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Reimbursement

OIG scrutinizes SNFs and therapy reimbursement

November 14, 2016  |  Pamela Tabar, Editor-in-chief
news

The office’s 2017 workplan targets rehabilitation, hospice and hyperbaric oxygen therapy services, in addition to SNF billing.

A Place For Mom joins effort to promote veterans' LTC resources

November 10, 2016  |  Pamela Tabar, Editor-in-Chief
news

A Place For Mom is partnering with a veterans resource organization to spread the word about the Veterans Aid and Attendance Pension, which can help pay the costs for assistance for those who qualify.

CMS finalizes site-neutral payment policies

November 4, 2016  |  Pamela Tabar, Editor-in-Chief
news

The Centers for Medicare and Medicaid Services has finalized a rule that will change the way services are reimbursed in off-campus and on-campus settings.

Life Care Centers reaches $145M settlement

October 26, 2016  |  Nicole Stempak, Senior Editor
news

The nation’s largest private nursing home company will pay $145 million to settle claims it overcharged the government for therapy treatments. 

BPCI Model 3: Bonanza or boondoggle?

October 6, 2016  |  Kevin R. McMahon
article

There’s an argument to be made for being an early adopter with Bundled Payments for Care Improvement (BPCI) Model 3, but there are also questions about how much participants will ultimately save.

Patients must be notified of hospital 'observation status'

August 8, 2016  |  Nicole Stempak, Senior Editor
news

The Notice Act, which went into effect Saturday, would requires hospitals to notify patients of their outpatient status to warn them of potential out-of-pocket hospital expenses and impact on possible nursing home stays funded by Medicare.

DOJ shuts down $1B Miami nursing home fraud scheme

July 22, 2016  |  Pamela Tabar, Editor-in-Chief
news

The largest-ever fraud case involved the owner of more than 30 skilled nursing facilities and two others accused of kickbacks and false billing, the Department of Justice indictment says.

Medicare proposes changes to primary care payment

July 13, 2016  |  Nicole Stempak, Senior Editor
news

The Centers for Medicare and Medicaid Services has proposed changes to the Physician Fee Schedule to change how Medicare pays for primary care with an emphasis on care management and behavioral health.

MedPAC launches plan for new payment system

June 30, 2016  |  Robert Gatty
article

The Medicare Payment Advisory Commission (MedPAC) submits it recommendations to Congress for how to establish a unified, cross-setting post-acute care payment system. The plan would redistribute payments among types of stays, making profits more uniform and...

Challenges to EHR implementation

June 29, 2016  |  Nicole Stempak, Senior Editor
news

A new study on implementation of electronic health records (EHR) has identified several obstacles for doctors, chief among them poor user experience.

Unified PAC payment feasible, MedPAC says

June 25, 2016  |  Nicole Stempak, Senior Editor
news

The Medicare Payment Advisory Commission (MedPAC) has issued its annual report on refinements to Medicare payment systems and on issues affecting the medicare program

Learning to operate under the value-based payment model

June 14, 2016  |  Richard A. Royer, MBA
article

By Richard A. Royer, MBA, CEO of Primaris

For nursing homes, learning to operate under a new payment model is challenging after existing in the fee-for-service sphere for so long. But the introduction of new value-based programs requires nursing...

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