The debate over whether Recovery Audit Contractor audits are an incentive-laced system of provider harassment or a necessary tool to redistribute misspent Medicare funds continues. Neither side appears...
Dreaded MFAR withdrawn
By
James M. Berklan
Oct 01, 2020
Providers got their wish in mid-August when the Centers for Medicare & Medicaid Services announced it was rescinding a controversial proposal that would have cut up to $50 billion annually nationwide from...
Providers fret bundled pilot
By
John Hall
Nov 05, 2015
Provider advocates generally accept a proposal to bundle Medicare payments for one of the most common orthopedic procedures, but many believe the plan is being rushed while serious concerns about issues...
Interoperability pressured
By
John Andrews
May 08, 2015
Congress is getting more involved in healthcare interoperability. Lawmakers have proposed legislation calling for changes to the process in order to speed up and broaden provider inclusion by the end of...
Hospice billings changed
By
Tim Mullaney
Oct 01, 2014
The Centers for Medicare & Medicaid Services recently updated instructions on coding hospice claims. Billing staffs should be aware of these changes, which went into effect Oct. 1, CMS stated in a memorandum...
MDS insight found lacking
By
James M. Berklan
Apr 01, 2014
Long-term care staffers’ understanding of the Minimum Data Set and its Quality Indicators is “mediocre at best,” according to recent survey results. Lack of exposure and involvement are...
MFP funding pressure builds
By
James M. Berklan
Feb 08, 2018
The National Council on Aging sounded alarm bells in early January, warning that the 12-year-old Money Follows the Person Medicaid program could soon run out of funding. The program promotes greater access...
Rise in improper payments
By
John Hall
Jan 04, 2016
Improper payment levels continue dogging the Centers for Medicare and Medicaid Services, which announced they rose significantly last year for both health programs. Additionally, the agency reported that...
Back pay total: $261,000
By
James M. Berklan
Oct 17, 2019
Shoddy bookkeeping and pay practices have cost a New York City-based nursing home operator more than $261,000. An investigation by the U.S. Department of Labor Wage and Hour Division found that three Centers...
Budget offers pay concerns
By
James M. Berklan
Mar 08, 2018
Even though a new, unified payment system has been discussed for several years, the mere mention of it in President Trump’s budget proposal jolted observers in February. The budget specifically said...