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 workers because of the Medicare cuts. Nursing homes also said they plan to cancel a total of 400 expansion projects that could have created … [Read more...] about Provider News Around the Web
Medicare: Physicians, Home Health Cuts
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 fix. A 1990s budget law called for automatic cuts to doctors if Medicare costs kept rising. Congress has issued so many waivers that a permanent fix would … [Read more...] about Medicare: Physicians, Home Health Cuts
MedPAC Recommends Reduce Payments to Specialists
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 would pay for the changes by lowering rates for nonprimary care services. Supporters of the proposal said it could … [Read more...] about MedPAC Recommends Reduce Payments to Specialists
DADS Alerts: Long Term Care Changes in Texas
Every week, DADS issues important news alerts for providers. Here are four of the nine alerts posted since September 2: DADS added a new section to its web site: Culture Change in Texas Long-term Care. The MDS Privacy Act Statement is available in Spanish in the MDS 3.0 RAI Manual. "Effective for dates of service or dates of discharge (services) on or after October 1, 2013, Medicaid fee-for-service, Medicaid managed care, Primary Care Case Management (PCCM), family planning … [Read more...] about DADS Alerts: Long Term Care Changes in Texas
TX Register Updates: Medical Board Changes
The following information was obtained from the September 16 issue of the Texas Register: Public Notice HHSC intends to submit transmittal number 11-045 to the Texas State Plan for Medical Assistance, which would limit payments for Medicare Part B services provided to dual eligibles to no more than the Medicaid payment amount for the same service, with the exception of dialysis services. See the Texas Register for more information. Proposed Rules The Texas Medical Board proposed … [Read more...] about TX Register Updates: Medical Board Changes
Primary Care Physicians Seek CMS Committee Changes
The Wall Street Journal reports that the American Academy of Family Physicians (AAFP), which represents primacy care doctors, has asked CMS to change the way its Relative Value Scale Update Committee (RUC) calculates Medicare reimbursements—which it says places a higher value specialists' work—and to add more members who represent primary care groups. A group of primary care physicians is suing CMS. An excerpt: "I think the whole thing needs to be replaced," said Paul Fischer, a doctor who … [Read more...] about Primary Care Physicians Seek CMS Committee Changes
Impact of Medicare Reductions on Texas
Last month, CMS issued a final rule announcing the reduction of Medicare skill nursing facility Prospective Payment System rates for FY12 by $3.87 billion. (Source) According to Avalere Health, which represents long term care providers, the cuts not only would affect long term care facilities, but would reduce economic activity in the most populous states, which includes Texas ( economic activity loss: $497 million; Medicare revenue loss: $349 million). An excerpt of the press … [Read more...] about Impact of Medicare Reductions on Texas
New Medicaid Cards, Medicare Cuts
HHSC now requires Medicaid recipients to have proof-of-coverage in the form a plastic card, which replaces proof-of-coverage letters in Texas. The change purportedly will save $30 million over four years. An excerpt: Until this month, the state spent nearly $1 million a month to print and mail paper forms that poor people on Medicaid could take to the doctor’s office as proof they’re enrolled and qualify for coverage. The majority of Texas Medicaid recipients are enrolled in managed-care … [Read more...] about New Medicaid Cards, Medicare Cuts
CMS Rule Links Payments and Qualify of Care
Last week, the Centers for Medicare and Medicaid Services issued fiscal 2012 proposed payment rates for doctors, outpatient hospitals, and dialysis centers. The proposed rule links payments for outpatient services and ambulatory surgical centers to quality of care. Additionally, the proposed rule would allow certain physician-owned hospitals to request a waiver from the healthcare reform law's ban on expansion. An excerpt: Outpatient departments are scheduled to get a 1.5 percent fee … [Read more...] about CMS Rule Links Payments and Qualify of Care
ILs and News Alerts: TxHmL Expansion, Provider Meetings
DADS released two information letters: All NF Admins: This letter replaces IL 11-37 and PL 11-08 issued on March 17, 2011. MDS 3.0, a revision of MDS 2.0, adds more substance to Section Q, the relocation/referral section. An excerpt from the four-page letter: The “new Section Q” directly asks if an individual wants to relocate back to the community and if they want a referral to a third-party independent community organization (local contact agency) to provide them information and … [Read more...] about ILs and News Alerts: TxHmL Expansion, Provider Meetings
