Latest therapy-billing showdown could be ominous sign for long-term care providers
By
James M. Berklan
Sep 10, 2014
Don’t let anyone tell you that long-term care operators don’t know how to read between the lines. They might not have known to fear a McKnight’s Monday news item before it broke, but...
Provider payment adjustments coming — this time without the indictments
By
James M. Berklan
Apr 30, 2021
Could it be that federal regulators and the caregivers they oversee are becoming more civil to one another?
‘Special’ times ahead for more nursing homes, and that’s not good
By
James M. Berklan
May 28, 2014
As spring blends into summer, some nursing home operators are going to start feeling more heat — and it will have nothing to do with the weather. They will be given places on the proverbial hot seat....
Looking to open eyes about ‘observations’
By
James M. Berklan
May 01, 2013
Bully for provider groups pulling out the stops to draw attention to the ludicrous mishandling of “observation stay” designations by many hospitals. One prong of the plan is to have providers...
Ready or not: The MDS is changing again!
By
Shelly Mesure, MS, OTR/L
Sep 25, 2013
On Oct. 1, the Centers for Medicare & Medicaid Services will be updating the Minimum Data Set with another round of changes. Most are minor but there will be two changes to the therapy section. Your case-mix...
50 shades of G-coding
By
Shelly Mesure, MS, OTR/L
Jul 02, 2013
Sorry, ladies, I didn’t mean to get your hopes up with that title. But does anyone else feel like there is a lot of ambiguity to the new G-Coding system? Well, it’s a little too early to tell...
The G-codes are here for payment claims — ready or not
By
Shelly Mesure, MS, OTR/L
May 23, 2013
Effective July 1, the Centers for Medicare & Medicaid Services will begin rejecting claims received for Medicare Part B patients that do not include the new requirement of G-coding. That really means providers...
Has CMS gone too far?
By
Shelly Mesure, MS, OTR/L
Sep 27, 2011
Previously, I’ve explained my position on the new rehab regulation changes to take effect on Saturday (Oct. 1). However, has CMS gone too far this time?
CMS ‘overpayment’ rule may come at a greater cost
By
Glenn P. Hendrix
May 02, 2012
The Centers for Medicare & Medicaid Services recently issued a proposed rule addressing how it will implement the 60-day deadline for returning overpayments made to federal health programs. If fully adopted,...
CMS did more than ‘just’ cut Medicare pay by 11.1%
By
Shelly Mesure, MS, OTR/L
Aug 19, 2011
Have you started your COT trending analysis? On Aug. 8, the Centers for Medicare & Medicaid Services released the final ruling and commentary for the new implementation of the MDS changes set to take effect...