14th Dec

Documentation is Key!

In the OIG, Office of Inspector General’s semiannual report to congress, the OIG reported that “the Medicare Payment System for Skilled Nursing Facilities needs to be reevaluated”.  The OIG reports that “Medicare payments for therapy greatly exceeded SNFs’ costs for

creative-problem-solving-technique-become-the-problem (2)
6th Nov

Stop the Madness!

Have you ever sat back and really looked at what is going on around you?  In this case, I am referring to the work setting and things like policies and procedures or processes that folks have been doing and when

Business Balance
7th Aug

Balancing Cost and Quality

On July 9th, CMS proposed The Comprehensive Care for Joint Replacement payment model to hold hospitals accountable for the quality of care they deliver to Medicare fee-for-service beneficiaries for hip and knee replacements from surgery through recovery. These bundled payments

10th Jun

Skilled Nursing Facility Reporting Program

The Improving Medicare Post-Acute Care Transformation (IMPACT) Act, enacted on Oct. 6, 2014, directs the Secretary of Health and Human Services to “specify quality measures on which Post-Acute Care (PAC) providers are required under the applicable reporting provisions to submit

Digital Online Budget Finance Bookkeeping Office Working Concept
20th Apr

Proposed Fiscal Year 2016

Overview On April 15, 2015, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule [CMS-1622-P] outlining proposed Fiscal Year (FY) 2016 Medicare payment rates for skilled nursing facilities (SNFs). The FY 2016 proposals and other issues discussed

Business People Corporate Celebration Success Concept
20th Apr

Permanent Solution To Sustainable Growth Rate

Finally, the Senate sent a permanent Sustainable Growth Rate (SGR) solution to the president’s desk on a vote of 92 to 8. The bill, H.R. 2, will eliminate the perennial threat of providers paying for a “Doc Fix” and inject

Businessman Analyzing Document
10th Feb

MANUAL MEDICAL REVIEW IS BACK!!

All four current RAs received approval on January 16, 2015, to begin issuing ADRs to providers for manual medical review of 2014 therapy claims on a post payment basis. The CMS procedures apply to claims made by outpatient therapy facilities,

Healthcare cost concept: stethoscope and dollars background
27th Jan

And the Doc-Fix Debate Begins—Again!!

There’s only one outstanding issue left to resolve before Congress can pass a permanent “doc fix,”  how to cover the roughly $140 billion price tag.   Last year, Congress kicked the can down the road again and failed to permanently do