[08/07/18]
Posted on August 7, 2018 in Long-Term Care, Home Health & Hospice
Published by: Hall Render
On July 31, 2018, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (CMS-1696-F) outlining Fiscal Year (“FY”) 2019 Medicare payment updates and quality program changes for skilled nursing facilities (“SNF”)(“Final Rule”). The Final Rule finalized the value-based purchasing payments that start October 1, 2018, updated several SNF Quality Reporting Program... READ MORE
Tags: acute care, cms, final rule, long term care, nursing home, PATIENT DRIVEN PAYMENT MODEL, POST ACUTE CARE, RESIDENT ASSESSMENT, SKILLED NURSING
[01/19/17]
Posted on January 19, 2017 in Health Law News
Published by: Hall Render
On January 12, 2017, the Department of Health and Human Services Office of Inspector General (“OIG”) published the “Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General’s Exclusion Authorities” Final Rule (“Final Rule”) revising and expanding its authority to exclude individuals and entities from participation in federal health care programs.... READ MORE
Tags: abuse, ACA, Affirmative, Affordable Care Act, Authority, Changes, DOJ, Early reinstatement, exclusion, Expand, False Claims Act, FCA, final rule, fraud, hhs, oig, Permissive, regulation, Reinstatement, Revisions, update
[01/18/17]
Posted on January 18, 2017 in Health Law News
Published by: Hall Render
On December 20, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published a Final Rule that included several changes to the recently implemented Comprehensive Care for Joint Replacement (“CJR”) program. The CJR Model is a retrospective bundled payment program limited to lower extremity joint replacement (“LEJR”) procedures and is designed to encourage hospitals... READ MORE
Tags: bundled payment, Cardiac Rehabilitation Incentive Payment Model, CJR, cms, Comprehensive Care for Joint Replacement, Episode Payment Models, EPM, final rule, hhs
[01/18/17]
Posted on January 18, 2017 in Health Law News
Published by: Hall Render
Background On December 20, 2016, the Centers for Medicare & Medicaid Services (“CMS”) published a final rule (the “Final Rule”)1 creating three new episode payment models (“EPMs”) covering services provided to Medicare beneficiaries admitted to certain Inpatient Prospective Payment System (“IPPS”) hospitals for heart attacks, coronary bypass surgery or surgical treatment of hip or... READ MORE
Tags: Acute Myocardial Infarction, AMI, bundled payment, CABG, Cardiac Rehabilitation Incentive Payment Model, CJR, cjr hospitals, cjr performance, cms, Comprehensive Care for Joint Replacement, Coronary Artery Bypass Graft, CR, CR Incentive Model, Episode Payment Models, episode payment models cms, EPM, final rule, hhs, SHFFT, Surgical Hip/Femur Fracture Treatment
[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
[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
