Colliding factors threaten to ‘muddy’ state Medicaid reimbursement
By
Kimberly Marselas
Oct 04, 2023
Several converging factors could make the next few years especially complicated for state Medicaid systems, with the potential for new cost-setting strategies to affect providers from coast-to-coast.
A key Medicaid advisory body appears ready to recommend new appeal opportunities for millions of Managed Medicaid beneficiaries and to add more oversight to better ensure plans cover medically necessary...
Stagnant Medicaid rates aren’t just putting operators faced with outsized staffing costs into the red; in some places, they may be limiting access to the very capital providers need to sustain daily...
Court rules nursing homes can’t sue state over Medicaid decisions
By
Kimberly Marselas
Apr 16, 2018
Ohio nursing homes don’t have standing to sue the state over Medicaid eligibility determinations unless specifically authorized.
MedPAC pushes 3 percent Medicare SNF cut in report to Congress
By
Kimberly Marselas
Mar 17, 2023
A key body that advises Congress on Medicare policy is calling for a 3% reduction in payments to skilled nursing facilities in fiscal year 2024.
Providers ‘on notice’ as CMS pressures states to shift Medicaid pay metrics
By
Kimberly Marselas
Nov 10, 2022
Providers still struggling to accurately capture diagnoses that drive federal reimbursement will be doubly left behind as more states start to use Patient Driven Payment Model-like systems to determine...
Link Medicaid hikes to worker pay to promote staff equity, researchers say
By
Kimberly Marselas
Feb 08, 2022
Tying increases in state Medicaid rates to wages would be an important way to address the disproportionate representation of Black women in long-term care’s lowest paying positions, say researchers...
Regulator insists brutal honesty from providers can turn the tide on Medicaid
By
Kimberly Marselas
Oct 18, 2022
DENVER — Despite perceptions of state officials being unapproachable or reluctant to help long-term care providers, the right provider stories can influence policies and help shift funding in the right...
Breaking agency to boost speciality potential: Vivage’s Jay Moskowitz
By
Kimberly Marselas
Mar 06, 2023
Just a year after deciding not to renew 11 leases it held with Omega Healthcare Investors, Vivage Senior Living is moving forward with a merger it hopes will reinvigorate innovative programs across its...
Expansion drove thousands of new Medicaid patients to nursing homes, but do they belong?
By
Kimberly Marselas
Sep 23, 2021
Medicaid expansion increased access to nursing home care for people younger than 65, but it’s unclear whether those patients would have been treated more adequately in other post-acute settings.