Welcome to The Billers' Association For Long-Term Care

The Billers’ Association for Long-Term Care is a membership community created specifically for long-term care billing professionals. This national association provides members with a resource of continuously updated tools, billing-specific education, and reimbursement and regulatory guidance. Become a member today and join your long-term care billing colleagues as you navigate the evolving world of post-acute care billing.

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CBO predicts 32 million will be without health coverage in 2026 with new repeal-and-delay bill

July 20, 2017
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After the Senate’s recommendation for repeal-and-replace of the Affordable Care Act (ACA) failed due to lack of support, Majority Leader Mitch McConnell is now suggesting a repeal-and-delay strategy that, if passed, is predicted will leave 32 million individuals without health coverage by 2026, and 17 million without coverage by next year. That’s 1 million more than were predicted to be without coverage under the initial repeal-and-replace tactic.

CMS using MEDCAC's recommendations for health outcomes in the Medicare population

July 12, 2017
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The Bottom Line

On August 30, 2017, the Centers for Medicare & Medicaid Services (CMS) will convene a panel of the Medicare Evidence Development &Coverage Advisory Committee (MEDCAC). This meeting will specifically focus on obtaining the MEDCAC's recommendations regarding the appraisal of the state of evidence for health outcomes in the Medicare population for surgical and endoscopic procedures.

The Skilled Nursing Facility Quality Reporting Program Review and Correct reports are now available

June 20, 2017
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The Bottom Line

The Skilled Nursing Facility (SNF) Quality Reporting Program (QRP) Review and Correct reports are available on demand in the CMS Certification and Survey Provider Enhanced Reporting (CASPER) application. Log into the CMS Network using your CMSNet user ID and password to access the Welcome to the CMS QIES Systems for Providers webpage, then select the CASPER Reporting link to locate your reports.

New Medicare cards offer greater protection to more than 57 million Americans

June 2, 2017
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The Bottom Line

New cards will no longer contain Social Security numbers, to combat fraud and illegal use

The Centers for Medicare & Medicaid Services (CMS) is readying a fraud prevention initiative that removes Social Security numbers from Medicare cards to help combat identity theft, and safeguard taxpayer dollars. The new cards will use a unique, randomly-assigned number called a Medicare Beneficiary Identifier (MBI), to replace the Social Security-based Health Insurance Claim Number (HICN) currently used on the Medicare card. CMS will begin mailing new cards in April 2018 and will meet the congressional deadline for replacing all Medicare cards by April 2019. Today, CMS kicks-off a multi-faceted outreach campaign to help providers get ready for the new MBI.

IMPACT Act, VBP, care coordination, and the SNF landscape

April 28, 2017
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Billing Alert for Long-Term Care

Now that we’re into the first quarter of the year, it is time to take stock of the postacute/SNF landscape, particularly as it pertains to evolutionary policy initiatives now and in the future. To start, there is little evidence on the horizon of an all-out retreat on the policy changes begat by the Affordable Care Act (ACA, or Obamacare). While some framework is building to "repeal and replace" the ACA, that framework will leave fundamentally intact the changes wrought by bundled payments, value-based purchasing, and the IMPACT Act. The Republican majority, a smattering of Democrats, and the incoming secretary of HHS have signaled support for these initiatives. Should a repeal strategy move forward any time soon, they will likely remain, whether fleshed or skeletal.

FREE: Please join us tomorrow for the Billers' Association quarterly webcast

March 28, 2017
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The Bottom Line

Please join us for the Billers' Association quarterly webcast. Each quarter, an industry expert will cover industry hot topics, as well as billing challenges, in this webcast. Each webcast will be 30 minutes in length, followed by a 15 minute live Q&A when members can ask questions and get direct feedback. Webcasts will be from 1-1:45pm EST on the following dates:

Wednesday, March 29, 2017: How to use the Triple-Check Process to avoid Medicare Audits
Wednesday, June 21, 2017
Wednesday, August 16, 2017
Wednesday, November 8, 2017

The Five-Star Quality Rating System Technical User's Guide is now available!

February 28, 2017
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The Bottom Line

Stay compliant with the most up-to-date Five-Star Quality Rating System. The Five-Star Quality Rating System Technical User’s Guide includes CMS’ technical guide to the Five-Star Rating System, as well as expert analysis and insight into how providers can use the guide, how ratings are affected, and what providers can do to improve their rating. Industry experts Reginald M. Hislop III, PhD, and Maureen McCarthy, RN, BS, RAC-MT, QCP-MT, provide analysis and insight to assist facilities in determining their overall facility five-star rating, employing strategic opportunities for marketplace differentiation, and driving performance with quality care that can translate to maximum star ratings.

SNFRM as the first measure for the Skilled Nursing Facility Value Based Purchasing

February 10, 2017
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The Bottom Line

In the Fiscal Year (FY) 2016 SNF Prospective Payment System (PPS) final rule, CMS adopted the SNFRM as the first measure for the Skilled Nursing Facility Value Based Purchasing (SNF VBP) Program. The measure is defined as the risk-standardized rate of all-cause, unplanned hospital readmissions of Medicare beneficiaries within 30 days of discharge from their prior hospitalization. Hospital readmissions are identified through Medicare hospital claims (not SNF claims) so no readmission data is collected from SNFs and there are no additional reporting requirements for the measure.

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