A new federal review process designed to lower the rate of improper government payments is sending provider staffs scurrying to justify their coding.
Latest MDS update could leave providers in ‘limbo,’ expert says
By
Danielle Brown
May 19, 2020
The Centers for Medicare & Medicaid Services has updated MDS 3.0 items (version 1.17.2) along with related technical data specifications. But providers could be left in “limbo” as they await for more...
CMS leaning on providers to form new PDPM pay rates
By
Danielle Brown
Sep 16, 2021
The Centers for Medicare & Medicaid Services is relying on data metrics regarding trends or changes in provider behavior, payments and beneficiary care quality as it considers potential adjustments to...
More than half of nursing homes missing out on PDPM, could lead to deals: expert
By
James M. Berklan
Jan 25, 2021
The federal government’s second-year Medicare payment system for nursing homes continues to be a boon for them, especially under pandemic conditions, but more than half are missing rightful reimbursements.
Keeping workers will be biggest struggle for nursing homes as pandemic persists, national policy expert...
By
Danielle Brown
Sep 30, 2020
Workforce challenges that have plagued long-term care operators during the coronavirus pandemic will get worse as the crisis further progresses this year, one of the nation’s top health policy analysts...
‘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.
CMS changes PDPM website, says new RAI manual to be delivered early
By
Marty Stempniak
Feb 15, 2019
After receiving a barrage of feedback, the Centers for Medicare & Medicaid Services is updating its new website for the Patient-Driven Payment Model, and touting a quick release for a much-anticipated...
Ask the payment expert … about MDS payment implications
By
Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT
Sep 12, 2023
Q: Are changes to the Patient Driven Payment Model expected with the revised MDS in October?
Higher facility assessment fees would fund measures to improve staffing, reduce resident density
By
Danielle Brown
May 24, 2021
Illinois lawmakers are looking to increase assessment fees paid by nursing homes in order to fund a proposed law that aims to change the way providers are reimbursed in a push to reduce understaffing and...
Providers ‘on notice’ as CMS pressures states to shift Medicaid pay metrics
By
Kimberly Marselas
Nov 10, 2022
Providers still struggling to accurately capture diagnoses that drive federal reimbursement will be doubly left behind as more states start to use Patient Driven Payment Model-like systems to determine...