Government to add nearly 6,000 updates to ICD-10

The CDC and CMS announced they will celebrate the one-year anniversary of the transition to the new classification system by implementing new diagnosis codes, hospital inpatient procedure codes and revision of existing code titles.  Read More »

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. Read More »

CMS pushes interoperability for LTC

The new initiative allows states to request the 90 percent enhanced matching funds to connect more Medicaid providers to a state health information exchange. Read More »

Nursing home operator files for bankruptcy following government shutdown

State and federal investigators shut down multiple nursing homes operated by New Beginnings Care, LLC. The company has filed for Chapter 11 bankruptcy. Read More »

CMS examines racial, ethnic disparities in healthcare

Racial and ethnic minority populations are more likely to be readmitted to the hospital within 30 days for certain chronic conditions. The Centers for Medicare & Medicaid Services is exploring the relationship readmission rates and diversity. Read More »

3-day waiver rule on the way out?

The 3-day hospital stay rule might be waving goodbye, but the American Health Care Association warns the new CMS proposal would put some nursing homes—and their residents—at a disadvantage. Read More »

JAMDA study IDs readmission spike

Better coordination between hospitals and post-acute care facilities could reduce patient readmission to hospitals and mortality rates. Read More »

RehabCare to pay $125M in fraud settlement

National therapy giant RehabCare is back in trouble again, this time agreeing to pay $125 million to settle false billing claims. Read More »

Ousted nursing home CEO could be back in charge

James G. Burkhart, former CEO of American Senior Communities LLC, has agreements with Health & Hospital Corporation that could allow him to own 63 nursing homes he used to manage. Read More »

National health spending picks up steam

The national healthcare spending growth rate has accelerated for the first time after five years of sluggish growth, according to new annual data from CMS. Read More »

CMS gets to work on new value-based fee structure

Now that the SGR is history, the Centers for Medicare & Medicaid Services is tackling the new value-based payment model. Leading long-term care organizations are playing important roles in advising the new policies. 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 »

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 »

CMS launches ACO kidney dialysis model

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

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

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

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 »

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 »

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 »

2015 OPTIMA Award: A breath for life

This year's OPTIMA Award winner, Silvercrest Center for Nursing and Rehabilitation, Briarwood, N.Y., has slashed its hospitalizations despite having one of the highest acuity rates in its region. Long-Term Living's Pamela Tabar spent two days visiting the site and learning how the SNF is using collaborative care teams, customized electronic documentation and early-intervention tools to keep its unique resident population out of the hospital. Read More »

CMS adds more participants to bundled payments initiative

The Centers for Medicare and Medicaid announced that 2,100 participants have moved on to the contract, risk-bearing period of the bundling pilot program. 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 »

Anthem to buy Cigna in $54B deal

Anthem’s purchase of Cigna constitutes the largest health insurance deal in history, but regulators will be watching closely for impacts on market competition. 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 »

American HealthTech launches RCM suite

Eligibility verification is step one in capturing revenue cycle management data to improve financial efficiency. Read More »

OIG says SNF billing for changes in therapy needs improvement

The OIG recommends the CMS accelerate its efforts to begin a new method for paying for therapy.  Read More »

CMS won’t deny ICD-10 claims for a year

In response to requests from the provider community, CMS is releasing additional guidance that will aim to allow for flexibility in the claims auditing and quality reporting process Read More »