Providers rip huge backlog of therapy claims reviews
By
James M. Berklan
Jan 01, 2014
A provider-sponsored survey recently uncovered huge backlogs of therapy claim reviews for beneficiaries who exceeded the Medicare Part B caps limits.
MedPAC focuses on rehab
By
James M. Berklan
Dec 01, 2013
The Medicare Payment Advisory Commission could be getting closer to formally recommending more uniform payments to skilled nursing facilities and inpatient rehabilitation facilities.
OIG finds ‘observation stay’ problems, calls for reform
By
James M. Berklan
Sep 01, 2013
Long-term care groups are among those hailing a federal study that raises critical questions about hospitals’ apparent over-use of “observation stay” designations for patients.
Fix flaws before changing nursing home pay: AHCA says
By
James M. Berklan
Aug 01, 2013
The Centers for Medicare & Medicaid Services should consider a higher market basket update for nursing homes due to improper calculations that could be costing providers, the American Health Care Association...
Case for bundled pay made
By
James M. Berklan
Jun 01, 2013
Large-scale bundling of government reimbursements is needed, say researchers who have studied the topic. Post-acute care was the fastest growing major healthcare spending category for government programs...
Feds limit Medicaid picks
By
James M. Berklan
Jan 02, 2013
While the administration has been flexible about numerous aspects of Medicaid expansion called for in the healthcare reform law, there is at least one thing that is not negotiable: States will not get...
Report: States headed for Medicaid funding upheaval
By
James M. Berklan
Aug 01, 2012
Regardless of whether states choose to expand Medicaid under healthcare reform law, they are facing huge fiscal crisis conditions, largely due to rising healthcare costs and government pension obligations,...
A post-acute common pay system possible, CMS says
By
James M. Berklan
Mar 01, 2012
Federal researchers believe a common evaluation and payment model for three types of post-acute care could be up and running in the not-so-distant future. The key might be patient acuity measures that...
Poll: IPAB best of options
By
James M. Berklan
Aug 02, 2011
In contrast to providers’ preference, more Americans want an independent payment board to make decisions about Medicare spending, rather than leaving the current system as is.
Washington owes Medicaid programs $4 billion, govs say
By
James M. Berklan
Aug 02, 2011
With federal lawmakers trying to figure out ways to cut expenditures, balance the budget and reduce the national deficit, funding to states — and healthcare providers in particular — has frequently...