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Showing 63 posts in Medicare/Medicaid.

Skilled Nursing Facility and Hospice Contracts – Prime Time to Update

Effective November 28, 2016, the Centers for Medicare and Medicaid Services published a final rule which revised the Medicare Conditions of Participation for Long-Term Care Facilities. There are three different phases of implementation. Read More ›

Categories: Contracts, Hospice, Hospitals, Medicare/Medicaid

MDHHS Issues New Guidelines for Programs of All-Inclusive Care for the Elderly (PACE) Organizations in Michigan

Programs of All-Inclusive Care for the Elderly (PACE) organizations provide certain medical and social services to eligible individuals who meet the Long Term Care level of care criteria. Read More ›

Categories: Long Term Care, Medicare/Medicaid

Hospice Provider Agrees to Pay $75 Million to Settle False Claims Act Lawsuit

Chemed Corporation and various of its subsidiaries, including Vitas Hospice Services LLC and Vitas Healthcare Corporation (collectively “Vitas”), recently settled allegations brought by the federal government that Vitas violated the False Claims Act by submitting to Medicare false claims for hospice services. Read More ›

Categories: Billing/Payment, Hospice, Medicare/Medicaid, Providers

OIG Report Could Trigger Increased CMS Oversight of Skilled Nursing Facilities

The U.S. Department of Health & Human Services ("HHS") Office of Inspector General ("OIG") recently issued a preliminary report regarding quality of care concerns at skilled nursing facilities ("SNFs"). The report was issued in connection with the OIG's ongoing review of potential abuse and neglect of Medicare beneficiaries in SNFs. Read More ›

Categories: Long Term Care, Medicare/Medicaid

OIG Recommends Audits of Meaningful Use Incentive Payments

In order to encourage health providers to use electronic medical records (“EHRs”) in lieu of paper records, Congress passed the Medicare and Medicaid Health Information Technology for Economic and Clinical Health Act (“HITECH Act”) in 2009. Read More ›

Categories: HITECH Act, Medicare/Medicaid

CMS Extends Home Health Agency Enrollment Moratorium for Six Months

The Centers for Medicare & Medicaid Services ("CMS") recently extended the temporary moratorium on the Medicare enrollment of new home health agencies ("HHAs"), subunits, and branch locations in Michigan. Read More ›

Categories: Medicare/Medicaid, Providers

CMS Delays Enforcement of Nursing Home Mega Rule

Mega Rule Enforcement DelayedThe Centers for Medicare & Medicaid Services ("CMS") recently announced that they will delay enforcement penalties related to Phase 2 of their revised nursing home Requirements for Participation (commonly referred to in the industry as the "Mega Rule"). Read More ›

Categories: Compliance, Long Term Care, Medicare/Medicaid, News & Events, Providers

Top Health Care Trends in 2017-Part 1: Pricing and Reimbursement

2017 Health Care TrendsFor the past decade, health care has remained one of the most tumultuous and dynamic industries; uncertainty, along with opportunity, are likely to continue in 2017. This three-part series will discuss some of the most important health care trends. This section will focus on some of the largest factors affecting costs and reimbursement in health care: 1) MACRA Implementation; 2) Medicaid Reimbursement; 3) Shifting Payment Models; and 4) Drug Pricing. Read More ›

Categories: Medicare/Medicaid, Pharmacy, Providers

CMS Releases 2018 Inpatient PPS Proposed Rule

Medicare and Medicaid ServicesOn April 14, 2017, the Centers for Medicare & Medicaid Services issued its 2018 Medicare Inpatient Prospective Payment System proposed rule (the “Proposed Rule”). The Proposed Rule was published in the Federal Register on April 28, 2017, and comments will be accepted through June 13, 2017.

The Proposed Rule suggests a number of changes that would affect hospital rates, inpatient quality reporting and readmissions reduction programs. Some of the most significant changes are highlighted below. Read More ›

Categories: Compliance, Medicare/Medicaid, Providers

CMS Releases Final Rule Revising Conditions of Participation for Home Health Agencies

health care written informationOn January 9, 2017, the Centers for Medicare & Medicaid Services (“CMS”) issued final rules that establish minimum standards for home health agencies (the “Rules”). According to CMS, the Rules are intended to improve the quality of health care services for Medicare and Medicaid patients and strengthen patients’ rights.

The Rules, which were published in the Federal Register on January 13, 2017, come more than two years after a draft proposal was introduced in October 2014. The Rules are mostly adopted as proposed, with a few clarifying changes. The Rules will become effective on July 13, 2017. This means agencies have less than six months to make changes necessary to comply with the revisions. Read More ›

Categories: Medicare/Medicaid, News & Events, Providers