In late December, 2016, the Centers for Medicare & Medicaid Services (CMS) finalized new Innovation Center models that continue the Administration’s progress to shift Medicare payments from rewarding quantity to rewarding quality by creating strong incentives for hospitals to deliver better care to patients at a lower cost.
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.
Those of us who work in the healthcare industry are pretty familiar with HIPAA; however, on occasion there is still confusion about what can and cannot be shared with others. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was established in an effort to protect the privacy of individually identifiable health information. Although it’s been around for many years, many of us are still confused by all the rules and regulations.
In the months leading to the New Year, much was left to be desired for long-term healthcare providers: Namely, answers. Beginning with anticipation over how CMS’ revision overhaul of Conditions of Participation (CoP) for Medicare will play out during Phase 1 (and 2, and 3) of the new survey process, and ending with scattered talk among the Trump administration of “repeal and replace” of ACA, providers have been anticipating the last straw.
As part of its effort to provide additional information on, and increase transparency with respect to the cost of prescription drugs, CMS is updating the Medicare Drug Spending Dashboard to include information for 2015. This online dashboard presents information for three categories of Medicare prescription drugs for both Part B and Part D: drugs with high spending on a per user basis, drugs with high spending for the program overall, and drugs with high unit cost increases in recent years
It was a rough way to start the fiscal year for a 99-bed nursing home operator in Oakland, California: a payback to their assigned Recovery Auditor of over $186,000 in Medicare payments they had earned three years ago for the provision of care to eligible patients. Why? The provider failed to properly review what services were being billed and failed to comply with certain details of billing Medicare for services. As a result, the planned remodel of their dining room and rehabilitation gym—both of which would have markedly improved patients’ quality of life—would have to wait several months for a round of capital funding.
Experts say care for dementia patients may get a boost now that the condition is being added to The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation Medicare Advantage Value-Based Insurance Design (MA-VBID) model. “I definitely see it as a positive,” says Renee Kinder, MS, CCC-SLP, RAC-CT, director of clinical education for Encore Rehabilitation Services in Louisville, Kentucky.
The Centers for Medicare & Medicaid Services launched three new policies on December 20, 2016, that continue the Administration’s progress to shift Medicare payments from rewarding quantity to rewarding quality by creating strong incentives for hospitals to deliver better care to patients at a lower cost. These new Innovation Center models that continue the Administration’s progress to shift Medicare payments from rewarding quantity to rewarding quality by creating strong incentives for hospitals to deliver better care to patients at a lower cost.