Articles and Blogs

On March 16, 2012, CMS published the long-awaited Supplemental Security Income (SSI) ratios used in computing Medicare Disproportionate Share Hospital (DSH) payments for Federal Fiscal Years (FFYs) 2006, 2007, 2008 and 2009. This should finally end the cost report settlement moratorium implemented by CMS in July 2008 and lead to a flood of Notices... READ MORE

The Medicare Payment Advisory Commission (MedPAC) voted on Wednesday of this week to recommend to Congress a significant change in the way skilled nursing facilities (SNFs) are reimbursed under the Medicare program within the next two years.  READ MORE

A Medicare beneficiary is not liable for custodial care services rendered by a Mississippi nursing home because the facility failed to give adequate notice the services were not covered by Medicare, a federal appeals court panel ruled on October 25.  The case (Mississippi Care Center of Morton LLC, Sebelius, 5th Cir., No. 10-60595, Oct.... READ MORE

On October 12, 2011, the U.S. Department of Justice unsealed an indictment charging Matthew Kolodesh a/k/a Matvei Kolodech, with conspiracy to defraud Medicare of more than $14 million.  According to the indictment, Kolodesh’s business, Home Care Hospice, Inc. (HCH), located in Philadelphia, PA, submitted Medicare claims for approximately $14.3 million dollars for patients who... READ MORE

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

While Congress was able to present the President with a compromised solution to cut Federal spending and raise the Government’s debt ceiling earlier this month, all long-term care providers should anticipate future reimbursement changes.  Under the current law, the Budget Control Act of 2011t , Medicare and Medicaid are unchanged. However, the Act requires for... READ MORE

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