According to the May 23 edition of CMS eNews:  “Section 603(c) of the American Taxpayer Relief Act of 2012 (ATRA) changed the payment liability for denials resulting from the outpatient therapy caps from beneficiaries to providers effective January 1, 2013.

In an effort to increase acute and post-acute care coordination and improve health outcomes, the Affordable Care Act established penalties in October 2012 for hospitals that have high readmission rates for heart attack, heart failure and pneumonia patients.  Moving forward,

On May 1, 2013, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule [CMS-1446-P] outlining proposed Fiscal Year (FY) 2014 Medicare payment rates for skilled nursing facilities (SNFs). The FY2014 proposals are summarized below. Changes to payment

It is not news to anyone that skilled nursing facilities, in particular therapy services, are under an enormous amount of scrutiny these days and are being inundated with CMS initiatives and regulations that often contradict one another.   A few examples

A written QAPI plan guides the nursing home’s quality efforts and serves as the main document to support implementation of QAPI. The plan describes guiding principles that will be used in QAPI as well as the scope QAPI will have

In a CMS Medicare FFS Provider e-News bulletin released 3-8-13, the Medicare Learning Network issued the following information about the effect of sequestration on Medicare Fee-For-Service Programs: Mandatory Payment Reductions in the Medicare Fee-for-Service (FFS) Program – “Sequestration” The Budget

Teamwork is a core component of Quality Assurance and Performance Improvement (QAPI).  Leadership must convey that it is everyone’ job to contribute to the organization’s Performance Improvement initiatives through clear guidelines identified in job descriptions.  Responsibility rests with the leadership

I do not think that anybody would disagree that creating a culture to support QAPI efforts begins with leadership. Support from the top is essential, and that support should foster the active participation of every caregiver.   The administrator and senior

The evolution of quality improvement philosophies in health care includes such models as MBO, Theory X, Theory Y, QA, QA&A, TQM, CQI, PI and the newest philosophy—QAPI.  Under the Affordable Care Act, Medicare and Medicaid certified nursing homes are required

President Obama has signed into legislation the American Taxpayer Relief Act and I want to share with you the relevant therapy provisions: No 2% sequester cut to Medicare providers The SGR fix is extended through December 31, 2013 The legislation does not preclude