Showing 60 posts in Medicare/Medicaid.
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
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
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
The 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 ›
For 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 ›
On 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 ›
On 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 ›
Hospice care is intended to help terminally ill beneficiaries continue living with minimal disruptions and to provide support for a beneficiary’s family and caregivers. In a recent report, the Department of Health and Human Services Office of Inspector General (OIG) found that hospices are not always meeting two key coverage requirements for the Medicare hospice benefit: (1) that beneficiaries sign an election statement and (2) that a physician certifies that the beneficiary is terminally ill. The purpose of these requirements is, among other things, to properly inform beneficiaries of the implications of hospice care and to prevent Medicare fraud. Read More ›
Categories: Long Term Care, Medicare/Medicaid
Recently, the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule (“Final Rule”) updating the Medicare Conditions of Participation (“CoPs”) for long-term care (“LTC”) facilities. It is the first time in over 15 years that substantial LTC CoP revisions have been released.
LTC facilities affected by the Final Rule include skilled nursing facilities for Medicare and nursing facilities for Medicaid, or those facilities that are duly certified. The Final Rule took effect on November 28, 2016, however CMS has planned for a phased implementation. LTC providers must complete the three implementation phases by November 28 in the years 2016, 2017 and 2018, respectively. CMS has estimated that the costs of compliance will be $62,900 in the first phase of implementation, and $55,000 per year for phases two and three. Read More ›
DOJ Starts Cracking Down on Individual Health Care Executives for False Claims Act and Stark Law Violations Committed by Their Companies
Healthcare executives and physicians take note: The Department of Justice is now cracking down on individuals, and not just companies, for False Claims Act, Stark law, and anti-kickback statute violations. Read More ›
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