Medicare/Medicaid

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 »

Ohio may integrate convicts into nursing homes

The costs of caring for sick and frail older convicts are skyrocketing and soon so will the numbers of elderly inmates in the nation’s prison systems. The Ohio Department of Corrections thinks it has found the answer to reducing the state's costs of providing care. Read More »

Happy birthday, Medicare & Medicaid

Happy birthday, Medicare and Medicaid—and can we say, you don’t look a day over 50. But, the healthcare world sure is different now, compared to when you were born. Read More »

CMS, Rhode Island partner on new dual-eligible care model

The Centers for Medicare & Medicaid Services is partnering with the state of Rhode Island to try out a new model for providing person-centered care to Medicare/Medicaid dual enrollees. Read More »

CMS: National health spending projections juggle expanded coverage, high-cost drugs

Overall national healthcare spending is expected to rise by modest amounts during the decade from 2014-2024, notes a Centers for Medicare & Medicaid Services budget report released today. Read More »

NOTICE Act receives full Senate approval

Legislation to inform Medicare beneficiaries of their outpatient status has passed through the legislative branch without a hitch. Now, it’s off to the White House. Read More »

CMS pilots program for joint hospice/curative care

A new pilot program model from the Centers for Medicare & Medicaid Services will test whether hospice care and curative care should be offered simultaneously, instead of asking terminally-ill patients to choose one or the other. Read More »

CMS proposes mandatory antibiotic stewardship programs in LTC

Centers for Medicare & Medicaid Services' proposed rule would require long-term care facilities to establish an antibiotic stewardship program in order to participate in Medicare. Read More »

CMS proposes massive new rules for LTC industry

The 400-page proposal includes new rules to reduce hospitalizations, infections and resident risks. But, opponents question the financial impacts: Feds estimate the cost would be nearly $90,000 per facility over two years.  Read More »

Former CMS administrator Marilyn Tavenner to become AHIP president

Tavenner left her CMS post in January, and Andy Slavitt has been nominated by President Barack Obama to fill the position. Read More »

Medicare: It works great…Let’s fix it

Medicare celebrates its 50th anniversary on July 30. Experts on aging discuss the program's history and future goals at an American Society for Aging event this past June. Read More »

Government audits find extensive Medicare Advantage overcharges

Some Medicare Advantage patients were overpaying by thousands of dollars a year, according to government audits. Read More »

Obama nominates Andy Slavitt as new CMS Administrator

Andy Slavitt has been serving as acting administrator since February. Read More »

Dying with a voice

The Centers for Medicare & Medicaid Services has proposed a milestone change within its latest Physician Fee Schedule--a new billing code for advanced care planning services. Will it encourage more docs to talk about end-of-life choices? Read More »

CMS proposes physician reimbursement for end-of-life discussions

In a milestone addition to its physician payment schedule, the Centers for Medicare & Medicaid Services proposes to add a new billing code to allow for the reimbursement of advanced care planning services. Read More »

Aetna’s Humana acquisition will swell its Medicare Advantage business

Aetna agreed to acquire rival Humana for $37 billion in cash and stock on July 3. Read More »

Proposed bill would help ensure home health agencies are reimbursed by Medicare

Two senators have introduced a bill that would reduce the number of inappropriate Medicare denials for home health agencies. Read More »

Assessment finds missing measures in Medicare’s pay-for-quality programs

A new Avalere assessment of quality measures finds many important medical conditions are not represented in Medicare's pay-for-quality programs. Read More »

BREAKING NEWS: SCOTUS votes to uphold subsidies in King v Burwell

The U.S. Supreme Court voted 6-3 today to uphold marketplace subsidies in the landmark case King v Burwell. Read More »

Getting ready for assessment data and the IMPACT Act

Workgroups responsible for implementing the standardization of documentation codes across care settings under the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) have been busy during the past year, and SNFs may have to be ready to report under the new assessment data as early as fall 2016, noted panel presenters at this week's Long-Term and Post-Acute Care Health IT Summit in Baltimore. Read More »

Feds arrest several doctors, nurses in largest Medicare fraud bust ever

More than 240 people were arrested in 17 cities for allegedly billing Medicare for $712 million for care that was never given.  Read More »

LTC professionals take their message to Congress

UPDATED June 23, 2015: Congressional actions got a few steps closer to repealing two key Obamacare provisions--the medical device tax and the Independent Payment Advisory Board. Read More »

Providers pleased by House vote to remove Medicare cuts from trade bill

The American Medical Association and LeadingAge offer praise for the House's vote to remove Medicare cuts that would have funded the Trade Adjustment Assistance program. Read More »

CMS lays ground rules for provider screening, fingerprinting for fraud risk

By March 2016, states with Medicaid providers must be ranked has having a "high," moderate," or "limited" risk of defrauding the program. Read More »

CMS opens data to entrepreneurs

The Centers for Medicare & Medicaid Services will make its Medicare data available to entrepreneurs with the mission of improving healthcare processes.  Read More »

GAO suggests ways to fight Medicaid fraud, improve Medicare audits

CMS plans to issue guidance for screening deceased Medicaid beneficiaries, provide more-complete data for screening Medicaid providers and consider whether the performance of Medicare administrative contractors can be improved. Read More »

Organizations respond to proposed Medicaid changes

Leaders from organizations representing providers of housing, care and services for older adults say they continue to scrutinize the 653-page proposal of reforms to Medicaid managed care plans that the Centers for Medicare & Medicaid Services issued May 26, but they shared their initial reactions with Long-Term Living. Read More »

CMS proposes changes to Medicaid managed care regulations

The Centers for Medicare & Medicaid Services is proposing several changes to its Medicaid managed care regulations to modernize them and improve quality in the delivery of care to beneficiaries. Read More »

Nursing home false claims allegations settled with $3.8M payment

Two California nursing homes persistently overmedicated residents, causing infection, sepsis, malnutrition, dehydration, falls, fractures, pressure ulcers and, for some residents, premature death, the federal government maintains. Read More »