House committee approves bill that would reform prior authorization under Medicare Advantage program
By
Danielle Brown
Jul 29, 2022
Providers demanding change to the Medicare Advantage program may soon get their wish after a House panel advanced a measure that would reform the program’s prior authorization process.
Lots to learn with new Five-Star
By
Steven Littlehale
Jul 22, 2022
On a recent flight, I sat next to an attorney whose principal focus was compliance. It turned out that we were both on our way to speak at events in the same popular Florida conference destination. She...
Ancillary services drove complex deal in major CommuniCare expansion
By
Kimberly Marselas
Jul 21, 2022
Adding ancillary services is widely viewed as a way for nursing home operators to layer in sustainability. When it comes time to sell, those related companies and their revenue diversification can draw...
Nursing home funding: Worth a closer look
By
Kimberly Marselas
Jul 19, 2022
The current nursing home funding system overlooks a simple fact: Living in a beautiful, updated home makes people feel better.
LTC: Seize on opportunity as senators support palliative care access
By
Allison Silvers
Jul 15, 2022
On June 17, 2022, Senators Rosen (D-NV), Barrasso (R-WY) and Fischer (R-NE) sent a letter to the Center for Medicare & Medicaid Innovation (CMMI) asking it to support access to palliative care wherever...
Providers warned not to interfere with resident healthcare coverage choices after $8 million settlement
By
Danielle Brown
Jul 13, 2022
The nation’s largest nursing home association is urging providers to properly educate staff on acceptable practices when it comes to discussing changes to residents’ healthcare coverage in order to...
CMS doubles down: Surveyors do not have to be COVID vaccinated
By
James M. Berklan
Jul 07, 2022
The Centers for Medicare & Medicaid Services has held audiences with skilled nursing providers, made presentations and entertained comments in recent months to assure operators that regulatory actions...
Disenrolling residents from MA plans leads to $7.85 million provider settlement with feds
By
Danielle Brown
Jul 01, 2022
A New York-based provider is settling allegations that it switched resident’s Medicare coverage to maximize its reimbursements for nearly $8 million.
Two sheets to the win
By
Gary Tetz
Jun 30, 2022
Infinite call-center wait times. Delivery mix-ups and delays. Rude responses to reasonable requests. Promises unfulfilled. I hear there’s a cutting-edge business principle called “the customer is always...
Federal officials keep heat on MA plans over denials, delays
By
Danielle Brown
Jun 30, 2022
Congressional lawmakers are being urged to address weaknesses in Medicare Advantage plans in response to a federal watchdog report that found that the MA organizations have often improperly denied or delayed...