Lawmakers say CMS should ban Medicare Advantage’s use of AI to deny care
By
Josh Henreckson
Jun 26, 2024
The Centers for Medicare & Medicaid Services should consider banning artificial intelligence from being used to deny Medicare Advantage coverage pending a “systematic review,” a group of 49 congressional...
CMS sends update on $75M nursing home recruitment campaign, but providers’ concerns linger
By
Josh Henreckson
Jun 13, 2024
CMS’ admitted lack of a plan thus far for the $75 million it intends to use to spur development of more nursing home workers is further puncturing providers’ hopes for helpful change.
Bill to block staffing rule, other LTC measures to headline Congressional hearing
By
Kimberly Marselas
Apr 29, 2024
A bill that many providers view as the best bet to upend the federal nursing home staffing mandate finalized last week will get another hearing in Congress Tuesday.
CMS provides first look at shorter, Risk-Based Survey process
By
Kimberly Marselas
Apr 04, 2024
The Centers for Medicare & Medicaid Services on Wednesday revealed initial information about a potential “Risk-Based Survey” option that could be available to some of the nation’s best performing...
Experts fear ‘bigger, stronger stick’ in new Medicare pay rule
By
James M. Berklan
Apr 01, 2024
Nursing home stakeholders are reacting with contempt and concern to key provisions of the newly proposed fiscal 2025 Medicare Part A pay rule.
CMS delivers providers payment lifelines in the wake of Change Healthcare outage
By
Josh Henreckson
Mar 12, 2024
Federal regulators are opening pathways to shore up nursing homes’ finances in the wake of a cyberattack that has impacted Medicare and Medicaid billing nationwide.
CMS official to providers: Help us capture data to drive Medicare Advantage reforms
By
James M. Berklan
Mar 07, 2024
The increased use of health data and providers’ own voices should be considered among the best tools available for achieving change in a system that increasingly relies on Medicaid Advantage and other...
PEPPER’s pause doesn’t wipe out prospects for nursing home self-monitoring
By
Kimberly Marselas
Feb 06, 2024
Federal regulators have suspended a key tool used by some nursing homes for internal auditing, but experts cautioned providers not to let the stoppage hinder their compliance efforts.
With ‘hundreds’ of facilities audited over schizophrenia, CMS pursues harsher antipsychotics stance
By
Kimberly Marselas
Jan 19, 2024
With half of nursing homes audited in a new process admitting to misdiagnosing schizophrenia patients, the Centers for Medicare & Medicaid Services is extending its drive to reduce the use of certain drugs...
CMS finalizes long-awaited prior authorization rule for Medicare Advantage
By
Josh Henreckson
Jan 18, 2024
A new rule on Medicare Advantage prior authorization finalized by the Centers for Medicare & Medicaid Services Wednesday suggests good news for providers and Medicare recipients.