Medicare/Medicaid News Around the Web

January 19, 2012 by  
Filed under Medicaid, Medicare

MedPAC, a group that advises Congress on Medicare, recommends an overhaul in the way skilled nursing homes are reimbursed. “Congress also should direct HHS to cut payments to skilled nursing facilities with relatively high risk-adjusted rehospitalization rates for their Medicare-covered skilled nursing facility stays.” – McKnight’s Raising the age of Medicare eligibility. “Medicare provides health [...]

Medicaid Cuts in Texas

January 4, 2012 by  
Filed under Medicaid, Medicare, Physicans

If you treat a patient who receives both Medicare and Medicaid, your reimbursement will be limited. Earlier this year, lawmakers eliminated the Medicaid co-pay to save money in the state budget. As a result, providers might turn away more Medicaid and Medicare patients. An excerpt from the Dallas Morning News: “Doctors have to make the [...]

ILs and PL: Cost Reporting, 1915(c) Waiver

DADS released eight information letters and one provider letter. CLASS CSAs, CLASS DSAs, and CDSAs: Effective January 1, 2012, a CMA and DSA can bill for pre-enrollment assessment activities on the same day. (Letter) ICF/MRs: DADS issued this letter to guide providers on using video surveillance cameras to monitor common areas. An excerpt: There is [...]

TX Register Updates: Plan B, MRA Changes

The following information was obtained from the December 30 issue of the Texas Register: Proposed Rules HHSC proposed new §351.507, adverse licensing, listing, or registration decisions by HHS agencies, in Chapter 351, Coordinated Planning and Delivery of Health and Human Services. The changes would permit agencies that license or regulate certain specified entities to consider [...]

Medicare/Medicaid News

December 23, 2011 by  
Filed under Medicaid, Medicare

Medicaid cut challenges will get a hearing in Arizona. “Three public-interest law groups challenged an enrollment freeze for childless adults in the state’s Medicaid program, the Arizona Health Care Cost Containment System. A lower-court judge and an Arizona appeals-court panel upheld the cuts and state lawmakers enacted the freeze as part of $500 million in [...]

Medicare/Medicaid News

December 8, 2011 by  
Filed under Medicaid, Medicare, Physicans

CMS expands competitive bidding in Medicare. “The first phase of the program was successfully implemented for nine product categories in nine areas of the country on Jan. 1, 2011.   To date, CMS monitoring data have shown a successful implementation with no changes in beneficiary health status.  Today, CMS released the detailed schedule for Round [...]

Supreme Court to Review Health Care Reform Law

November 18, 2011 by  
Filed under Medicaid, Medicare

In March 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act, which, among other things, would expand Medicaid to cover at least 30 million more Americans. The controversial law has been challenged numerous times. Some courts have ruled the law constitutional; others have ruled it unconstitutional. Perhaps the most controversial [...]

Provider News Around the Web

Most of you probably know about Provider magazine, affiliated with the American Health Care Association and the National Center for Assisted Living. Provider is a monthly publication for long term care professionals. Medicare cuts lead to nursing home layoffs. “According to a new survey from Avalere Health, nursing homes plan to lay off about 20,000 [...]

Medicare: Physicians, Home Health Cuts

November 2, 2011 by  
Filed under Home Health, Medicare, Physicans

Unless Congress decides otherwise by January 1, physicians will face a 27.4 percent cut in Medicare reimbursement fees. From the AP: No one expects lawmakers to allow the axe to fall, but 48 million beneficiaries and their doctors are looking on nervously. Temporary reprieves have created a recurring problem that gets harder and harder to [...]

MedPAC Recommends Reduce Payments to Specialists

September 28, 2011 by  
Filed under Medicare, Physicans

American Medical News reports that MedPAC, which advises Congress on Medicare, recommended significant cuts to specialists to prevent such cuts for primary care physicians. An excerpt: The Medicare Payment Advisory Commission has drafted recommendations to Congress that would block a 29.5% pay cut scheduled for 2012 and future across-the-board Medicare rate reductions, but the plan [...]

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