CMS officials have delivered an early gift to help providers like you map out where they should focus their compliance efforts — not just for 2024, but for 2025 as well.
Nursing homes become ‘high-risk,’ owners to be fingerprinted under new doc pay rule proposal
By
Kimberly Marselas
Jul 08, 2022
Nursing home owners could face heightened background screening requirements under a proposal tucked more than 1,000 pages into a huge new proposed physician pay rule released Thursday.
Another reason for nursing home envy
By
James M. Berklan
Jul 07, 2022
Whether they’re teammates or rivals, nursing homes and hospitals should ever pass up a chance to learn from one another.
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.
‘Death spiral’ for SNFs as Medicare Advantage pay decreases
By
Kimberly Marselas
Sep 06, 2022
Pressure to accept low-ball contracts with Medicare Advantage plans that continue to reduce reimbursement is driving some skilled nursing providers into “a death spiral,” a major aging services association...
Providers suffering Medicare appeals backlog — at their own hand?
By
James M. Berklan
Apr 29, 2015
If providers were charged a fee for challenging Recovery Audit Contractor findings, there wouldn’t be the current overwhelming backlog of Medicare appeals, says the administration — and, surprise,...
Reducing errors
By
Kimberly Marselas
Sep 04, 2015
Experts warn that common MDS mistakes still plague many providers, threatening the bottom line and resident care. But software may hold the solution.
Why LTC operators should care about anti-kickback statute trends
By
Richard Cheng
Feb 12, 2016
Skilled nursing facility operators should pay close attention to anti-kickback statutes trends because enforcement is evolving and the issues can affect providers greatly.
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.
‘Incomplete’ oversight lets Medicaid managed care denials go largely unchecked: MACPAC
By
Kimberly Marselas
Sep 22, 2023
While much of the outrage around managed care denials has been directed toward Medicare Advantage plans, a federal advisory panel Thursday outlined policies that could force states to better track denials...