HHS chief returns focus of low COVID-19 vax rates to nursing homes
By
James M. Berklan
Jan 04, 2024
The nation’s top health official met with US nursing home leaders for the second time in two weeks Wednesday to discuss what he called concerningly low COVID-19 vaccination rates among long-term care...
Lawmakers pushing CMS to ease Medicare Advantage prior authorizations
By
Kimberly Marselas
Jun 26, 2023
Close to 300 members of Congress are urging federal regulators to do more to reduce burdensome Medicare Advantage requirements that can slow delivery of care to nursing home and other patients.
CMS 5-claim audits so far a ‘debacle’
By
Jessica R. Towhey
Aug 22, 2023
A new federal review process designed to lower the rate of improper government payments is sending provider staffs scurrying to justify their coding.
CMS provides first look at shorter, Risk-Based Survey process
By
Kimberly Marselas
Apr 04, 2024
The Centers for Medicare & Medicaid Services on Wednesday revealed initial information about a potential “Risk-Based Survey” option that could be available to some of the nation’s best performing...
Key senator pressures state survey agencies over staffing-related delays
By
Kimberly Marselas
Sep 13, 2022
Sen. Bob Casey Jr. (D-PA) is demanding state survey agencies report information on extensive delays, staffing shortages and other challenges in the nursing home inspection process.
Watchdog urges Medicaid to bolster overpayment collection efforts
By
Kimberly Marselas
Jun 30, 2023
The Government Accountability Office is urging Medicaid overseers to do a better job of recouping overpayments, citing their allegedly lenient oversight of state auditing efforts.
CMS proposes appeals process for Medicare patients placed on observation stay
By
Josh Henreckson
Jan 02, 2024
Medicare patients initially admitted to hospitals as inpatients but later reclassified as outpatients under observation would finally have a process to appeal those decisions, thanks to a long-awaited...
Medicare Advantage plan settles upcoding allegations for $22.5M
By
Kimberly Marselas
Aug 02, 2023
A Medicare Advantage plan will pay $22.5 million to settle allegations that it systematically reviewed patient charts to tack on additional charges before submitting claims to Medicare, federal law enforcement...
Eli Lilly expects Medicare about-face on Alzheimer’s drugs coverage
By
Alicia Lasek
Apr 23, 2023
New data on Lilly’s experimental drug donanemab may influence CMS’s restrictive stance on coverage of this and other amyloid-busting Alzheimer’s treatments, a company executive says.
AHCA/NCAL to CMS: Safeguard temporary nurse aide jobs by reissuing employment waiver
By
Alicia Lasek
Oct 04, 2022
The industry advocate is urging CMS to reissue a blanket waiver that would allow nursing homes to employ temporary nurse aides beyond the public health emergency.