Lawmakers demand answers about rating system quirks
By
John O'Connor
Oct 01, 2014
After The New York Times noted that providers are apparently gaming the Five Star rating system by enhancing staffing and quality data, federal lawmakers quickly put an indignant pen to paper.
Medicare Part B could have saved $110 million, OIG asserts
By
Elizabeth Newman
Sep 18, 2014
If the Medicare Part B program had used average Medicare Part D drug dispensing and fee rates, it would have saved the government $110 million in 2011, according to a report from the Department of Health...
CMS should publicly push Congress to reform therapy payment system, long-term care provider association...
By
Tim Mullaney
Sep 09, 2014
The Centers for Medicare & Medicaid Services should openly urge Congress to change the way therapy services are reimbursed, the nation’s largest long-term care provider association stated in recent...
Federal judge blocks new RAC contracts
By
Tim Mullaney
Sep 04, 2014
Adding to the ongoing controversy around Medicare’s Recovery Audit Contractor program, a judge has ruled that the government cannot award new RAC contracts until disputed payment terms are resolved.
CMS announces Medicare appeals without administrative law judge hearings
By
Tim Mullaney
Jul 07, 2014
Long-term care providers will be able to appeal certain Medicare claims decisions without going through an administrative law judge hearing, the Office of Medicare Hearings and Appeals (OMHA) announced...
Federal government needs to boost Medicaid managed care oversight, GAO says
By
Tim Mullaney
Jun 20, 2014
The government’s oversight of Medicaid managed care organizations is not strong, even though these entities cover about 50 million people and are growing rapidly, according to a recently released...
CMS to hold Medicare Advantage conference
Jun 12, 2014
The Centers for Medicare & Medicaid Services will hold its Medicare Advantage & Prescription Drug Oversight & Enforcement 2014 Program Audits conference on Tuesday, June 24 .It is designed to “provide...
Proposed Life Safety Code updates encourage more homelike environments
By
Tim Mullaney
Apr 15, 2014
Updated fire safety regulations could encourage more home-like healthcare environments while increasing security to safeguard against wandering, according to a proposed rule announced Monday.
CMS budget defines nursing home quality targets, requests an additional $50 million for surveys
By
Tim Mullaney
Mar 12, 2014
The Centers for Medicare & Medicaid Services’ proposed budget for fiscal year 2015 requests additional funds for survey activities and lists the agency’s targets for nursing home quality measures.
Likely closure can’t stop CMS termination
By
Julie Williamson
Mar 01, 2014
Despite meeting criteria for “irreparable injury,” a Rochester, NY-based skilled nursing facility that is appealing Medicare and Medicaid termination can’t qualify for a stay of termination,...