Articles and Blogs

Long-Term Care, Home Health & Hospice

OIG: Expand Oversight and Reduce Incentives to Hospices Focusing on Nursing Facility Residents

[07/22/11]

Posted on July 22, 2011 in Long-Term Care, Home Health & Hospice

Written by: Kendra Conover

Recently, the Office of Inspector General (“OIG”) published a report of its findings pertaining to the nearly 70% growth of Medicare spending for hospice care provided to nursing facility (“NF”) residents from 2005 – 2009.  During that time, Medicare spending on hospice care for residents in NFs increased sixty-nine percent (69%) from $2.55 billion to... READ MORE

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Medicare Issues Therapy Billing Guidance

[07/21/11]

Posted on July 21, 2011 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

Effective August 1, 2011, the Centers for Medicare & Medicaid Services (CMS) is implementing two (2) significant changes affecting skilled nursing facilities (SNFs) and hospital swing-bed providers billing for Part A claims.  The changes include the following: 1.         Any Part A claim reporting an End of Therapy Other Medicare Required Assessment must include Occurrence... READ MORE

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Michigan Begins Medicaid Estate Recovery

[07/08/11]

Posted on July 8, 2011 in Long-Term Care, Home Health & Hospice

Written by: Fahey, Sean J.

Michigan’s Department of Community Health will enforce Michigan’s Medicaid Asset Recovery Act (MCL Sec. 400.112g) with efforts starting July 1, 2011.  Michigan may file claims in the probate estates of individuals age 55 or older who received Medicaid benefits that paid for long term care services after September 30, 2007.   Michigan’s claim would seek... READ MORE

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CMS Issues Revised CMS-855A

[07/07/11]

Posted on July 7, 2011 in Long-Term Care, Home Health & Hospice

Written by: Brian D. Jent

Effective July 2011, the Centers for Medicare & Medicaid Services (CMS) adopted a revised Medicare Enrollment Application – Institutional Providers CMS-855A (CMS-855A).  Some of the more significant changes include a couple of additonal documentation requirements, significant changes to the ownership disclosure requirements, and an attachment for Physician-Owned Hospitals. The CMS-855A has been significantly reformatted which... READ MORE

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Hospice Contracts With Assisted Living Facilities

[07/07/11]

Posted on July 7, 2011 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

When the new hospice Conditions of Participation (CoPs) became effective in Decmeber of 2008 there was a provision in the CoPs stating a hospice must have an agreement with a nursing home if the hospice provides services in the nursing home.  While it was a standard business practice for hospices to have agreements with nursing homes prior... READ MORE

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Some Long-Term Care Facilities Exempt from Movie Licensing Fees under Agreement

[07/06/11]

Posted on July 6, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Motion Picture License Corporation (MPLC) has reached an agreement with long-term care advocacy groups to exempt certain facilities from licensing fees when showing movies for residents. Under the United States Copyright Act, a “public performance” of copyrighted materials, including movies, traditionally requires a separate license.  The MPLC has reached an agreement with the... READ MORE

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Updates to Hospice Face-to-Face Encounters

[07/01/11]

Posted on July 1, 2011 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

In response to the changes contained in the Patient Protection and Affordable Care Act (ACA) designed to address increasing lengths of stay in hospice programs, CMS added a “face-to-face encounter” requirement to the hospice certification requirements. Effective January 1, 2011, a hospice physician or nurse practitioner must have a “face-to-face” encounter with each hospice... READ MORE

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Indiana Medicaid Estate Recovery – Indiana Ready to Get More Aggressive?

[06/29/11]

Posted on June 29, 2011 in Long-Term Care, Home Health & Hospice

Written by: Fahey, Sean J.

Recently, the Indiana State Department of Administration, on behalf of Indiana’s Family and Social Services Administration (FSSA), posted a Request for Proposals to contract with multiple attorneys for Indiana Medicaid estate recovery.  The Request for Proposals is at http://www.in.gov/idoa/proc/bids/rfp-11-84/ .  It appears Indiana plans to get much more aggressive in Medicaid estate recovery, including... READ MORE

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Indiana Enacts Uniform Adult Guardianship and Protective Proceedings Act

[06/24/11]

Posted on June 24, 2011 in Long-Term Care, Home Health & Hospice

Written by: Fahey, Sean J.

Indiana recently enacted the Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act (the “Act”).  The Act is effective July 1, 2011, and is designed to eliminate multi-state jurisdictional issues and “Granny snatching” cases.  The Act is located in Indiana Code 29-3.5. Typically, the fact pattern arises when (1) an Indiana older adult resident visits... READ MORE

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