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 5-claim audits so far a ‘debacle’
By
Jessica R. Towhey
Aug 22, 2023
A new federal review process designed to lower the rate of improper government payments is sending provider staffs scurrying to justify their coding.
Consumer groups urge CMS to enforce nurse aide training enforcement initiatives
By
Josh Henreckson
Dec 19, 2023
For all its increased regulatory pressure on nursing homes in recent years, the Centers for Medicare & Medicaid Services hasn’t fully embraced the Biden administration’s full agenda for long-term care....
CMS pledges to use ‘full array’ of tools to enforce 2024 Medicare Advantage rules
By
Josh Henreckson
Jan 12, 2024
Despite early fears, long-term care leaders have some reason to be optimistic that changes to Medicare Advantage rules for 2024 will be enforced.
Standard surveys continue to lag, with infection control a major tripwire
By
Kimberly Marselas
Oct 24, 2023
A year and a half after a federal watchdog blasted the Centers for Medicare & Medicaid Services over extensive delays in nursing home inspections, year-end data for fiscal year 2023 shows there has been...
Aging committee chair delivers another broadside about nursing home surveys
By
Jessica R. Towhey
Jul 28, 2023
A powerful US senator is bringing added firepower in his quest to fix what he sees as major issues with state surveys of nursing homes. It’s an effort that had one leading advocate channeling Alanis...
LTCH closures send more patients to nursing homes, but are they ready?
By
Kimberly Marselas
Nov 22, 2023
Shifting payment policies have decreased Medicare spending on patients requiring mechanical ventilation, but they also have led to the closure of many long-term care hospitals and have driven more patients...
Providers find few silver linings, stew over minimum staffing demands
By
James M. Berklan
Sep 05, 2023
The initial jolt of the newly proposed nursing home staffing mandate has softened little over the long holiday weekend and now those tasked with making it work — providers — are coming to grips with...
CMS must ‘ease burdens’ if it wants more long-stay residents in value-based care: report
By
Kimberly Marselas
Jan 29, 2024
The Centers for Medicare & Medicaid Services must do more to move states away from an “extremely bifurcated” Medicare and Medicaid system that sometimes leaves dually eligible beneficiaries confused...
Expect another Five-Star freeze amid nursing home survey delays, experts warn
By
Kimberly Marselas
Feb 20, 2024
Staffing measures used to calculate nursing homes’ federal ratings will freeze in April, further complicating a system based on often outdated and constantly changing metrics, experts warned last week.