[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
Tags: bufford, care, cms, independent, jent, Litigation and Risk Management, long, long term care, Medicaid/Medicare Enrollment and Regulatory Compliance, nursing home, pharmacy, review, selby, term
[02/06/12]
Posted on February 6, 2012 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
The Centers for Medicare & Medicaid Services (CMS) has pushed back the start of two anti-fraud programs to June due to provider concerns. Two pilot programs, one that would require prior authorization for scooters and power wheelchairs and one allowing recovery audit contractors (RAC) to review claims prior to payment, were initially slated to begin January 1, 2012. READ MORE
Tags: abuse, authorization, bufford, California, claim, Claims, cms, demonstration project, Florida, fraud, Home Health, Illinois, january, jent, june, Litigation and Risk Management, long term care, Louisiana, Medicaid/Medicare Enrollment and Regulatory Compliance, Michigan, New York, North Carolina, Ohio, payment, Pennsylvania, power, prior, RAC, review, scooter, selby, Texas, wheelchair
[01/05/12]
Posted on January 5, 2012 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
The Centers for Medicare & Medicaid Services (CMS) has issued revisions to the process Home Health Agencies (HHA) must undergo prior to initial certification. The revised process adds an additional review of enrollment criteria performed by the Regional Home Health Intermediary (RHHI) or Medicare Administrative Contractor (MAC). READ MORE
Tags: agency, bufford, cms, CNN, CoPs, enrollment, hha, Home Health, initial certification, jent, Litigation and Risk Management, long term care, MAC, Medicaid/Medicare Enrollment and Regulatory Compliance, re-review, review, RHHI, RO, S&C 12-15-HHA, SA, selby, site visit
[10/10/11]
Posted on October 10, 2011 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
Effective October 1, new PPS rules for fiscal year 2012 require nursing homes to diligently review claims prior to submission. As previously discussed, significant cuts in SNF reimbursement are aimed mostly at therapy services. SNFs submitting claims under the previous rules can expect high rates of denials and rejections. Even facilities billing under the new... READ MORE
Tags: 3.0, bufford, claim, cms, denial, fiscal year, fy, jent, long term care, mds, Medicaid/Medicare Enrollment and Regulatory Compliance, october 1, rate cut, rejection, review, selby, snf, submission, therapy
