Online resource packed with regulatory news and expert guidance, tips & tools pertinent to professionals across the post-acute care continuum.
According to the Federal Register, CMS is proposing a rule that would update the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2016. In addition, it includes a proposal to specify a SNF all-cause all-condition hospital readmission measure, as well as a proposal to adopt […]
Q: Regarding tube feeding, I have a resident who resides in a SNF, she receives only flushes, no nutrition via PEG tube. She was skilled for a tube in the past (2013), but has not received any nutrition for a year; does she qualify for another benefit period? She is still receiving flushes with occasional feeding. […]
Yes another SNF, another therapy contract and more fraud settlements. The only thing that isn’t different is the contractor – RehabCare once again (a coincidence?…not likely). In news released late last week, a Maine SNF settled with the Department of Justice for $1.2 million, allegations of improper Medicare billings for “unnecessary, inflated, and unreasonable” therapy […]
Q: I work in ambulance billing. I know that under Original Medicare, many non-emergent transports of bed confined and non-wheelchair patients is billable to the SNF. Is the same true for Medicare Advantage plans? Also, is there some way to tell when to bill the SNF? A: Medicare Advantage plans are not subject to consolidated billing […]
Q: We have had residents who are inmates of the sheriff’s depart. Because of being in the custody of the sheriff’s department the resident has to be handcuffed to the bed or w/c at all times. They usually are not in restraints due to the facilities policies, but due to sheriff’s department policy. How should this […]
According to a press release that went out on Feb 12, 2015, The U.S. Department of Health and Human Services (HHS) announced a new multi-payer payment and care delivery model to support better care coordination for cancer care as part of the Department’s ongoing efforts to improve the quality of care patients receive and spend […]
Q: If a stroke patient uses 100 Medicare days in a skilled nursing facility, and then after 60 days of wellness, incurs a new hospital stay for a kidney infection, could the patient qualify again for the 100 days of Medicare in a skilled nursing facility? A: After using the 100 Medicare Part A SNF benefit, and […]
Tuesday, February 24, 2015 1:00 p.m.-2:30 p.m. ET When a vendor invoice is received, are you confident with your skilled nursing facility consolidated billing processes and knowing whether or not it should be paid? Join expert Janet Potter, CPA, MAS, for this 90-minute webcast to review the five major categories of skilled nursing facility consolidated […]
Upcoming webcast! SNF Therapy Contracts: Implementing a Shared Risk Arrangement to Reduce Citation Risk. Tuesday, March 10, 2015: 1:00 p.m.–2:30 p.m. (ET) The use of contracted therapists in your SNF immediately increases your citation and criminal risk in terms of billing and liability. In this 90-minute webcast, expert Reginald M. Hislop III, PhD, discusses how to […]
Q: How do I know if my resident is Traditional Part A or has a Medicare Advantage Plan? My confusion comes into play when the Business office admits a Medicare Part A patient into our skilled nursing facility, but then I see copies of insurance cards that say Blue Cross Anthem, Blue Shield, Secure Horizons, AARP, […]