Articles and Blogs

The Centers for Medicare & Medicaid Services (“CMS”) recently issued the final rule for hospice agreements with long-term care (“LTC”) providers.  The rule requires LTC facilities to have written agreements specifying the respective roles and responsibilities for the hospice and LTC provider for any arrangements for the provision of hospice care within the LTC facility.... READ MORE

On July 12, 2013, CMS issued S&C: 13-46-ALL regarding changes for State Survey Agency (“SA”) obtaining OCR information from providers seeking initial enrollment in the Medicare program or for providers undergoing a change of ownership (“CHOW”).  In the past, the SAs would send the provider an OCR clearance request with the initial Medicare enrollment packet. ... READ MORE

In Indiana, a spouse can be obligated to pay for medical care received by the other spouse under the doctrine of necessaries. The modern version of the doctrine of necessaries imposes limited secondary liability upon the financially superior spouse when the other spouse is unable to pay for his or her necessary expenses using... READ MORE

On July 1, 2013, a new law comes into effect in Indiana that dramatically impacts an individual’s ability to provide greater certainty with respect to his or her end of life care planning and offers a new advance directive to individuals. Indiana recently enacted a law, Indiana Code Section 16-36-6, that establishes the use... READ MORE

Originally due last Fall, the Centers for Medicare & Medicaid Services (“CMS”) has published the Quality Assessment and Performance Improvement (“QAPI”) Provider Toolkit and Provider Resources for skilled nursing facilities (“SNFs”).  These items have been published on a new CMS website dedicated to helping SNFs develop and implement a QAPI program, as required by... 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

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