The Centers for Medicare & Medicaid Services (CMS) is announcing that under the new program, home health agencies (HHAs) could choose to undergo either pre-claim or post-payment reviews, or to forgo reviews but take a 25% payment reduction on all claims submitted for home health services. In the CMS memo issued Tuesday, CMS proposes to roll out the reviews in Illinois, Ohio, North Carolina, Florida and Texas, with the option to expand to other states under the jurisdiction of Medicare … [Read more...] about New Version of Pre-Claim Review for Home Health Proposed by CMS
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
The 11-member Physician-Focused Payment Model Technical Advisory Committee(PTAC) established by MACRA to consider whether models submitted by stakeholders qualify as Medicare alternative payment models voted to move forward on proposals for two alternative payment models for review by the HHS secretary. One model, the Patient and Caregiver Support for Serious Illness model, was submitted by the American Academy of Hospice and Palliative Medicine. The second model is the Advanced Care Model … [Read more...] about Two new proposals address alternative payment models for patients in Palliative Care.
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.
In a press release by Centers for Medicare & Medicaid Services (CMS) MyHealthEData, a Trump initiative was announced as a way to empower healthcare patients by giving them control of their healthcare data, and allowing it to follow them through their healthcare journey. "CMS launched the “Blue Button 2.0” tool, calls on all health insurers to make data available to patients. According to the press release: The government-wide MyHealthEData initiative is led by the White House Office … [Read more...] about MyHealthEData Initiative to give patients control and access to Healthcare data
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
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
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
Beginning on Jan. 1, 2019, physician assistants can now supervise cardiac and pulmonary rehabilitation programs under the Medicare program as well as provide and manage Hospice care for terminally ill Medicare patients. The extended medical privileges for physicians assistants could benefit Medicare beneficiaries who live in medically underserved and rural communities, where a PA might be the only available medical professional to provide some services, according to news reports. According to … [Read more...] about New Hospice Care Law allows Physician Assistants to manage Hospice care for Medicare Patients
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.