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therapy

Revised RAI Manual Effective October 1

[10/02/13]

Posted on October 2, 2013 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The most recent revisions to the Resident Assessment Instrument (“RAI”) User’s Manual became effective yesterday for all assessments with an assessment date on or after October 1.  The significant portion of the revisions addresses changes to therapy coding and swallowing and nutrition.   READ MORE

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CMS Releases FY 2014 SNF PPS Rates, Updates Therapy Day Reporting Requirements

[08/05/13]

Posted on August 5, 2013 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Centers for Medicare & Medicaid Services (“CMS”) recently released the final rule for fiscal year (“FY”) 2014 skilled nursing facility (“SNF”) prospective payment system (“PPS”) rates.  These rates will take effect October 1, the start of FY 2014.   READ MORE

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Details on MedPAC Report on SNFs

[03/19/13]

Posted on March 19, 2013 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

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.   READ MORE

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Providers Face Greater Risk of Claim Denial Under New PPS Rules

[10/10/11]

Posted on October 10, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

Effective October 1, new PPS rules for fiscal year 2012 require nursing homes to diligently review claims prior to submission.  As previously discussed, significant cuts in SNF reimbursement are aimed mostly at therapy services.   SNFs submitting claims under the previous rules can expect high rates of denials and rejections.  Even facilities billing under the new... READ MORE

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What Risk Categories Mean to Providers and Suppliers

[08/13/11]

Posted on August 13, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

Earlier this week, we highlighted the implementation by Centers for Medicare & Medicaid Services (CMS) of enrollment revalidations and screening categories, and which categories CMS places certain long-term care providers. It is important for providers and suppliers to understand what each screening category (limited, moderate, or high) entails and be aware of any events... READ MORE

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Medicare to Cut $3.87 Billion in Skilled-Nursing Facility Pay

[07/29/11]

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

Written by: Bufford, David W.

Effective fiscal year (FY) 2012, The Centers for Medicare & Medicaid Services (CMS) final rule on Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2012, released July 29, reduces Medicare skilled nursing facility (SNF) Prospective Payment System (PPS) payments by 11.1%. CMS states this action was taken to “better align... 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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