Information Letter No. 18-07 - Addressed to Nursing Providers. Nursing Facility (NF) providers MUST ensure that a designated resident has a valid Daily Care service authorization reflected on the Medicaid Eligibility Service Authorization Verification (MESAV) at the significant steps in the submission and approval process for NF Specialized Services. The letter addresses how to minimize billing issues. NF staff must ensure all appropriate and necessary forms and assessment submissions have … [Read more...] about Daily Care Service Authorization Necessary for the (PASRR) Specialized Services Authorization
HHSC published the proposed changes mandated by House Bill (H.B.) 2025 to the ICF/IID rules which calls for changes to rules governing administrative penalties, license terms and related policies in various programs including the ICF/IID program, DAHS, ALFs, NFs and Pediatric Extended Care Facilities. HB 2025 is the act relating to the regulation of certain long-term care facilities, including facilities that provide care to persons with Alzheimer ’s disease or related disorders; authorizing an … [Read more...] about PPAT Notice-Proposed Changes to the ICF/IID Administrative Penalties Rules
The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) issued quality improvement goals for skilled nursing providers in long term and post-acute care. The goals, aligned with the priorities of the Centers for Medicare & Medicaid Services and federal mandates, were identified to improve care delivery during the next three years. According to reports: The goals outlined by the AHCA and NCAL include: --Safely reduce long- and short-stay hospitalizations by … [Read more...] about American Health Care Association/National Center for Assisted Living Announce Quality Improvement Goals for Nursing Providers
A proposal was recently released by the Center for American Progress (CAP) for Medicare Extra, an enhanced version of the Medicare program and a plan to guarantee universal health coverage in the United States. The plan would be available to all Americans, regardless of income, health status, age, or insurance status. According to reports, Medicare Extra highlights and tries to resolve the reasons for the high cost of the American healthcare system head-on by placing caps on doctor and … [Read more...] about Medicare Extra for All Plan: A Universal Healthcare plan backed by Progressives and Conservatives.
Health and Human Services Secretary Alex Azar and the Trump administration are proposing new regulations for short-term health insurance plans, focusing on value-based care as a priority. According to reports, Azar's speech focused on value-based care, an approach in which doctors and hospitals are reimbursed by private health insurance and the government for how well patients emerge after a medical procedure versus the amount of care provided. The proposed rule — which would allow people to … [Read more...] about Trump proposes new rule for affordable Healthcare: Limited duration health plan for 364 day
More than 8.8 million Americans are enrolled in the Affordable Care Act healthcare law spearheaded by President Barack Obama. An unpopular mandate of the Affordable Care Act, a tax penalty for the uninsured was repealed by a bill passed by Congress and signed by President Trump in December. Now, Texas is among 20 states where 20 Republican state attorneys general are suing to overturn the law, asking a federal court to hold the Affordable Care Act's individual mandate and the … [Read more...] about Texas, and 19 other states battle Affordable Care Act as “unconstitutional” in Federal Court
A new plan signals revived interest in public options and even Medicare-for-all. To address healthcare challenges, the Center for American Progress proposes a new system— Medicare Extra that would include important enhancements to the current Medicare program: an out-of-pocket limit, coverage of dental care and hearing aids, and integrated drug benefits. Medicare Extra would be available to all Americans, regardless of income, health status, age, or insurance status. According to reports, the … [Read more...] about “Medicare Extra for All” plan proposed for universal healthcare
National reports by Human rights advocates say that nursing homes are overprescribing antipsychotics to patients. According to the latest data from the federal Centers for Medicare & Medicaid Services, known as CMS, the percentage of long-term nursing home residents being given antipsychotic drugs dropped from about 24 percent in late 2011 to under 16 percent last year. Yet advocacy groups reveal that misuse of drugs remains a major problem in nursing facilities. The findings outlined in a … [Read more...] about Elderly patients at risk at Nursing homes that overmedicate
According to reports, nursing home cuts will freeze skilled nursing facilities' share of the “market basket” at a 2.4% increase in October. The Congressional Budget Office (CBO) had previously projected a 2.7% hike, though the final rate won't be set until CMS announces its proposed rules for 2019. The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) President and CEO Mark Parkinson issued the following statement regarding the Senate budget proposal: “We are … [Read more...] about Government’s two-year spending plan includes $1.9 billion Nursing home cuts
CMS is adding flexibility to their expansion of benefits by redefining health-related supplemental benefits to include services that increase health and improve quality of life, including coverage of non-skilled in-home supports and more. Hospice care and palliative care are considered as well as supplemental benefits down the road. Benefits will only be available to some of the participants of Medicare Advantage plans. These benefits will not be extended to original Medicare. Supplemental … [Read more...] about CMS proposed adding non-skilled in-home care as a supplemental benefit to Medicare Advantage plans in 2019.