Online resource packed with regulatory news and expert guidance, tips & tools pertinent to professionals across the post-acute care continuum.
The Centers for Medicare & Medicaid Services (CMS) issued frequently asked questions and answers (FAQs) for healthcare providers regarding Medicare payment for laboratory tests and other services related to the 2019-Novel Coronavirus (COVID-19). The agency is receiving questions from providers and created this document to be transparent and share answers to some of the most […]
CMS announced on February 27 the selection of 205 applicants to participate in Emergency Triage, Treat, and Transport (ET3) Model, a new payment model that gives flexibility to ambulance staff when addressing emergency needs of Medicare fee-for-service beneficiaries. This voluntary, five-year payment model will allow participating EMS to treat SNF residents within the facility following […]
CMS has issued an update to the Medicare Benefit Policy Manual for home health. The update reflects policy changes finalized in the 2019 and 2020 PPS final rules, according to Change Request 11577. These changes include implementation of the Patient-Driven Groupings Model (PDGM), the shift to a 30-day payment period, changes to requests for anticipated payment […]
According to a 2019 study by Bankers Life, 56% of baby boomers mistakenly believe that Medicare covers ongoing long-term care. In an attempt to address gaps in LTC Medicare payments, former CMS technical expert Diane Omdahl recommends to Forbes that residents take out a reverse mortgage to cover gaps in care costs. “Let’s be very […]
An extensive manual change concerning enrollment deactivations suggests that CMS is trying to make it easier for providers to avoid the hassle of accidental removal from Medicare — but you still have to know and follow the rules. Currently, Chapter 15 of the Medicare Program Integrity Manual, which covers enrollment, has simple templates for letters […]
There is now a second game available on the Medicare arcade through Medicare Administrative Contractor (MAC) National Government Services. The game is called the MBI quiz jumper. It allows the player to control a character as he jumps from platform to platform. Landing on certain boxes will prompt a question about new Medicare Beneficiary Identifiers […]
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 […]