Originally due last Fall, the Centers for Medicare & Medicaid Services (“CMS”) has published the Quality Assessment and Performance Improvement (“QAPI”) Provider Toolkit and Provider Resources for skilled nursing facilities (“SNFs”). These items have been published on a new CMS website dedicated to helping SNFs develop and implement a QAPI program, as required by the Affordable Care Act (“ACA”). Continue Reading →
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CMS Releases Clarifying FAQs on Therapy Caps and ABNs
Please find below the frequently asked questions (“FAQs”) the Centers for Medicare & Medicaid Services (“CMS”) recently released concerning therapy caps and advanced beneficiary notice of noncoverage (“ABNs”).
CMS Releases Study of General Inpatient Hospice Care
Recently, the Centers for Medicare & Medicaid Services (“CMS”) released the results of a study of hospice general inpatient care (“GIP”) based on an analysis of Medicare Part A hospice claims for beneficiaries who received GIP in 2011. The intent was to identify suspected abuse of GIP in hospice inpatient facilities by hospice providers because this is the second most expensive level of hospice care. Continue Reading →
CMS Acknowledges Name Change for ICF/IID Professionals
The Centers for Medicare & Medicaid Services (“CMS”) recently released a Survey & Certification Letter acknowledging the change in nomenclature for the professionals working in Intermediate Care Facilities for Individuals with Intellectual Disabilities (“ICF/IID”). Formally known as Qualified Mental Retardation Professionals (“QMRPs”), these professionals are now Qualified Intellectual Disabilities Professionals (“QIDPs”). QIDPs are required to integrate, coordinate and monitor the treatment programs for ICF/IID clients. Continue Reading →
FY 2014 Proposed Medicare Rate Would Increase SNF Reimbursement by $500 Million
The Centers for Medicare & Medicaid Services will publish the proposed fiscal year (“FY”) Medicare payment rate in the Federal Register later today. Announced last week, the proposed rate includes a 2.3% market basket increase; however, a forecast error correction and other mandated adjustments will reduce the market basket increase to 1.4%. This will still result in an estimated $500 million increase in the aggregate payments to skilled nursing facilities during FY 2014. The complete proposed payment rate rule is available in the Federal Register. Continue Reading →
CMS Comments on Compliance, QAPI Regulations
During yesterday’s Open Door Forum, Jeanette Kranacs, the Director of the Division of Institutional Post-Acute Care for the Centers for Medicare and Medicaid Services (“CMS”) commented that CMS will not be issuing instructions to surveyors on evaluating compliance and ethics programs until the regulations have been promulgated. CMS was required to have final regulations and various tools in place as of March 2012, but has not yet released any regulations on the ethics and compliance programs for skilled nursing facilities (“SNFs”). Continue Reading →
Details on MedPAC Report on SNFs
Posted by David W. Bufford on March 19, 2013 in Long-Term Care, Medicaid/Medicare enrollment and regulatory compliance 0
The Medicare Payment Advisory Commission’s (“MedPAC”) recent Report to Congress included a chapter dedicated to skilled nursing facilities (“SNFs”), which MedPAC reports received $31 billion in Medicare reimbursement in 2011. Recently, SNFs have been under pressure from repeated reimbursement cuts; however, MedPAC’s analysis states that SNF reimbursement is adequate. Continue Reading →
MedPAC Releases Report to Congress, Suggests Broad Reforms to Post-Acute Landscape
Posted by David W. Bufford on March 18, 2013 in Home Health, Hospice, Long-Term Care, Medicaid/Medicare enrollment and regulatory compliance 0
The Medicare Payment Advisory Commission’s (“MedPAC”) March 25th Report to Congress outlines inefficiencies they believe exist in the post-acute world and lead to excessive Medicare payments to providers. MedPAC recommendations include Congress evaluate post-acute provider reimbursement and encourage use of the lowest cost mix of services necessary to achieve the best outcomes.
CMS Revises NG-Tube Surveyor Guidance
Based on additional feedback, the Centers for Medicare & Medicaid Services (CMS) has revised the surveyor guidance issued in September 2012 on Naso-Gastric Tubes (NG Tubes) for F-Tag F322. Since the NG Tube regulation, §483.25(g), was published, the use of NG Tubes has become increasingly rare in favor of other forms of enteral feeding tubes. Recognizing this, CMS is considering all forms of enteral feeding tubes as NG Tubes solely for purposes of the interpretive guidance of F-Tag F322.
Should you have any questions, please contact:
Todd Selby at 317.977.1440 or tselby@hallrender.com;
Brian Jent at 317.977.1402 or bjent@hallrender.com; or
David Bufford at 502.568.9368 or dbufford@hallrender.com,
or your regular Hall Render attorney.
Could Growing Antibiotic-Resistant Bacteria Problem Lead to the End of Antibiotics?
McKnight’s published an article this morning on the rise in Carbapenem-Resistant Enterobacteriaceae (CRE) in long-term care facilities. The Center for Disease Control & Prevention (CDC) states these bacteria kill about half of all people who become infected, and are resistant to antibiotic treatments. These CRE bacteria are even resistant to the antibiotics “of last resort” and can transfer their resistance to other kinds of bacteria. Continue Reading →