Medicaid termination doesn’t always cross state lines: OIG
By
Elizabeth Newman
Sep 04, 2015
Twelve percent of providers terminated from a state Medicaid program continued participating in other states, a new government study has found.
Ask the payment expert … about RACs
Apr 06, 2015
I thought the Recovery Audit Contractors were on hold, so why did I receive a request from our RAC for a Medicare Advantage resident?
Data expert lays bare PDPM myths, truths, observations
By
James M. Berklan
Apr 04, 2019
The Patient-Driven Payment Model is the biggest overhaul of nursing home reimbursement in at least a generation, but it is only a temporary fix, cautioned an expert at the recent National Investment Center...
CMS fact sheet gives rules on ‘maintenance’ caregiving
By
James M. Berklan
May 01, 2013
The Centers for Medicare & Medicaid Services has issued a fact sheet, that clarifies the conditions the terms under which “maintenance therapy” will be covered by Medicare.
Verma: Some alternative pay models should be mandated
By
James M. Berklan
Jun 06, 2019
Making new Medicare payment models mandatory is crucial to avoid “selection effects,” where only providers who benefit financially from a model participate, reducing potential savings, said Medicare...
ACOs save on backs of SNFs
By
Marty Stempniak
Apr 08, 2018
Providers taking part in a Medicare experiment saved money by funneling care away from skilled nursing facilities and toward physician services, according to a new analysis.
Therapists’ value extolled
By
James M. Berklan
May 01, 2019
Controversy emerged when a panelist representing therapists asserted to a crowd of about 1,300 at the joint AANAC/AADNS meeting that “your therapist is the most highly educated person in the building”...
Pay switch costs a bundle
By
James M. Berklan
Nov 02, 2018
Total episode payments declined but the Medicare program lost big from 2013 to 2016 with Bundled Payments for Care Improvement. The total cost was nearly $290 million. Model 2, the most commonly used track...
Poll: IPAB best of options
By
James M. Berklan
Aug 02, 2011
In contrast to providers’ preference, more Americans want an independent payment board to make decisions about Medicare spending, rather than leaving the current system as is.
CMS plan to target CCRCs
By
James M. Berklan
Feb 02, 2020
A new federal proposal effectively proposing new Medicaid taxes could lead to the closure of some skilled nursing units in continuing care retirement communities in 18 states, according to provider advocates.