Articles and Blogs

Medicaid/Medicare Enrollment and Regulatory Compliance

Study Reports SNF Providers Face Grim Reimbursement Future

[08/02/12]

Posted on August 2, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

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

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Home Health Agencies’ Claims for Ordered/Referred Services Must be Billed Using Individual Physician’s Name and NPI

[07/24/12]

Posted on July 24, 2012 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

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

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Another Antipsychotic Measure Fails to Pass

[07/06/12]

Posted on July 6, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

In an on-going push to regulate the use of antipsychotic medications in nursing facilities, another piece of legislation has failed to pass Congress.  The Senate did not pass a proposed regulation that would have standardized protocols for obtaining informed consent before administering antipsychotics for off-label use.   READ MORE

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CMS to Poll 4,200 Nursing Facilities to Best Develop QAPI Standards

[07/02/12]

Posted on July 2, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Centers for Medicare & Medicaid Services (CMS) is giving nursing home providers the opportunity to participate in the development of a new quality improvement initiative that was mandated by the Affordable Care Act (ACA).  While few people expected any issues with the implementation of the provisions in the ACA that affected long-term care... READ MORE

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Nursing Facility Antipsychotic Legislation Fails to Clear Senate

[05/29/12]

Posted on May 29, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

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

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CMS Releases Final Rule Requiring Providers to Include NPI on Enrollment and Claim Filings

[04/26/12]

Posted on April 26, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Centers for Medicare & Medicaid Services (CMS) just released a final rule requiring all providers of medical or other items or services and suppliers that qualify for a National Provider Identifier (NPI) to include their NPI on all applications to enroll in the Medicare and Medicaid programs and on all claims for payment submitted... READ MORE

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OIG Publishes Report on Failure of Nursing Homes to Prepare, Respond to Disasters

[04/16/12]

Posted on April 16, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Office of the Inspector General (OIG) just released a report on the failure of nursing facilities to develop and implement adequate emergency preparedness and response programs.  The “Gaps Continue to Exist in Nursing Home Emergency Preparedness and Response During Disasters: 2007-2010” report is the summation of an OIG study to assess emergency preparedness and... READ MORE

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Reactivation of Provider Number Requires Re-Certification Survey

[04/09/12]

Posted on April 9, 2012 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

On April 6, 2012, CMS issued a Survey and Certification Transmittal stating that when a Home Health Agency (“HHA”) deactivates its provider number (the provider number is now referred to as the CMS Certification Number or CCN), the HHA must be surveyed for compliance with the CMS Conditions of Participation (CoPs) for HHA’s if... READ MORE

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CMS Reverses Course on Requiring Independent Pharmacy Review

[04/04/12]

Posted on April 4, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

In a surprise reversal, the Centers for Medicare & Medicaid Services (CMS) has dropped a controversial proposed regulation that would require nursing homes to hire independent pharmacists to oversee residents’ medication regimens. The proposed rule had been developed in response to the belief that relationships between long-term care providers and pharmacy suppliers could conflict... READ MORE

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MedPAC Considers SNF Bundled Payments, Therapy Cap Changes

[03/13/12]

Posted on March 13, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Medicare Payment Advisory Commission (MedPAC) is an independent Congressional advisory agency that makes formal recommendations to Congress in March and June of each year.  MedPAC was created to advise Congress on issues affecting the administration of the Medicare Program.  While Congress is not obligated to follow MedPAC’s recommendations, the recommendations are heavily considered.  This... READ MORE

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