Tag: regulatory guidance

SNF PPS final rule published, new payment model to begin October 1, 2019

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. […]

MedPAC weighs in on several topics affecting post-acute care in public meeting

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 […]

Submit comments on IMPACT Act quality measures by May 3, 2018

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 […]

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. […]

CMS IMPACT Act special open door forum March 28

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 […]

RCS-1 draft model calculation worksheet

SNF providers are on the edge of their seats as they anticipate CMS’ consideration of a replacement for the Resource Utilization Group (RUG) system, which will change the way facilities are reimbursed for SNF Medicare Part A residents beginning as early as FY2019. The Resident Classification System, Version 1 (RCS-1) will be the most significant […]

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. […]

Tune into CMS’ next SNF/LTC open door forum March 8

The next CMS Skilled Nursing Facilities (SNF)/Long Term Care (LTC) Open Door Forum scheduled for: Thursday, March 8, 2018, 2:00 PM – 3:00 PM Eastern Time (ET). Announcements and updates will include: Low Volume Appeals Opportunity Announcement SNF QRP Update Payroll-Based Journal (PBJ) Update Click here for call-in information.

Survey preparation experts will share their top tips on Wednesday, March 7

It’s important that providers understand how the new survey process differs from prior survey cycles and what to expect from surveyors before they arrive at the facility. On Wednesday, March 7, from 1:00-2:00pm, ET survey preparation experts Reginald M. Hislop III, PhD, and Diane R. Hislop, RN, will help providers prepare for the new QIS-driven […]