[01/30/12]
Posted on January 30, 2012 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
The Centers for Medicare & Medicaid Services (CMS) released updated guidance on Section 6501 of the Patient Protection and Affordable Care Act (PPACA) that requires state Medicaid agencies to terminate the participation of any individual or entity if such individual or entity is terminated under Medicare or any other state Medicaid plan. READ MORE
Tags: billing, bufford, chip, cms, for cause, Home Health, Hospice, jent, Litigation and Risk Management, long term care, medicaid, Medicaid/Medicare Enrollment and Regulatory Compliance, Medicare, PPACA, selby, termination
[01/21/12]
Posted on January 21, 2012 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
This week, the Centers for Medicare & Medicaid Services (CMS) updated Section 40.1 of Publication 100-1, the Medicare General Information, Eligibility and Entitlement Manual, to reflect Section 3108 of the Patient Protection and Affordable Care Act (PPACA). This update permits physician assistants to perform the initial certifications and recertifications of a beneficiary’s need for skilled... READ MORE
Tags: ACA, assistant, bufford, care, certification, cms, cps, facility, jent, long term care, Medicaid/Medicare Enrollment and Regulatory Compliance, np, pa, physician, physician extender, PPACA, pub 100-1, recert, recertification, selby, snf, snf-level
[01/10/12]
Posted on January 10, 2012 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
Under the Patient Protection and Affordable Care Act (PPACA), skilled nursing facilities (SNFs) are required to seperately report expenditures for wages and benefits for direct care staff (breaking out (at a minimum) registered nurses, licensed professional nurses, certified nurse assistants, and other medical and therapy staff). CMS recently posted updates to the Provider Reimbursement Manual... READ MORE
Tags: bufford, cost, cost report, direct care, expenditure, facility, jent, long term care, Medicaid/Medicare Enrollment and Regulatory Compliance, nf, nursing home, period, PPACA, report, selby, skillind nursing, snf
[11/21/11]
Posted on November 21, 2011 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
The Elder Justice Act (EJA) was enacted as part of the Patient Protection and Affordable Care Act (PPACA) in March, 2010, and creates a duty for long-term care providers to swiftly report any reasonable suspicion of a crime committed against any individual who is a recipient of care from the facility, or face significant... READ MORE
Tags: bufford, ci, cmp, covered individual, criminal reporting, eja, elder justice act, jent, long term care, Medicaid/Medicare Enrollment and Regulatory Compliance, nf, nursing home, PPACA, reasonable suspicion, selby, snf
[10/20/11]
Posted on October 20, 2011 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
CMS has just released the highly anticipated final regulations for accountable care organizations (ACOs) under Section 3022 of the Affordable Care Act (ACA). The ACA requires accountable-care agreements to be offered under Medicare, starting in 2012. READ MORE
Tags: ACA, accountable care, act, advance payment, bufford, cms, cost of care, final rule, jent, long term care, Medicare, medicare shared savings program, model, organization, PPACA, regualtion, regulation, selby
[10/14/11]
Posted on October 14, 2011 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
Just weeks after ongoing development of the CLASS Act stalled, Secretary Sebelius announced today the implementation of the CLASS Act has been completely halted. Reflecting concerns over the sustainability of the program and the potential for the development of a new entitlement program, the Department of Health and Human Services determined the financing plans related to the Act... READ MORE
Tags: bufford, class act, cms, halt, jent, long term care, Obama, PPACA, sebelius, selby, stalled
[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: 6121, abuse, ACA, appendix PP, bufford, care, cms, dementia, f497, interpretive guideline, jent, long term care, Medicaid/Medicare Enrollment and Regulatory Compliance, nf, nurse aide, nursing facility, nursing home, PPACA, prevent, resident, selby, skilled, skilled nursing facility, snf, tag, training
[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: 10 years, ACA, accountable care, assisted living, billing, bufford, cah, clinic, clinical laboratories, cms, database, dmepos, enrollment, excluded, fbi, final adverse action, fingerprint, group, hha, high, Home Health, home health agency, Hospice, hospital, initial enrollment, jent, license, limited, long term care, MAC, medicaid, Medicaid/Medicare Enrollment and Regulatory Compliance, Medicare, mental health, moderate, moratorium, new practice location, nursing home, oig, on site, on-site visit, payment, physcian, PPACA, practitioner, recertification, reimbursement, Rural Health, screening, selby, skilled nursing facility, snf, suspension, therapy, visit
[07/29/11]
Posted on July 29, 2011 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
Effective fiscal year (FY) 2012, The Centers for Medicare & Medicaid Services (CMS) final rule on Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2012, released July 29, reduces Medicare skilled nursing facility (SNF) Prospective Payment System (PPS) payments by 11.1%. CMS states this action was taken to “better align... READ MORE
Tags: ACA, Affordable Care Act, bufford, case mix index, change of therapy, classification, cmi, cms, consolidated billing, COT, final rule, fy 2011, fy 2012, jent, long term care, market basket, Medicaid/Medicare Enrollment and Regulatory Compliance, Medicare, omra, other medicare required assessment, payment, PPACA, pps, recalibration, reduction, rug, rug-iv, selby, skilled nursing facility, snf, spike, therapy
[07/29/11]
Posted on July 29, 2011 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
The Centers for Medicare & Medicaid Services (CMS) increased fiscal year (FY) 2012 Medicare payments by 2.5% for hospice providers in a final regulation released July 29. Also included in the final regulation are requirements for hospice providers to start collecting quality of care data and changes to the way CMS counts hospice patients... READ MORE
Tags: ACA, accountable care, beneficiary, bufford, cap, cap accounting, cms, current method, days of care, elect, encounter, face to face, fiscal year, fy, fy 2011, fy 2012, fy 2014, Hospice, hospice cap, increase, jent, long term care, market basket, Medicaid/Medicare Enrollment and Regulatory Compliance, Medicare, october, payment, PPACA, qapi, quality assessment and performance improvement, rectification narrative, reduction, selby, terminal illness, two-percentage point, wage index
