Impatient with the conservative participation in its Medicare Shared Savings Program, the Centers for Medicare & Medicaid Services has proposed an overhaul of its most popular accountable care organization...
Providers rip huge backlog of therapy claims reviews
By
James M. Berklan
Jan 01, 2014
A provider-sponsored survey recently uncovered huge backlogs of therapy claim reviews for beneficiaries who exceeded the Medicare Part B caps limits.
A “punt” by the U.S. Supreme Court left long-term care providers breathing a deep, maybe temporary, sigh of relief regarding California’s proposed Medicaid funding cuts.
Fix flaws before changing nursing home pay: AHCA says
By
James M. Berklan
Aug 01, 2013
The Centers for Medicare & Medicaid Services should consider a higher market basket update for nursing homes due to improper calculations that could be costing providers, the American Health Care Association...
Ask the payment expert: Why are there so many lower RUG levels in residents receiving therapy?
Quality isn’t necessarily a deciding factor when a nursing home closes. So suggests a new report that found both high- and low-quality providers were among the more than 550 facilities that closed from...
Managed care: Fear awaits
By
James M. Berklan
Jul 06, 2015
The White House Office of Management and Budget review has passed an ambitious new policy that could radically overhaul the Medicaid managed care system.
Proposed 9% therapy pay cut has providers up in arms
By
James M. Berklan
Sep 01, 2020
Provider advocates have warned that the Trump administration’s proposed 9% Medicare payment cuts for physical and occupational therapy could send some companies out of business.