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.
Skilled services 101: Understanding the medical appropriateness exception
By
Renee Kinder
Oct 07, 2021
In our industry, we have all read it numerous times. Some of us can quote portions of it in our sleep… three consecutive calendar days, for a condition that was treated during the qualifying hospital...
Four tips on making smarter purchasing decisions
By
Rich McKeon
Oct 31, 2014
Rising drug costs and declining reimbursements significantly impact profits, and long-term care pharmacies today have to do more with less.
Medicare should pay for skilled nursing services without a qualifying hospital stay, experts tell Senators
By
Tim Mullaney
Jul 31, 2014
The time has come to eliminate hospital stay requirements for beneficiaries to qualify for Medicare coverage of skilled nursing services, experts told a Senate committee Wednesday.
CMS announces Medicare appeals without administrative law judge hearings
By
Tim Mullaney
Jul 07, 2014
Long-term care providers will be able to appeal certain Medicare claims decisions without going through an administrative law judge hearing, the Office of Medicare Hearings and Appeals (OMHA) announced...
Charges that Omnicare forgave nursing providers’ debts as a form of kickbacks can proceed, judge...
By
Tim Mullaney
Jun 17, 2014
A whistleblower can pursue charges that long-term care pharmacy Omnicare ignored skilled nursing companies’ overdue bills in exchange for certain kinds of business, a federal district court recently...
June 3 Super Tuesday webinar: why you need to pay attention to PEPPER reports
May 22, 2014
Providers will learn how the government’s PEPPER reports are connected to their facilities’ health during a June 3 McKnight’s Super Tuesday webcast. Featured speaker Leah Klusch, the...
Five LTC commissioners issue full alternative report
By
Tim Mullaney
Sep 24, 2013
Five members of the Congressional Commission on Long-Term Care have released a full report, providing an alternative to the commission report released last week. The five commissioners split with nine...
CMS widens audits, hones in on Part A claims, expert says
By
James M. Berklan
Jun 01, 2013
The Centers for Medicare & Medicaid Services has increased its scrutiny of Medicare Part A filings recently and as a result, has reclaimed more funds than ever from providers, a long-term care compliance...
Medically Complex Medicare Part B
By
Shelly Mesure, MS, OTR/L
May 08, 2013
While CMS tries to figure out how to proceed with the manual medical review process, we continue to track our caps and apply our modifiers. In the meantime, has anyone noticed how our typical Medicare...