Policy

Medicare fraudsters nabbed in $223 million nationwide bust

This week’s Medicare fraud sting operation involved nearly 100 people across multiple states, including physicians, nurses and therapists. Read More »

Skilled nursing: The continuing quest for quality

While quality and satisfaction scores have improved, skilled nursing facilities need to continue to improve and adapt to government policy and reimbursement cuts to survive. Read More »

Skilled care in the south of France

Every country in the world--from Argentina to Zimbabwe--is confronted with the problem of caring for its elderly and paying for that care. Here's a firsthand look at how senior care is provided at a facility in France. Read More »

CMS Publishes FY 2014 Proposed Payment Guidance

CMS publishes proposals for changes to FY 2014 payment rates, quality data collection and reporting requirements, and qualification criteria for long-term care providers in the Federal Register.  Read More »

Florida loses its court battle to override HIPAA requirements

Who is entitled to access a deceased person’s protected health information? In Florida, the state’s law allows access to a range of unauthorized representatives. Read More »

National hospice provider charged with false claims submissions

Vitas Hospice Services is charged by DOJ with engaging in business practices that resulted in inappropriate patient admissions and upcoded claims submissions to Medicare. Read More »

CMS proposes $180 million increase in hospice reimbursements

CMS has proposed a new rule that would raise hospice payments under Medicare by $180 million next year. Read More »

Activists petition for safer bed rails in nursing homes

Bed rails are supposed to keep residents safe, but some advocates say stricter standards are needed to keep them from doing more harm than good. Read More »

A resurgence of fraud cases based on quality allegations

Alleged poor quality charges are landing providers in the poorhouse. A look at cases based on poor quality of care and the subsequent verdicts handed down. Read More »

CMS sweetens the deal for fraud whistleblowers

Know about someone conducting sneaky Medicare billing practices? CMS’ new whistleblower proposal might pay you more than your boss does. Read More »

Senate committee approves Tavenner for CMS helm

Marilyn Tavenner has obtained a vote of confidence from a Senate committee in her bid to become the first confirmed administrator of the Centers for Medicare & Medicaid Services in seven years. Read More »

Industry leaders weigh in on President Obama’s FY2014 budget proposal

This summer will be a busy one as Congress deliberates the 2014 budget and how, without revisions, its proposed cuts to Medicare may affect the physicians, hospitals and long-term care providers. Read More »

The pros and cons of per capita caps for Medicaid

Federal agencies and lawmakers keep revising one possible way to curb Medicaid spending growth: Per capita caps. Read More »

SNFs soon may face penalties for avoidable readmissions

Next year, in an effort to improve quality of care, skilled nursing facilities may share the penalties already levied to hospitals for 30-day Medicare hospital readmissions. Read More »

Parkinson’s disease organizations unite to raise awareness of the need to participate in clinical trials

Clinical trials serve a crucial role in bringing new medications and treatments to the people who suffer from various disease. But it takes people willing to take the time to participate. Recently, 16 international organizations have banded together to encourage participation in Parkinson's disease trials. Read More »

Obama budget will cut Medicare but boost Medicaid and mental health

President Obama's new budget, released by the White House Wednesday, includes plenty of cuts, but also contains a few surprising increases. Read More »

Obama proposes $7.6 billion increase in vets’ LTC benefits

President Obama has proposed a $152.7 billion budget to expand access to healthcare, eliminate disability claim backlogs and end homelessness for veterans.  Read More »

Assisted living 2013: On the upswing

Two top industry executives share their insights on assisted living’s climate and trends. Assisted living survived the economic downturn and the collapse of the housing market intact and it is geared up and ready to continue moving forward. Read More »

CMS releases guidelines on delegated nursing roles in SNFs

A new Centers for Medicare & Medicaid Services document clarifies what tasks physicians may delegate to nurses within nursing homes serving Medicare and Medicaid residents. Read More »

SNFs included in Rhode Island’s first nurse residency program

In addition to hospitals and clinics, nursing homes will be a practice setting in a newly developed Rhode Island nurse residency program. Read More »

One-on-one with…. Ruta Kadonoff

Senior Editor Pamela Tabar talks with Ruta Kadonoff, vice president of quality and regulatory affairs for the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), about quality in long-term care—and why being able to measure it will be important for business. Read More »

2% Medicare payment reductions begin today

The waiting is over. No resolution to the budget crisis means that sequestration begins—today. Long-term care facilities will feel the effects upfront, but a quieter casuality might be healthcare's information technology and data-sharing initiatives. Read More »

Aging baby boomers and Blue Ocean opportunities

Expect changes as the Baby Boom generation ages. As in their youth, they will do things differently from their parents and create  their own concepts of elderhood. Read More »

Fla insurance shutdown hits 100,000 Medicare/Medicaid beneficiaries

Florida’s Universal Health Care Insurance suddenly closed its doors last week, giving beneficiaries three days to choose another insurance provider. Read More »

HHS finalizes rule on funding payment rates for new Medicaid beneficiaries

The federal government last Friday announced a final rule that provides 100 percent payment of the cost of certain newly eligible adult Medicaid beneficiaries. Read More »

AMDA Foundation names its 2013 Medical Director of the Year

AMDA Foundation presents its annual Medical Director of the year award at its 2013 conference in Washington, D.C. Read More »

White House, Congress might consider combining Medicare Parts A and B

Sweeping changes may be on the horizon for the way Medicare billing is divided, as President Obama and Republicans put the idea of combining Medicare Parts A and B back on the discussion table, the New York Times reports today. Read More »

Florida nursing home background checks may include residents

Employees are subject to background checks before they are hired at an LTC facility. Residents may soon be included in that process. Read More »

Pressure ulcers: What we don’t know can hurt us

Knowledge about the prevention and treatment of pressure ulcers has come a long way, but has it come far enough to prevent and reduce the incidence of this problem in long-term care? Read More »

DOJ nabs more home health, therapy fraudsters

The Department of Justice and Medicare fraud teams continue to look hard at therapy and home care billing. Read More »