Articles and Blogs

Medicaid/Medicare Enrollment and Regulatory Compliance

CMS to Host Conference Call Related to MDS 3.0, PPS

[10/10/11]

Posted on October 10, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

CMS will host their monthly Skilled Nursing/LTC Open Door Forum on Thursday, October 20, from 2-3pm EST.  This call was originally scheduled on October 13.  The information to participate in the call is available here. The recent changes to MDS 3.0 and PPS are likely to be heavily discussed topics.    Should you have any questions, please contact: Todd Selby... READ MORE

Tags: , , , , , , , , , , , , ,

Initial Release of the Medicaid Program Integrity Manual

[09/28/11]

Posted on September 28, 2011 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

On September 23, 2011, the Department of Health and Human Services (DHHS) Centers for Medicare & Medicaid Services (CMS) published the initial release of the Medicaid Program Integrity Manual.  The new Manual is designed to encourage continuity and consistency within the Medicaid Integrity Program (MIP) by providing a comprehensive guide to MIP’s operations.  The... READ MORE

Tags:

CMS Interpretive Guideline Changes on Use of Feeding Tubes

[09/08/11]

Posted on September 8, 2011 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

Yesterday, CMS sent a new transmittal to the state survey agencies on the use of feeding tubes in nursing homes. In short, F321 has been combined into F322 and according the CMS the changes were made to provide nursing home surveyors with guidance to determine compliance with use of feeding tubes by nursing homes. ... READ MORE

Tags: , , , , , , , , , , , , , , , , , , ,

CMS Provides Guidance for Nursing Facility Gardens

[09/08/11]

Posted on September 8, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

CMS released a Survey & Certification letter today providing guidance for nursing homes that desire to utilize on-site gardens to provide fresh produce for residents. After numerous inquiries from facilities, CMS confirmed that residents can benefit from home-grown foods as long as food-borne illness dangers are mitigated to the greatest extent possible.  READ MORE

Tags: , , , , , , , , , , , , , , , , , , , , , , , ,

CMS Revises Nurse Aide Training Requirements

[08/28/11]

Posted on August 28, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

CMS recently published a Survey & Certification Memorandum (S&C:11-35-NH) detailing progress in the implementation of Section 6121 of the Affordable Care Act (ACA).  Section 6121 of the ACA mandates enhanced nurse aide training in nursing homes.  The enhanced training focuses on two areas: 1) how to care for residents with dementia, and 2) how... READ MORE

Tags: , , , , , , , , , , , , , , , , , , , , , , , , ,

Revised CMS-855 Forms Published, New CMS-855O to Order and Refer Items

[08/23/11]

Posted on August 23, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The US Office of Management and Budget has approved the revised Medicare Provider-Supplier Enrollment Applications, the CMS-855 forms.  These updates to the 2008 versions include multiple changes to comply with enhanced disclosure requirements. Such changes include:   READ MORE

Tags: , , , , , , , , , , , , , , , , , , , , , , , , , ,

What Risk Categories Mean to Providers and Suppliers

[08/13/11]

Posted on August 13, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

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

Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Update to Revalidation Enrollment Procedures

[08/11/11]

Posted on August 11, 2011 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

As an update to the previous post on the revalidation enrollment procedures it is important for hospices, home health agencies, and DMEPOS to know what level of screening they will receive from the Medicare Administrative Contractor (“MAC”).  In some instances these providers and suppliers will be screened at either a “high” or “moderate” level... READ MORE

Tags: , , , , , , , , , , , , , , , , , , ,

Medicare Providers and Suppliers Must Begin Enrollment Revalidations

[08/10/11]

Posted on August 10, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

As of March 2011, the Centers for Medicare & Medicaid Services (CMS) implemented new screening criteria in the Medicare provider/supplier enrollment process.  Newly enrolling and revalidating providers and suppliers are placed in one of three categories – limited, moderate, or high – each representing the level of risk to the Medicare program for that... READ MORE

Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Providers Should Anticipate Reimbursement Changes in Debt Ceiling Agreement

[08/08/11]

Posted on August 8, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

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

Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,