‘Special’ times ahead for more nursing homes, and that’s not good
By
James M. Berklan
May 28, 2014
As spring blends into summer, some nursing home operators are going to start feeling more heat — and it will have nothing to do with the weather. They will be given places on the proverbial hot seat....
Lawmakers go to bat for providers over backlogged Medicare appeals
By
James M. Berklan
May 22, 2014
Angry lawmakers ripped an overwhelmed Medicare appeals process that has wilted under a tenfold increase in audits recently. Federal officials from two key agencies agreed that the Medicare’s Recovery...
When a provider gets caught in a web: The Cochran photo affair
By
James M. Berklan
May 21, 2014
The list of losers in this week’s sensational story about photos secretly being shot of a U.S. Senator’s Alzheimer’s-afflicted wife, is large. A long-term care operator is just hoping...
CMS requests survey buildup
By
James M. Berklan
Apr 01, 2014
The Centers for Medicare & Medicaid Services is asking for $49 million more in its next budget, largely to expand long-term care inspection programs.
Referral fees OK, says OIG
By
James M. Berklan
Mar 01, 2014
A long-term care provider that requested clearance for a system of paying an agency to refer patients is in the clear.
Extra audits clog and freeze Medicare appeals process
By
James M. Berklan
Mar 01, 2014
Providers who want to have an administrative law judge consider a Medicare claim appeal can save their breath and memos for now.
Stability sought via budget deal
By
James M. Berklan
Jan 17, 2014
Providers are likely looking forward to a fiscal 2014 with generally stable funding sources and no repeat of a government shutdown. The Senate was expected to vote on and pass a massive $1.1 trillion government...
CMS looking for accountable care organization comments and new Pioneer ACO participants
By
James M. Berklan
Dec 23, 2013
The Centers for Medicare & Medicaid Services announced Friday that it is seeking a second round of applicants to the Pioneer ACO Model.
PET scans for Alzheimer’s rejected for Medicare pay
By
James M. Berklan
Nov 01, 2013
Earlier this year, the Department of Health and Human Services released an action plan for tackling Alzheimer’s diagnostics, treatment and funding.
Cases subject to escrow
By
James M. Berklan
Oct 01, 2013
Federal regulators have expanded the use of escrow accounts so that as of this month, providers will be subject to their use for any kind of deficiency from a standard or complaint survey that draws a...