A six-year-old Medicare demonstration program that focuses on pre-approvals for power wheelchairs and other mobility devices will get new life this fall. Overall, 31 items were added to the program, according...
PPS comments are sought
By
James M. Berklan
Aug 09, 2017
Federal regulators have agreed to gather more comments from providers and others on the revision of new skilled nursing prospective payment system case-mix methodology.
Medicare appeals backlog to be fixed by 2020, HHS says
By
James M. Berklan
Dec 06, 2016
Federal health officials say tweaks to the system will enable them to eradicate a massive backlog of Medicare decision appeals in 2019. They made the prediction in a court brief filed in U.S. District...
Ask the Payment Expert about … expedited review
By
Patricia Boyer
Sep 04, 2015
The expedited review process was developed so a resident could quickly appeal the process if he or she disagreed when a facility decided that a resident is no longer covered under skilled services.
Providers challenge proposal that adjusts payments, care
By
John Andrews
Jun 05, 2015
Providers in the post-acute care sector seem to be united in wanting BACPAC to take a hike.
Ask the payment expert … about RACs
Apr 06, 2015
I thought the Recovery Audit Contractors were on hold, so why did I receive a request from our RAC for a Medicare Advantage resident?
RAC battles move forward
By
Amy Novotney
Apr 06, 2015
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...
Politicians pressure auditors to back down, paper claims
By
John Andrews
Feb 01, 2015
The prospects of politician intervention with Medicare audits has sparked some debate over whether elected officials are exerting undue influence, or simply defending providers’ rights against government...
Bill could gut scheduling
By
Kimberly Marselas
Sep 01, 2014
A Congressional proposal to provide low-wage hourly employees with more stability and workplace protections could hit nursing homes.
Extra audits clog and freeze Medicare appeals process
By
James M. Berklan
Mar 01, 2014
Providers who want to have an administrative law judge consider a Medicare claim appeal can save their breath and memos for now.