Payment Models

New CMS initiative to improve care for nursing home residents

The Centers for Medicare & Medicaid Services (CMS) will test a new payment model for nursing facilities and practitioners to further reduce avoidable hospitalizations and lower Medicare and Medicaid spending while improving patient care.

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CMS releases v1.13 of the RAI User’s Manual

The newly released RAI includes ICD-10 coding information and other clarifications.

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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.

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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.

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CMS proposes SNF changes

Payments to skilled nursing facilities, quality reporting, value-based purchasing and staffing data collection are addressed in a proposed rule published April 20 in the Federal Register.

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SNFs, hospice and home health programs prominent in OIG work plan for 2015

The billing, hiring, care-provision and deficiency-correction practices of nursing homes, hospices and home health programs are among the areas to be targeted by the U.S. Department of Health and Human Services Office of Inspector General in 2015.

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CMS updates Medicare COT assessment requirements

CMS recently updated the change of therapy requirements found in the RAI User’s Manual. Understanding the changes can ensure correct reimbursement and avoid miscalculations.

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CMS issues final rule with home health payment changes for 2015

Changes effective Jan. 1 will apply to face-to-face encounters, therapy reassessments, rate setting, home health quality reporting and speech-language pathologists' conditions of participation.

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Home health payments reduced $58 million under CMS proposal

Payments to home health agencies would decrease by 0.3 percent in fiscal year 2015 under changes to the Medicare prospective payment system proposed by the Centers for Medicare & Medicaid Services. CMS will accept comments on the proposal until Sept. 2.

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CMS proposes changes to SNF reimbursement

The Centers for Medicare & Medicaid Services is proposing changes to payment rules under the SNF prospective payment system, a wage index update, and a Change in Therapy assessment policy update. June 30 is the last day to comment.

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