CMS let the cat out of the bag, but it’s managed care that’s ready to pounce
By
Kimberly Marselas
May 05, 2021
If you work with managed care (and who doesn’t anymore), chances are pretty good you’re already on a collision course that’s been accelerated lately
CMS eyeing PDPM case-mix additions, changes
By
Kimberly Marselas
Apr 24, 2023
Federal regulators are weighing changes to the three-year-old Patient Driven Payment Model to account for missed opportunities — and potentially inappropriate coding choices — a top Medicare official...
Medicare Advantage plans forcing providers to take ‘optional’ payment reductions
By
Kimberly Marselas
Nov 15, 2022
Many skilled nursing providers are still underusing Interim Payment Assessments under the nascent Patient Drive Payment Model, but one new pressure is driving some to submit those extra patient evaluations...
BREAKING NEWS: CMS gives skilled nursing 2.4% Medicare pay raise, unveils another new resident classification...
By
Kimberly Marselas
Apr 27, 2018
In a flurry of activity late Friday, the Centers for Medicare & Medicaid Services announced an $850 million pay raise for skilled nursing facilities for fiscal 2019 that comes along with major simplifications...
‘Audits are back,’ and COVID-19 care is in the hot seat
By
Kimberly Marselas
Apr 21, 2021
Flexibilities granted to providers during the ongoing public health emergency are likely to result in increased medical reviews and automated denials, a therapy billing specialist is warning.