Articles and Blogs

In November 2011, the Office of Inspector General (“OIG”) initiated a study regarding the use of atypical antipsychotic drugs in nursing homes.  The findings from the study indicated these types of drugs were being overprescribed to high-risk nursing home residents suffering from dementia; were being prescribed for uses not approved by the FDA; and... READ MORE

Please find below the frequently asked questions (“FAQs”) the Centers for Medicare & Medicaid Services (“CMS”) recently released concerning therapy caps and advanced beneficiary notice of noncoverage (“ABNs”). READ MORE

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... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) recently released a Survey & Certification Letter acknowledging the change in nomenclature for the professionals working in Intermediate Care Facilities for Individuals with Intellectual Disabilities (“ICF/IID”).  Formally known as Qualified Mental Retardation Professionals (“QMRPs”), these professionals are now Qualified Intellectual Disabilities Professionals (“QIDPs”).  QIDPs are required to integrate, coordinate and monitor the treatment... READ MORE

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... READ MORE

The Centers for Medicare & Medicaid Services (“CMS”) recently released a Survey and Certification Letter updating the State Operations Manual (“SOM”) guidelines  on surveys of deemed status long-term care (“LTC”) providers when the provider has been found to have a condition level instance of noncompliance, including immediate jeopardy (“IJ”), in a complaint survey.  This change... READ MORE

On April 9, 2013, the Centers for Medicare & Medicaid Services (“CMS”) announced the contract winners for Round 2 of the Durable Medical Equipment, Prosthetics, Orthotics and Supplies (“DMEPOS”) Competitive Bidding Program.  This article is intended to answer some frequently asked questions about the Round 2 Competitive Bidding Program and the effect on referral agents. READ MORE

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... READ MORE

The Centers for Medicare and Medicaid Services (“CMS”) announced today the contract suppliers for Round 2 and the national mail-order program of the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (“DMEPOS”) Competitive Bidding Program. As of April 9, 2013, there are 799 suppliers that have been awarded contracts in this round, and these contracts will affect... READ MORE

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... READ MORE