CMS should publicly push Congress to reform therapy payment system, long-term care provider association...
By
Tim Mullaney
Sep 09, 2014
The Centers for Medicare & Medicaid Services should openly urge Congress to change the way therapy services are reimbursed, the nation’s largest long-term care provider association stated in recent...
Federal judge blocks new RAC contracts
By
Tim Mullaney
Sep 04, 2014
Adding to the ongoing controversy around Medicare’s Recovery Audit Contractor program, a judge has ruled that the government cannot award new RAC contracts until disputed payment terms are resolved.
CMS announces Medicare appeals without administrative law judge hearings
By
Tim Mullaney
Jul 07, 2014
Long-term care providers will be able to appeal certain Medicare claims decisions without going through an administrative law judge hearing, the Office of Medicare Hearings and Appeals (OMHA) announced...
Federal government needs to boost Medicaid managed care oversight, GAO says
By
Tim Mullaney
Jun 20, 2014
The government’s oversight of Medicaid managed care organizations is not strong, even though these entities cover about 50 million people and are growing rapidly, according to a recently released...
Proposed Life Safety Code updates encourage more homelike environments
By
Tim Mullaney
Apr 15, 2014
Updated fire safety regulations could encourage more home-like healthcare environments while increasing security to safeguard against wandering, according to a proposed rule announced Monday.
CMS budget defines nursing home quality targets, requests an additional $50 million for surveys
By
Tim Mullaney
Mar 12, 2014
The Centers for Medicare & Medicaid Services’ proposed budget for fiscal year 2015 requests additional funds for survey activities and lists the agency’s targets for nursing home quality measures.
Long-term care groups applaud a pause in Medicare audits, urge permanent changes
By
Tim Mullaney
Feb 21, 2014
Long-term care stakeholders are praising the government’s decision to temporarily pause the recovery audit contractor program, which is associated with a huge backlog of Medicare claims appeals.
Overdocumentation and cloning in electronic health records are overlooked risks, investigators say
By
Tim Mullaney
Jan 09, 2014
Auditors reviewing Medicare and Medicaid claims from electronic health records are largely treating them in the same manner as paper claims, even though they pose unique risks for overbilling and fraud,...
CMS fails to measure outcomes of the zone program integrity contractor program: government report
By
Tim Mullaney
Nov 26, 2013
The Centers for Medicare & Medicaid Services is not thoroughly assessing how well zone program integrity contractors are contributing to Medicare anti-fraud efforts, according to a new report from the...
Nursing homes will be subject to escrow for all civil monetary penalties, CMS announces
By
Tim Mullaney
Sep 05, 2013
Nursing homes facing a civil monetary penalty due to any type of deficiency will be subject to escrow and entitled to request an independent informal dispute resolution process, according to a newly issued...