Articles and Blogs

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

On August 1, 2012, the Centers for Medicare and Medicaid Services (“CMS”) published a display copy of the Final Rule for the FFY 2013 Inpatient Prospective Payment System (“PPS”).  Hospitals will see an approximately 2.3% net increase in payments in FFY 2013. Documentation and Coding Adjustment CMS continues to refine payments via documentation and... READ MORE

National Government Services, Inc. (NGS) recently announced important information regarding Medicare claims and payments for Part A Indiana and Michigan providers.  With the impending transition of these providers to Wisconsin Physician Services (WPS), NGS posted the following transition timeline: National Government Services Transition Timeline Date Activity July 19, 2012 {5:00 p.m. ET} National Government... READ MORE

The Office of Inspector General (OIG) released a report this morning detailing issues found in the use of antipsychotics in nursing facilities.  Utilizing a sample of records from January through June of 2007, the OIG found over 99% of records reviewed failed to meet one or more Federal requirements.   READ MORE

On May 11, 2012, the Centers for Medicare and Medicaid Services (“CMS”) issued the 2013 Inpatient Prospective Payment System (“IPPS”) Proposed Rule.  In the IPPS Proposed Rule, CMS proposed to change the rules for: Calculating new teaching hospital full-time equivalent cap (“FTE cap”) by moving from a 3-year window to a 5-year window; What... READ MORE

Last Thursday, a proposed regulation aimed at curbing the high levels of “off-label” uses for antipsychotic medications failed to pass the Senate.  This proposed legislation relates back to a report last November by Daniel R. Levinson, the U.S. Inspector General, that exposed the high levels of antipsychotic medications administered to nursing facility residents.  That report stated a... READ MORE

Wisconsin Physicians Service (WPS) will soon begin to serve as the Medicare Administrative Contractor (MAC) for Jurisdiction 8, which includes the states of Indiana and Michigan.  According to listserve communications, Indiana Part A providers and Michigan Part A providers will transition to WPS effective July 23, 2012.  Indiana Part B suppliers will transition to... READ MORE

This installment of Hall Render’s Health Law Broadcast series on health care reform is designed to provide you with the insight, analysis and practical suggestions with respect to the various reform initiatives that will affect your organization. On May 7, 2012, the Centers for Medicare and Medicaid Services (“CMS”) published a final rule (“Final... READ MORE

Disproportionate Share Hospital (DSH) Routine Use Data is now available through CMS.  In our Update indicating new SSI Ratios for Medicare DSH were published on March 16, 2012 for Fiscal Years (FYs) 2006 – 2009, we recommended that Hospitals obtain their DSH Routine Use Data in order to have the underlying data used by... READ MORE

On April 26, 2012, Corporate Communications at National Government Services, Inc. issued the following statement: “Recently, the Region B Medicare Recovery Audit Contractor (RAC), CGI Federal, announced that ‘Based on a technical error discovered, CGI finds the Rituximab edit, an automated take back, was disallowed in error. Therefore, CGI reverses the original decision on... READ MORE