Online resource packed with regulatory news and expert guidance, tips & tools pertinent to professionals across the post-acute care continuum.
Agencies will soon be required to submit all claims using new Medicare beneficiary identifiers (MBIs), but agencies should be prepared for times when those MBIs change. Medicare beneficiaries or their authorized representative can request to change the MBI if needed, as can CMS, according to a release from Medicare Administrative Contractor (MAC) CGS. This could happen if the […]
SNF admissions from hospitals dropped in all 50 states last year, according to the 2019 Industry Trend Report from Trella Health. The report examined Medicare Part A and Part B claims submitted across the postacute care continuum, and found that 23.3% of patients were discharged to home health, while only 21.1% were discharged to a […]
There are less than fifty days until the Medicare Beneficiary Identifiers (MBIs) transition period is over. Providers will be required to use MBIs on claims beginning Jan. 1, 2020. As of that date, there only will be a few exceptions for when providers will be allowed to use Social Security-based Health Insurance Claim Numbers (HICNs) […]
CMS has released a fact sheet for 2020 Medicare Part A premiums and deductibles. The 2020 coinsurance amounts are as follows: Part A Deductible and Coinsurance Amounts for Calendar Years 2019 and 2020 by Type of Cost Sharing 2019 2020 Inpatient hospital deductible $1,364 $1,408 Daily coinsurance for 61st-90th Day $341 $352 Daily coinsurance for lifetime […]
The 2020 PPS final rule, which was posted to the Federal Register October 31, reinforces the plan to implement the Patient-Driven Groupings Model (PDGM) on Jan. 1, 2020. But CMS has eased off of plans to implement an 8.01% decrease in agencies’ payments due to changes it anticipates agencies will make in response to the […]
Starting in January 2020, Medicare-enrolled nurse practitioners in Maryland will be allowed to certify home health services as part of the Medicare Total Cost of Care (TCOC) Model. The change will be effective for services provided on or after Jan. 1, according to change request 11330. Currently Medicare only pays for home health if a […]
CMS issued a proposed notice that they received an application from the Joint Commission (TJC) for continued recognition as a national accrediting organization for HHAs that wish to participate in the Medicare or Medicaid programs. Within 60 days of receiving an organization’s complete application, the state required CMS to publish a notice that: 1) identifies […]
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 […]
The Department of Justice (DOJ) announced plans to pursue criminal charges against SNFs accused of violating the False Claims Act, according to Bloomberg Law. In the past, these violations have been treated subject to civil penalties, but the DOJ will now bring criminal charges against more egregious offenders. The False Claims Act penalizes providers that […]
We are seeking speakers to present at the 2020 National Provider Enrollment Forum, to be held April 19-22 in New Orleans at the Sheraton New Orleans Hotel. Click here to view and complete the speaker application. Presenters must complete the application prior to the September 30 deadline. Accepted speakers and co-speakers receive free admission to […]