Online resource packed with regulatory news and expert guidance, tips & tools pertinent to professionals across the post-acute care continuum.
A class-action lawsuit filed by 14 SNF residents in 2011 challenging the Medicare three-day rule saw its first day in court on August 12. The lawsuit addresses the rule requiring residents to be admitted to an acute-care hospital for a minimum of three days prior to entering a SNF to receive Medicare coverage. The residents […]
In an effort to reduce burden, the Department of Health and Human Services (HHS) and CMS are seeking to update regulations around nondiscrimination outlined in the Affordable Care Act (ACA). The proposed rule was published in the Federal Register June 14. It would make “substantial revisions” to Section 1557 of the ACA by eliminating “provisions […]
It’s official: According to CMS’ Skilled Nursing Facility (SNF) Prospective Payment System (PPS) final rule published in the Federal Register yesterday evening, the Patient-Driven Payment Model (PDPM)—the new case-mix methodology to replace RUG-IV)—is effective October 1, 2018. Facilities will have a year to transition to PDPM from RUG-IV by the October 1, 2019 implementation date. […]
The evolving post-acute care industry landscape introduces greater accountability, a heightened focus on patient outcomes, and significant payment reform for skilled nursing facilities (SNFs). Building solid processes and systems is critical for staying compliant under the numerous Centers for Medicare & Medicaid Services (CMS) regulatory changes effective at the beginning of each new fiscal year. […]
The Medicare Payment Advisory Commission (MedPAC) held their public meeting over two days this week at the Ronald Reagan Building, International Trade Center in Washington to discuss multiple topics impacting post-acute care. The meeting agenda included the following: Medicare Advantage encounter data validation and potential uses: ISSUE: During public sessions, Commissioners regularly highlight situations in […]
To satisfy requirements of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), CMS has contracted with RTI International and Abt Associates to develop quality measures for the transfer of health information and care preferences domain that may be used in post-acute care settings such as skilled nursing facilities, inpatient rehab facilities, long-term […]
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 […]
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. […]
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 […]
CMS’ upcoming IMPACT Act Special Open Door Forum (SODF) on Wednesday, March 28, 2:00pm-3:00pm, ET, will provide information and solicit feedback pertaining to development and testing of Standardized Patient Assessment Data Elements as mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 (the IMPACT Act). This SODF will provide an update on the national […]