Recently, the Centers for Medicare & Medicaid Services (“CMS”) released the results of a study of hospice general inpatient care (“GIP”) based on an analysis of Medicare Part A hospice claims for beneficiaries who received GIP in 2011. The intent was to identify suspected abuse of GIP in hospice inpatient facilities by hospice providers because this is the second most expensive level of hospice care. (more…)
Posts Tagged ‘snf’
CMS Releases Study of General Inpatient Hospice Care
Authored By: Todd J. Selby
FY 2014 Proposed Medicare Rate Would Increase SNF Reimbursement by $500 Million
Authored By: David W. Bufford
The Centers for Medicare & Medicaid Services will publish the proposed fiscal year (“FY”) Medicare payment rate in the Federal Register later today. Announced last week, the proposed rate includes a 2.3% market basket increase; however, a forecast error correction and other mandated adjustments will reduce the market basket increase to 1.4%. This will still result in an estimated $500 million increase in the aggregate payments to skilled nursing facilities during FY 2014. The complete proposed payment rate rule is available in the Federal Register. (more…)
Sequestration Cuts Impact Nursing Homes and Post-Acute Care Providers
Authored By: Todd J. Selby
In a transmittal issued on April 5, 2013, CMS provided guidance on survey activities that will be affected by the sequestration cuts. The transmittal provides guidance on several areas that will have an immediate and potentially negative effect on nursing homes and post-acute care providers. These changes will affect the survey process as conducted by the state survey agencies.
CMS Comments on Compliance, QAPI Regulations
Authored By: David W. Bufford
During yesterday’s Open Door Forum, Jeanette Kranacs, the Director of the Division of Institutional Post-Acute Care for the Centers for Medicare and Medicaid Services (“CMS”) commented that CMS will not be issuing instructions to surveyors on evaluating compliance and ethics programs until the regulations have been promulgated. CMS was required to have final regulations and various tools in place as of March 2012, but has not yet released any regulations on the ethics and compliance programs for skilled nursing facilities (“SNFs”). (more…)
Final Rule Published Regarding Nursing Facility Closure Requirements
Authored By: Todd J. Selby
On March 19, 2013, the Centers for Medicare & Medicaid Services’ (“CMS”) Final Rule regarding notification and relocation requirements for closing a long-term care (“LTC”) facility was published in the Federal Register.
Under the new requirements, 60 days prior to the closure of an LTC facility, the administrator must provide written notice to the following: (more…)
Details on MedPAC Report on SNFs
Authored By: David W. Bufford
The Medicare Payment Advisory Commission’s (“MedPAC”) recent Report to Congress included a chapter dedicated to skilled nursing facilities (“SNFs”), which MedPAC reports received $31 billion in Medicare reimbursement in 2011. Recently, SNFs have been under pressure from repeated reimbursement cuts; however, MedPAC’s analysis states that SNF reimbursement is adequate. (more…)
MedPAC Releases Report to Congress, Suggests Broad Reforms to Post-Acute Landscape
Authored By: David W. Bufford
The Medicare Payment Advisory Commission’s (“MedPAC”) March 25th Report to Congress outlines inefficiencies they believe exist in the post-acute world and lead to excessive Medicare payments to providers. MedPAC recommendations include Congress evaluate post-acute provider reimbursement and encourage use of the lowest cost mix of services necessary to achieve the best outcomes.
CMS Clarifies Delegation of Tasks by Physicians in Long-Term Care Facilities
Authored By: Todd J. Selby
The Centers for Medicare & Medicaid Services (“CMS”), in the March 8, 2013 Memorandum, issued new guidance specifying those tasks that can and cannot be delegated in skilled nursing facilities (“SNFs”) and nursing facilities (“NFs”). Physicians who improperly assign tasks to non-physician practitioners (“NPPs”) jeopardize the SNFs’ and NFs’ compliance with federal and state regulations, which potentially affects the facilities’ reimbursement.
CMS Expected to Postpone Compliance Program Enforcement
Authored By: David W. Bufford
The Centers for Medicare & Medicaid Services (CMS) has unofficially announced it will not be enforcing the upcoming March 23rd compliance program requirements until final regulations are published. As required under the Affordable Care Act, nursing facilities are required to have a compliance program in place by March 23, 2013. Despite ambiguity in the actual statute, which states a facility must have a compliance program in place “on or after” March 23rd, this is widely accepted in the industry as the date for the requirement to be effective. (more…)
CMS Proposes Extension on Automatic Sprinkler Requirements
Authored By: Todd J. Selby
In 2003, two fires in long-term care facilities resulted in 31 resident deaths. As a result of these two events, CMS analyzed the fire safety precautions in place in these facilities and determined that resident safety could be greatly improved by requiring that all long-term care facilities have automatic sprinkling systems installed throughout the buildings. Consequently, on August 13, 2008, CMS published a final rule that required all buildings with long-term care facilities must have automatic sprinkler systems installed throughout the facilities no later than August 13, 2013.
Topical Index
- Home Health (44)
- Hospice (40)
- Litigation and Risk Management (38)
- Long-Term Care (140)
- Medicaid/Medicare enrollment and regulatory compliance (70)