Adding to the ongoing controversy around Medicare’s Recovery Audit Contractor program, a judge has ruled that the government cannot award new RAC contracts until disputed payment terms are resolved.
Federal government needs to boost Medicaid managed care oversight, GAO says
By
Tim Mullaney
Jun 20, 2014
The government’s oversight of Medicaid managed care organizations is not strong, even though these entities cover about 50 million people and are growing rapidly, according to a recently released...
ACA objection by provider earns temporary injunction
By
Tim Mullaney
Feb 01, 2014
A Catholic long-term care provider and the federal government opposed each other in recent Supreme Court filings over the Affordable Care Act’s so-called “contraception mandate.”
AHCA announces legislative priorities and $1 million ad buy
By
Tim Mullaney
Sep 11, 2013
The nation’s largest long-term care provider association will advocate for site-neutral payments and other policies in a concerted effort to prevent further reductions in reimbursement, the American...
Proposed hospital payment measures do not consider post-acute care sufficiently, AHCA tells CMS
By
Tim Mullaney
Nov 26, 2014
A potential new Medicare payment measure for hip and knee replacements needs to be revised, or it could limit patients’ access to care, according to the American Health Care Association/National...
Draft bill proposes counting observation stays for SNF coverage, limiting RAC oversight
By
Tim Mullaney
Nov 24, 2014
Hospital observation stays would count toward establishing Medicare eligibility for post-acute services, under comprehensive reforms in a new draft bill from the House Committee on Ways and Means. The...
Government report describes bungled manual review process for therapy claims
By
Tim Mullaney
Jul 12, 2013
There was no timely guidance for therapy contractors from the Centers for Medicare & Medicaid Services, according to a recent report from the Government Accountability Office. That resulted in a struggle...
Misleading data on SNF margins threatens fruitful payment reform, Parkinson warns lawmakers
By
Tim Mullaney
Jul 03, 2013
Lawmakers may have an inaccurate understanding of skilled nursing facility margins based on outdated and partial information, the leader of the nation’s largest nursing home organization is cautioning....
Providers, CMS at odds over dual eligible program
By
Tim Mullaney
Nov 13, 2014
Some nursing homes and other providers are engaging in “bad behavior” by trying to persuade people to opt-out of a managed care demonstration project, a top government official recently claimed....
Increase managed care transparency, long-term care providers urge Senators
By
Tim Mullaney
Aug 18, 2014
The government should collect and release more claims information from managed care plans, the nation’s largest long-term care provider association stated in a recent letter to leaders of the Senate...