Tag: OIG

Higher acuity residents drove the price for skilled nursing facility bed prices to record high in 2013

The average price paid for a skilled nursing facility bed reached a record $73,300 in 2013, according to a recently released annual report published by Irving Levin Associates. The price-per-bed number increased 21% from 2012, the report states. The numbers reflect census changes to include more high-acuity patients paying through Medicare or a managed care […]

OIG reverses course on referral services discounts

Providers cannot use an online service that involves money for referrals within its network, federal regulators now say, reversing course on an advisory opinion that was first issued three years ago. The statement came from the Department of Health and Human Services Office of Inspector General. The notice of termination on OIG Advisory Opinion No. 11-18 was […]

Proposed budget plan would hurt millions of seniors in nursing homes

A Republican budget plan unveiled in the House of Representatives Tuesday would slash healthcare spending by $732 billion over the next decade, in part by reengineering Medicaid. House Budget Committee Chairman Paul Ryan (R-WI) was the chief architect of the plan for fiscal year 2015, and its healthcare provisions are similar to his past budgets. He envisions […]

Bill affecting LTC payments and ICD-10 transition passed by House on Thursday

A bill linking skilled nursing facilities’ Medicare payments to hospital readmissions passed the House of Representatives Thursday. The measure also would extend the ICD-10 transition period and prevent a looming physician pay cut. The Senate is scheduled to vote on the bill Monday, and it then likely would go quickly to the White House for the […]

Medicare reimbursements to be cut by 24% starting April 1

Congress will be racing against the clock until the payments that doctors receive in exchange for treating Medicare patients are cut significantly. If Congress fails to pass legislation by March 31, the 685,000 doctors that participate in Medicare will see their reimbursements cut by 24% starting April 1. The cut is based on the sustainable […]

New tool for assessing post-acute care presented in House and Senate

Lawmakers in both houses of Congress have presented a draft bill calling for post-acute care providers to furnish standard assessment data, with the goal of enabling better quality oversight and producing Medicare payment reform. The Senate Finance and House Ways and Means committees on Tuesday introduced companion versions of the “Improving Medicare Post-Acute Care Transformation […]

Medicaid Fraud Control Units recover over $10 million in 2013

Medicaid Fraud Control Units recovered about $10.3 million from nursing facilities in FY 2013, according to an annual report issued Friday. Practically every state operates a fraud control unit, and the report from the Department of Health and Human Services Office of the Inspector General compiled results from all of these units. The investigations included: Allegations of […]

Severe cuts to SNF reimbursements proposed for FY 2015

In the budget document released by the Office of Management and Budget, the White House’s proposed 2015 budget includes severe cuts to skilled nursing facility reimbursements. This proposal is drawing strong criticism from the nation’s largest long-term care provider group. To cut federal spending on healthcare by $402 billion over the next 10 years, the […]

Adverse events occur during SNF stays

A recent study published by the Office of the Inspector General (OIG) found that over 20% of Medicare beneficiaries experience adverse events during their SNF stay. The study also found that an additional 11% experience temporary harm events during their SNF stay. The study estimated the national incidence rate, preventability, and cost of adverse events […]

OIG releases 2014 work plan

The Office of Inspector General (OIG) released a report that focused on its fiscal year 2014 Work Plan. The work plan summarizes the activities the OIG plans to pursue with respect to HHS programs and operations during the current fiscal year (FY) and future years. The OIG Work Plan for FY 2014 provides brief descriptions […]