Ask the payment expert … about quality and reimbursement correlations
By
Patricia Boyer
Jun 01, 2013
How can the Centers for Medicare & Medicaid Services correlate quality of care and reimbursement?
You always need to remember that Medicare is an insurance plan. As such, Medicare has rules, just like...
Providers refocus on 15% drug reduction
By
Tim Mullaney
Jun 01, 2013
Skilled nursing providers fell short of reaching a 15% reduction in off-label antipsychotic use by the end of 2012, the American Health Care Association formally announced last month. However, AHCA did...
CMS to revise audit practices
By
John O'Connor
Jun 01, 2013
Here’s the good news for providers dealing with Recovery Audit Program contractors: The federal government will make fewer additional document requests, starting this month. Now the not-so-good news:...
Forecast error costs SNFs $320 million
By
James M. Berklan
Jun 01, 2013
The nation’s skilled nursing facilities can expect an aggregate $500 million boost in Medicare payments next year — $320 million less than the Centers for Medicare & Medicaid Services proposed.
Things heating up in case of the runny eggs
By
John O'Connor
Jun 03, 2013
Looks like CMS and nursing home inspectors have more than a little egg on their face, thanks to a recent circuit court ruling in favor of a wrongly accused operator.
CMS updates survey guidelines for antipsychotic drugs in dementia care
By
McKnight's Staff
May 31, 2013
The Centers for Medicare & Medicaid Services has updated survey guidelines regarding nursing homes’ use of antipsychotic medications for dementia care. The 59-page interim guidance revises Appendix...
Government officials face increased pressure over troubled dual-eligible initiative
By
McKnight's Staff
May 31, 2013
A long-criticized project to improve the healthcare delivery and payment system for people eligible for both Medicare and Medicaid has again been under fire in recent days, prompting government officials...
Care plans and discharge planning: Steps for success!
By
Lisa Thomson
May 29, 2013
Let’s take a look at the facility policies and procedures to determine that they include how the facility will ensure that the care plans are developed using resident individualized assessment information,...
CMS: Providers may need to reimburse beneficiaries due to inaccurate therapy denial codes
By
McKnight's Staff
May 24, 2013
Therapy providers should review therapy cap denials for 2013 and refund any beneficiary payments for these services, according to a Medicare newsletter released Thursday.
The G-codes are here for payment claims — ready or not
By
Shelly Mesure, MS, OTR/L
May 23, 2013
Effective July 1, the Centers for Medicare & Medicaid Services will begin rejecting claims received for Medicare Part B patients that do not include the new requirement of G-coding. That really means providers...