Protect LTC from unintended consequences of drug pricing reform
By
Alan G. Rosenbloom
May 03, 2019
Policymakers should ensure that any approach to restructure manufacturer rebates shares savings with pharmacies and prevents insurers, PBMs or manufacturers from shifting their losses downstream.
Fines, fines, fines… we are not fine
By
Jessica Curtis
Jan 10, 2022
Record instances and dollar amounts of fines to skilled nursing facilities just made public last month highlight the tense regulatory environment operators are managing through. Despite federal “provider...
SNFs face troubling trend following Golden Gate decision
By
Nancy Reynolds, Esq.
Nov 26, 2018
Skilled nursing facilities and other long-term care establishments are finding their advertising claims under fire as plaintiffs use state consumer protection statutes to lodge malpractice claims against...
The plight of the immigrant workforce: A moral dilemma of the current LTC environment
By
Moroni Fernandez Cajavilca
Jan 22, 2024
The long-term care industry has supported increasing the number of immigrant workers as a solution to the nationwide staffing shortages but has largely ignored the potential exploitative environment of...
To help elderly patients, CMS should prohibit PBM fees – not reform them
By
Alan G. Rosenbloom
Feb 16, 2018
Over just the past few years, the nation’s three largest pharmacy benefit managers (PBMs) – CVS Caremark, Express Scripts and Optum Rx – have come to control more than 80% of prescriptions...
Berwick stresses need to lower healthcare costs, improve quality
Nov 18, 2010
Dr. Donald Berwick, administrator of the Centers for Medicare & Medicaid Services, during testimony to the Senate Finance Committee Wednesday, touted several provisions in the healthcare reform law.
Payment reform: Ready! Set! Don’t go! No, I mean go!
By
Steven Littlehale
Apr 23, 2018
Perhaps you think that the new therapy-payment bombshell (RCS-1) has turned out to be a dud. I hope to make the point that it was not.
The importance of data accuracy
By
Steven Littlehale
Apr 10, 2013
Has a day gone by when you haven’t heard about a new healthcare reform requirement coming of age? This month skilled nursing facilities were supposed to have started having an operational compliance...
OIG signals new focus on nursing homes
By
Neville M. Bilimoria
Feb 17, 2023
The federal Office of Inspector General recently published its “OIG’s Top Unimplemented Recommendations: Solutions To Reduce Fraud, Waste, and Abuse in HHS Programs.” In the 94-page document,...
What’s in a name?
By
Tara Roberts
Mar 04, 2015
The new name of the American Coalition for Healthcare Claims Integrity is the Council for Medicare Integrity. Does that mean they’ll change their focus? Not quite.