Medicare Advantage enrollees get less post-acute care than traditional beneficiaries: analysis
By
Joe Bush
Sep 19, 2022
Members of Medicare Advantage plans used post-acute care less than people with traditional Medicare, according to an analysis of 62 studies.
Federal court opens door for nursing homes to challenge Medicare, Medicaid rules
By
Danielle Brown
Apr 30, 2021
Providers may challenge rules and regulations established by federal agencies that they believe violate the Medicare and Medicaid Acts, thanks to a ruling this week by a federal court.
Loophole allows low volume Medicare providers exemption from auditing
By
Kristin Walter
Dec 15, 2017
The current implementation of Medicare’s sliding scale ADR limit policy is preventing the recovery of improper payments and has afforded a significant portion of providers with immunity from billing...
Stop the ‘siloed’ policy making for skilled nursing
By
Alan G. Rosenbloom
Mar 21, 2012
Last week, three reports issued by three separate government agencies made incongruent recommendations — or no recommendations at all — related to skilled nursing facility (SNF) patient care and policy....
Campaign 2012 boosted importance, value of nursing home care in public policy dialogue
By
Alan G. Rosenbloom
Nov 12, 2012
Despite the customary complaints about negativity and the avalanche of TV ads, the 2012 campaign was unusually substantive from the standpoint of the entitlement reform discussion because both sides were...
The Jimmo scorecard and CMS compliance update
By
Steven Littlehale
Nov 25, 2014
In some ways, 2014 has been a monumental year. But it’s not over yet, especially with regard to Centers for Medicare & Medicaid Services steps regarding the historic Jimmo settlement agreement signed...
Providers grateful for certain opportunities in proposed 2025 Medicare pay rule
By
James M. Berklan
Apr 02, 2024
Even though debate will continue about how much Medicare reimbursement should rise next year, there’s little disagreement that the Centers for Medicare & Medicaid Services got at least a few things right...
Of Purell and payment reform
By
Tim Mullaney
Apr 16, 2013
I was sympathetic when the Partnership for Sustainable Health Care called for a speedier shift away from fee-for-service last week — and I also thought about Purell. Yes, that Purell.
Medicare Advantage: A not-so-advantageous deal for beneficiaries and providers
By
Brendan Williams
Nov 29, 2023
Open enrollment is well underway for Medicare, as television viewers inundated with cheesy insurance company ads can tell. Those ads must work. For the first time 2024 will see most Medicare...
What the long-term care world needs now
By
Dave Sedgwick
Apr 27, 2010
The time has come to decentralize long-term care organizations to attract more entrepreneurial, innovative and committed leaders.