationships for decades are more likely to age to become more like each other mentally, physically and emotionally. That means doctors need to monitor the health of their patient--and their patient’s partner. Read More »

The fate of your stars: CMS and the new quality measures

As the opening keynote at the Memory Care Forum in Philadelphia, NASL policy guru Cynthia Morton discusses what’s coming next from CMS on long-term care quality measures and how that data might affect your five-star quality rating. Read More »

Crusading to protect the elderly

Are the new Justice Department Elder Justice Task Forces a smokescreen to cut costs? Long-Term Living's politics and policy reporter, Robert Gatty, examines the forces at play in the new initiatives. Read More »

Hospice experience inspires woman to become a hospice nurse

A woman decides to become a hospice nurse based on her personal experience with hospice care for her teenage son. Read More »

DOJ to South Dakota: Stop sticking people with disabilities in SNFs

The Department of Justice is cracking down on South Dakota, accusing the state of putting people with disabilities in nursing homes unecessarily rather than providing community-based services. Read More »

CMS adds quality measures to 5-star rating system

The Centers for Medicare & Medicaid Services adds six new quality measures to the Nursing Home Compare system, including data on short-stay residents' trips to the emergency room. Read More »