Tag: CMS

Direct patients to Medicare resources during open enrollment

A State Health Insurance Program (SHIP) is an insurance counseling service that is provided free of charge by the Administration on Community Living in partnership with the Centers for Medicare & Medicaid Services as well as state aging agencies to help assist Medicare beneficiaries and their caregivers. By discussing coverage, cost and convenience, the goal […]

CMS’ October release of quarterly OASIS Q&As offer guidance on PDGM, OASIS-D1

The latest release of CMS OASIS quarterly Q&As delve into issues around the Patient-Driven Groupings Model (PDGM) and OASIS-D1 as well as GG items capturing mobility and self-care. The October 2019 Q&As — published to the CMS website Oct. 15 — include 37 questions and responses on a range of topics. PDGM was the dominant […]

AHCA raises concerns with CMS’ proposed abuse warning icon

Just a week after the CMS proposal to add a warning icon to the Nursing Home Compare pages of SNFs with a history of abuse, The American Health Care Association (AHCA) has called for a less severe logo. In an open letter to CMS administrator Seema Verma, AHCA president and CEO Mark Parkinson recommended a […]

New change request outlines rebuttal process for providers with deactivated Medicare billing

CMS has issued a change request outlining the rebuttal process for providers or suppliers whose Medicare billing has been deactivated. CR 10978 provides instruction to Medicare Administrative Contractors (MACs) to advise providers of rebuttal rights and how to receive and process rebuttals. The change request takes effect Dec. 31, 2019. Providers can submit a rebuttal […]

CMS to flag SNFs with abuse citations on Nursing Home Compare

CMS announced October 7 its intent to display warning icons on the Nursing Home Compare website for SNFs with abuse citations. Beginning October 23, a red circle (see below) will appear on the individual pages for SNFs that received an abuse citation within the last year. SNFs that receive the abuse icon will also be […]

CMS requiring hospitals to disperse SNF quality data to patients

CMS released a final rule on September 26 requiring hospitals to provide SNF quality reports to patients at discharge. These reports should include information about SNFs such as quality measures, star ratings, and readmission rates. To avoid favoritism, hospitals cannot legally recommend a preferred SNF to patients, so patients are often forced to locate a […]

CMS finalizes discharge rule and clarifies points about aide competency testing

The long-awaited final discharge planning rule, released today, appears to offer some good news for home health agencies. And simultaneously CMS clarifies in a separate rule that pseudo-patients are OK to be used for home health aide competency testing, an issue there has been a lot of questions about. CMS states in the rule that […]

CMS announces decline in 2020 Medicare Advantage premiums

CMS announced September 24 that “Medicare Advantage [MA] premiums in 2020 are expected to decline 23% from 2018 while plan choices, benefits and enrollment continue to increase.” This average monthly premium will be the lowest rate in 13 years. Accompanying this announcement, for the first time in a decade, a new Medicare Plan Finder was […]

CDC releases fact sheets to help discuss pain management, risks of opioids

Four new fact sheets have been released by the Centers for Disease Control and Prevention (CDC) to aid a discussion between patients and providers about pain management options and possible risks of opioid medication. The fact sheets are designed to help providers talk with patients about acute pain, chronic pain, prescription opioids and reducing risk […]