Obama sending mixed message on Medicare prescription prices
Apr 30, 2015
Prescription drug prices are likely to resurface as a hot political potato in the looming presidential race, beginning with the president’s recent bombshell that he wants to let Medicare bargain...
RAC groups battle provider plea for short-stay payment relief
By
John Hall
Feb 19, 2015
Third-party firms that audit Medicare bills for payment issues are pushing back hard against a hospital association plea for more favorable short-stay reimbursements, adding to the ongoing unwelcome specter...
Obtaining critical claims data may soon get easier
By
John O'Connor
Jun 05, 2015
The government plans to make new claims data and other resident-care information available to providers and entrepreneurs as never before. Is it too good to be true?
‘Not a shock:’ MedPAC considering 5% pay cut for SNFs
By
Danielle Brown
Dec 14, 2021
The Medicare Payment Advisory Commission is leaning toward recommending a 5% pay cut for skilled nursing facilities in fiscal 2021 after a new report found that Medicare margins may indicate SNF pay rates...
Federal court opens door for nursing homes to challenge Medicare, Medicaid rules
By
Danielle Brown
Apr 30, 2021
Providers may challenge rules and regulations established by federal agencies that they believe violate the Medicare and Medicaid Acts, thanks to a ruling this week by a federal court.
Loophole allows low volume Medicare providers exemption from auditing
By
Kristin Walter
Dec 15, 2017
The current implementation of Medicare’s sliding scale ADR limit policy is preventing the recovery of improper payments and has afforded a significant portion of providers with immunity from billing...
Stop the ‘siloed’ policy making for skilled nursing
By
Alan G. Rosenbloom
Mar 21, 2012
Last week, three reports issued by three separate government agencies made incongruent recommendations — or no recommendations at all — related to skilled nursing facility (SNF) patient care and policy....
Campaign 2012 boosted importance, value of nursing home care in public policy dialogue
By
Alan G. Rosenbloom
Nov 12, 2012
Despite the customary complaints about negativity and the avalanche of TV ads, the 2012 campaign was unusually substantive from the standpoint of the entitlement reform discussion because both sides were...
The Jimmo scorecard and CMS compliance update
By
Steven Littlehale
Nov 25, 2014
In some ways, 2014 has been a monumental year. But it’s not over yet, especially with regard to Centers for Medicare & Medicaid Services steps regarding the historic Jimmo settlement agreement signed...
Of Purell and payment reform
By
Tim Mullaney
Apr 16, 2013
I was sympathetic when the Partnership for Sustainable Health Care called for a speedier shift away from fee-for-service last week — and I also thought about Purell. Yes, that Purell.