Articles and Blogs

The 2% across-the-board cut in reimbursement for Medicare providers, the result of last summer’s “Super Committee” failure, is scheduled to take place January 1, 2013.  The President recently signed legislation requiring a report detailing how the sequestration process will affect Medicare providers.  Skilled nursing facilities (SNFs) have already seen significant cuts to reimbursement; an... READ MORE

As part of the Centers for Medicare & Medicaid Services (CMS) ongoing program to reduce the rate of anti-psychotic use in nursing facilities, the recent changes to the Nursing Home Compare (NHC) website included reports of the usage rates of anti-psychotics in a facility’s score.  However, there is a discrepancy between the methodologies utilized... READ MORE

Need a quick reference to find specific contacts at Medicare organizations that service your state? The Centers for Medicare & Medicaid Services (CMS) recently published an interactive Provider Compliance Group Map. Should you have any questions, please contact: Todd Selby at 317.977.1440 or tselby@wp.hallrender.com; Brian Jent at 317.977.1402 or bjent@wp.hallrender.com; or David Bufford at 502.568.9368 or dbufford@wp.hallrender.com, or your regular... READ MORE

Data collected and analyzed by the Office of Inspector General (OIG) since 2010, indicate that home health agencies (HHAs) are predisposed to commit Medicare fraud, waste and abuse. In 2010, Medicare inappropriately paid $5 million for erroneous claims submitted by HHAs. With one in four claims being suspect, the OIG established six (6) criteria... READ MORE

The Alliance for Quality Nursing Home Care (AQNHC) released the results of a study conducted concerning the future of skilled nursing facility (SNF) reimbursement.  While SNF providers have recently seen their reimbursement rates improve, the study report projects SNF providers are facing $65 billion in reimbursement cuts over the next ten years. The reimbursement... READ MORE

After facing significant reimbursement cuts last year, skilled nursing facility (SNF) providers have reason to celebrate after the Centers for Medicare and Medicaid Services (CMS) released the FY 2013 SNF Prospective Payment System (PPS) schedule.  Effective October 1st of this year, SNF providers can expect a 1.8% increase in their PPS reimbursement.  While a modest bump,... READ MORE

This afternoon, the Centers for Medicare & Medicaid Services (CMS) issued a notice updating the Medicare Hospice Wage Index with an estimated 0.9% increase in payments for FY 2013. The payment increase is the net result of a 1.6 percent increase in the hospital market basket update, which is offset by a 0.7 percentage point decrease... READ MORE

In the near future, Regional Home Health Intermediaries (RHHIs) and Parts A and B Medicare Administrative Contractors (A/B MACs) will be contacting home health agencies (HHAs) that have previously submitted claims for ordered or referred services using a group name and national provider identifier (NPI).  HHAs will be informed they should begin submitting such... READ MORE

Since 2005, a group of associations, such as LeadingAge, AHCA, AMDA, and many others, has hosted an annual summit to discuss the information technology (IT) issues long term care and post acute care providers face.  The group, known as the Long Term and Post Acute Care (LTPAC)  Collaborative, publishes a Road Map for LTPAC providers to... READ MORE

The Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (“DMEPOS”) Competitive Bidding Program Round 1 Recompete will begin later this year.  Below is the schedule the Centers for Medicare & Medicaid Services (“CMS”) has announced so far: READ MORE