Jimmo correction: Assistants may provide maintenance services in skilled nursing facilities
By
Tim Mullaney
Jan 17, 2014
Skilled nursing facilities may be reimbursed for maintenance therapy services performed by assistants, the Centers for Medicare & Medicaid Services clarified in a recent Medicare Benefit Policy manual...
CMS completes minimum staffing study; targeting ‘onerous’ MA authorizations
By
Kimberly Marselas
Jan 25, 2023
Two proposed rules should help patients improve their Medicare Advantage plan selections while standardizing expectations for skilled nursing and other healthcare providers, federal officials reiterated...
‘Death spiral’ for SNFs as Medicare Advantage pay decreases
By
Kimberly Marselas
Sep 06, 2022
Pressure to accept low-ball contracts with Medicare Advantage plans that continue to reduce reimbursement is driving some skilled nursing providers into “a death spiral,” a major aging services association...
‘Impossible’ Medicare Advantage denials decried during Senate hearing
By
Kimberly Marselas
May 18, 2023
A Senate subcommittee Wednesday sent letters to the nation’s largest Medicare Advantage insurers, demanding they reveal internal documents that illustrate how they make coverage determinations.
Analysts break ground with first batch of SNF Medicare Advantage data
By
James M. Berklan
Oct 11, 2021
Managed care plans typically hold all the cards when it comes to rate-setting. But a new way of analyzing billing data could finally give increasingly leveraged providers a better leg to stand on, financial...
MA plans pocket billions more by enrolling less-costly patients
By
Kimberly Marselas
Jun 16, 2023
Medicare Advantage plans may be receiving overpayments of as much as 20%, finds a new study published by a health and aging think tank.
Low-quality Medicare Advantage plans should expect scrutiny, CMS says
By
McKnight's Staff
Apr 13, 2012
Medicare Advantage plans with fewer than five stars on the quality scale should expect some form of audit, a Centers for Medicare & Medicaid official said this week.
CMS issues notice of sanctions to Medicare Advantage insurer
May 19, 2010
The Centers for Medicare & Medicaid Services this week informed Medicare Advantage insurer Quality Health Plans of its intent to impose intermediate sanctions and a civil monetary penalty (CMP) on the...
8.5% payment boost to Medicare Advantage plans ‘clear signal of support’ from CMS: expert
By
Danielle Brown
Apr 06, 2022
The 8.5% boost in average revenue slated for Medicare Advantage plans in 2023 is proof of the Centers for Medicare & Medicaid Services support of the program and could mean improved payment for post-acute...
Clinical briefs for Tuesday, March 21
By
Alicia Lasek
Mar 20, 2023
LeadingAge: MA program failures jeopardize health of nearly 30 million older adults … Behavioral health is crucial ingredient in new Michigan home care program … Patients prefer to see test results...