Articles and Blogs

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. READ MORE

Based on additional feedback, the Centers for Medicare & Medicaid Services (CMS) has revised the surveyor guidance issued in September 2012 on Naso-Gastric Tubes (NG Tubes) for F-Tag F322.  Since the NG Tube regulation, §483.25(g), was published, the use of NG Tubes has become increasingly rare in favor of other forms of enteral feeding... READ MORE

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,... READ MORE

The Patient Protection and Affordable Care Act (PPACA) requires all skilled nursing facilities (SNFs) and nursing facilities (NFs) to have an effective compliance and ethics program in place by March 23, 2013.  Unfortunately, the Centers for Medicare & Medicaid Services (CMS) has failed to publish final regulations covering these programs, as required under PPACA, by... READ MORE

Under the Bundled Payments for Care Improvement initiative, organizations will enter into payment arrangements that include financial and performance accountability for episodes of care. The Centers for Medicare & Medicaid Services (CMS) hopes these models may lead to higher quality and more coordinated care at a lower cost to Medicare.   READ MORE

Today, the Centers for Medicare & Medicaid Services (CMS) announced that over 500 organizations will begin participating in the Bundled Payments for Care Improvement initiative. Through this new initiative, made possible by the Affordable Care Act (ACA), CMS will test how bundling payments for episodes of care can result in more coordinated care for... READ MORE

On December 19, 2012 the Department of Justice announced the owners and operators of two Miami health care agencies pleaded guilty for their participation in a $48 million home health Medicare fraud scheme.  According to plea documents, the owners conspired with patient recruiters for the purpose of billing the Medicare program for unnecessary home... READ MORE

The Federal Communications Commission (FCC) has just issued a release detailing the establishment of the Healthcare Connect Fund (the “Fund”) to reform and modernize its universal service program for health care.  Recognizing the importance of high-speed data connectedness for quality patient care and burgeoning  health care practices such as telemedicine, the FCC is expanding and reforming its existing Rural Health... READ MORE

The Centers for Medicare & Medicaid Services (CMS) will soon be distributing a free toolkit to nursing facilities, CMS Regional Offices, and State Survey Agencies. Hand in Hand is a high quality training series for nursing homes that emphasizes person-centered care for persons with dementia, as well as the prevention of abuse. Section 6121 of... READ MORE

While hospices are required to ensure that substantially all core hospice services, including nursing services, are performed by hospice employees, hospices have been permitted to utilize contracted staff members to supplement hospice employees during periods of peak patient loads or extraordinary circumstances. The Centers for Medicare & Medicaid Services (CMS) agrees the nation-wide shortage of hospice nurses has... READ MORE