Tag: Medicare

CMS updates to Medicare manuals could impact reimbursement

In an MLN Matters article dated March 16, 2018, CMS instructed providers to make sure their billing staff are aware of changes made to Medicare manuals. CMS stated that these updates to the Medicare manuals are intended only to clarify the existing content and to correct various omissions and minor technical errors. No policy, processing […]

New Medicare card project special open door forum March 20

CMS will host a Special Open Door Forum to give providers an opportunity to ask questions about the New Medicare Card Project on Tuesday, March 20 from 2:00pm-3:00pm, ET. Providers are encouraged to use this call to get answers to questions and get prepared to accept the new Medicare Beneficiary Identifier starting April 1, 2018. […]

MedPAC encourages Medicare beneficiaries to use higher-quality PAC providers

During the Medicare Payment Advisory Commission’s (MedPAC) public meeting on Thursday, March 1, analyst Evan Christman reviewed options for modifying Medicare’s hospital discharge rules to encourage beneficiaries to use higher-quality PAC providers. Christman pointed out that Medicare assigns responsibility for discharge planning to the hospital, and while part of this responsibility includes providing the beneficiary […]

New CMS policy could change inpatient rehab denial trend

In the past, Medicare contractors have been allowed to deny a claim for inpatient rehab if the required three-hour minimum of direct care mark was missed by mere minutes, even if the additional minutes were made up on a subsequent day. Now, however, due to new guidance released by CMS, this denial trend could change. […]

Ethical principles for long-term care billers

The following post is an excerpt from Medicare Guide for SNF Billing and Reimbursement by Janet Potter, CPA, MAS, and Frosini Rubertino, RN-CNE, CDONA/LTC, CPRA. The following ethical principles are based on the core values of The Billers’ Association for Long-Term Care. They apply to all members. Long-term care billing professionals shall do the following: […]

2018 dates announced for Medicare Boot Camp: Long-Term Care Version

Ensure that your staff is providing quality resident care, performing accurate documentation, and properly billing for services. The Medicare Boot Camp—Long-Term Care Version follows a Medicare patient from preadmission through discharge, addressing the function of each department, and uncovering the pitfalls along the way. HCPro’s industry-leading instructors cover the latest Medicare rules and regulations so […]

CMS proposes patient-reported outcome measure for SNFs in 2018

Last week, the Centers for Medicare & Medicaid Services (CMS) released their List of Measures under Consideration (MUC) for 2018 pre-rule making. CMS officials capped the measures at 32, more than 100 shy of the 184 measures submitted for consideration by stakeholders during an open call for measures. Each year, CMS publishes a list of […]

Long-Term Care Quality Measures: A Guide to Data Analysis, Performance Improvement, and Public Reporting, coming soon!

Increasingly, we rely on data and data analysis to objectively view the quality of care delivered in our long-term care facilities. The data gathered and reported by the quality measures (QM) systems designed for long-term care are information-rich and provide guidance, direction, statistics, frequency, and monitoring of potential quality problems. Armed with this information, facilities […]

TIP: What providers can be doing to prepare for RCS-1

The Summary of Advance Notice published back in April announcing potential options for revising certain aspects of the SNF PPS payment method places significant importance on clinical categories and resident characteristics documented within the MDS. This new model, RCS-1, would replace RUG-IV, if approved. This change is expected to happen by January 2019, pending public […]