Medicare/Medicaid

Study: More insurance options can improve long-term services and supports

A new study sponsored by LeadingAge, The SCAN Foundation and AARP found the number of Americans who need long-term help with daily activities will more than double by 2055. New insurance options are needed to pay for increasing costs.  Read More »

CA advocates sue to stop illegal unloading of nursing home residents

California Advocates for Nursing Home Reform and three nursing home residents have filed a lawsuit against the state saying it is allegedly illegally allowing residents to be "dumped" from nursing homes to hospitals. Read More »

Office of Inspector General plans to crack down on fraud and cut costs

The OIG released its Work Plan for fiscal year 2016. Long-term care providers can expect reviews of claims and payment documentation as well as consolidated equipment and pharmaceutical purchases. Read More »

Skilled nursing facility provider accused of falsifying Medicare claims

Department of Justice intervenes in three separate lawsuits alleging SavaSeniorCare provided unnecessary therapy treatment and delayed discharges to increase Medicare payments to help meet unrealistic corporate financial goals. Read More »

CMS issues proposed rule for patient preferences in discharge summaries

The proposal would affect long-term care hospitals, inpatient facilities and home health agencies that participate in CMS reimbursement programs. Read More »

UPDATE U.S. Senate passes budget bill to avert shutdown, keep 2% Medicare cuts

With Senate passage, the bill retains the reimbursement cuts created by the sequstration in 2011. Read More »

Budget deal could include 2% Medicare cuts

Congressional and White House leaders reached a late-night federal budget deal that would include across-the-board 2-percent Medicare cuts. Read More »

Psychologists charged in $25 million Medicare fraud scheme

Two psychologists have been charged with billing Medicare for unnecessary, or never performed, psychological tests and services to nursing home residents. Read More »

Fight brewing over proposed CMS arbitration rule

The long-term care industry argues that the CMS arbitration rule goes too far; state attorneys general seek an outright ban. Read More »

HHS Alzheimer’s Advisory Council welcomes six new members

The Department of Health and Human Services (HHS) Advisory Council on Alzheimer’s Research, Care and Services announced its new members this week. The council advises the HHS secretary on federal programs for people who have Alzheimer’s and other dementias. Read More »

National hospice provider found guilty of filing false claims

The Department of Justice is expected to seek more than $202 million in Medicare reimbursement, fines and other penalties in the largest-ever whistleblower lawsuit involving a hospice care provider. The second phase of the trial against AsercaCare is scheduled to begin next week.  Read More »

CMS launches ACO kidney dialysis model

The new accountable care organization model creates a shared-cost program for end-stage renal disease. Read More »

Report: New regs are a bitter pill for LTC pharmacies

Long-term care pharmacies provide crucial senior-specific medication management services to skilled nursing facilities. But will the current regulatory environment drive independent LTC pharmacies out of business? Read More »

Mastering the new SNF regs to maximize reimbursement

The new skilled nursing facility regulations under the IMPACT Act are coming. Has your facility adopted the best processes and attitudes to maximize reimbursement? Policy experts explain why sticking to the old status quo on processes won't be good enough. Read More »

AHCA/NCAL opening session: Team leadership, quality improvement needed in changing times

The opening general session of the AHCA/NCAL Annual Conference and Expo focused on the importance of cross-discipline teamwork, with special highlights on the role of the Certified Nursing Assistant (CNA). Read More »

CMS proposes individualized care plan for long-term care patients

CMS proposes revising the requirements long-term care facilities must meet to participate in Medicare and Medicaid programs. Read More »

AHCA/NCAL: New CMS nursing home regulations ‘simply too much’

The new proposed rules from the Centers for Medicare & Medicaid Services are not sitting well with the head of the American Health Care Association, who says they will takes years and extraordinary cost to implement. Read More »

CMS to issue payment reduction for 2014 PQRS reporting

Registrants who did not satisfactorily report quality measures will be subject to a 2 percent reduction in 2016. Read More »

MedPAC reviews possible new post-acute pay model

The commission discusses how to balance quality of patient care with new Medicare payment system. Read More »

New tool identifies ways to improve 5-star quarterly rating

LeadingAge is launching a reporting tool to calculate how to improve resident care and increase 5-star ratings. Read More »

Omnicare wins $300M alleged fraud case

Omnicare was accused of offering "illegal remuneration to skilled nursing facilities in exchange for referrals to its pharmacy business." Read More »

ALFA, ASHA: Proposed changes to labor exemptions will be ‘harmful to industry’

The Department of Labor’s proposed changes to the way "exempt employees" are defined and the minimum salary requirements exemptions for certain categories of employees and institute minimum salary requirements for exempt status will do more harm than good in the senior care market, say two of the nation’s senior living associations. Read More »

CMS unveils 4-year plan to improve health equity

The Centers for Medicare & Medicaid Services releases six priorities to reduce health disparities among Medicare beneficiaries over the next four years. Read More »

Former nursing home employee convicted of theft

A nursing home business office manager has been found guilty of writing checks from resident accounts and keeping the money for herself. Read More »

CMS pilot model to provide additional benefits for chronic conditions

The Centers for Medicare & Medicaid Services announces a new pilot program using the value-based insurance design model to provide better – and cheaper – care. Read More »

MatrixCare to release clinical analytics for CMS benchmarks

Electronic Health Records provider MatrixCare debuts new dashboard to measure and compare the most current CMS benchmark data. Read More »

CMS announces initiative to improve care in nursing homes

The new initiative provides funding to would allow nursing homes to test a new payment model. Read More »

SNFs repond to the new MDS-focused survey process

Have you experienced this new surveyor process yet? Be ready for scrutiny of your ADL services and documentation. Read More »

CMS extends execution delay for ‘two-midnight’ rule again

The Centers for Medicare and Medicaid Services has pushed the deadline for the "two-midnight" rule to the end of the year. Read More »

An Obamacare repeal?

Expect another try by the GOP to repeal the Affordable Care Act. This latest attempt at repeal is tied to the federal budget. Read More »