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...
With every SNF already under scrutiny, federal task force aims to cut healthcare spending, eliminate...
By
Jessica R. Towhey
Aug 30, 2023
A new task force from the US House Budget Committee will look at how to reduce healthcare spending, including ways to modernize healthcare and support access to care.
Bill to block staffing rule, other LTC measures to headline Congressional hearing
By
Kimberly Marselas
Apr 29, 2024
A bill that many providers view as the best bet to upend the federal nursing home staffing mandate finalized last week will get another hearing in Congress Tuesday.
OIG urges CMS to use claims to uncover abuse of Medicare patients
By
Kimberly Marselas
Nov 10, 2023
The Centers for Medicare & Medicaid Services has pledged to issue new guidance on resident abuse after a federal watchdog found the agency was failing to use claims data to spot potential cases of neglect...
As values shift, it’s time to add something back to nursing
By
Kimberly Marselas
Oct 24, 2023
It seems like everything these days requires a value proposition to be appealing. What can we add to an experience or a product to make it better and one-up the competition?
PEPPER’s pause doesn’t wipe out prospects for nursing home self-monitoring
By
Kimberly Marselas
Feb 06, 2024
Federal regulators have suspended a key tool used by some nursing homes for internal auditing, but experts cautioned providers not to let the stoppage hinder their compliance efforts.
CMS ‘naive’ about staffing minimum proposal details, professor claims
By
Jessica R. Towhey
Sep 20, 2023
The proposed federal staffing rule is “shockingly low” and will not measurably improve working and care conditions in nursing homes, consumer advocates claimed during a webinar that was conducted without...
Biden’s regulatory Death Star
By
Brendan Williams
Sep 11, 2023
Despite federal data showing that the COVID-19 pandemic contributed to massive job losses for nursing and residential care facilities – with the workforce 218,200 workers smaller last month...
CMS official to providers: Help us capture data to drive Medicare Advantage reforms
By
James M. Berklan
Mar 07, 2024
The increased use of health data and providers’ own voices should be considered among the best tools available for achieving change in a system that increasingly relies on Medicaid Advantage and other...
Experts fear ‘bigger, stronger stick’ in new Medicare pay rule
By
James M. Berklan
Apr 01, 2024
Nursing home stakeholders are reacting with contempt and concern to key provisions of the newly proposed fiscal 2025 Medicare Part A pay rule.