The Centers for Medicare and Medicaid Services seeks to deny coverage for an artificial spinal disk called Charite. Lack of evidence that the surgery required to implant the disk is "reasonable and necessary" is the reason, says CMS. From Kaiser Network's report: The proposal to deny Medicare coverage for Charite could prompt private health insurers to take similar actions. According to the Journal, such actions would represent a "rare setback" for J&J, which has "excelled at persuading … [Read more...] about Medicare News: No Coverage for Artificial Spinal Disks
Medicare News: Ultrasound Coverage
Here is some important news for providers and good news for abdominal aneurysm sufferers: next year Medicare will begin coverage for ultrasound screening for abdominal aortic aneurysms for high-risk beneficiaries, according to the Kaiser Network. "High-risk" groups include: • Beneficiaries with a history of aneurysms in their family • Males who've smoked more than 100 cigarettes in their lifetimes Beneficiaries currently in the Medicare program will not receive coverage for … [Read more...] about Medicare News: Ultrasound Coverage
New Mexico and Nurse Aide Training Waivers
I have been doing some research into the issue of Nurse Aide Training Waivers in New Mexico. Given that many facilities in New Mexico are located in small rural communities, losing Nurse Aide Training due to survey issues is a huge problem for some of those facilities. What can such a facility do when there is an urgent need for Nurse Aide Training during the time period the facility is disallowed from the program? The Federal Regulations allow waivers in some instances. Note that 42 USC … [Read more...] about New Mexico and Nurse Aide Training Waivers
Update Your QAAC With Safe Resident Handling and Movement Practices
DADS has posted Provider Letter #05-50 - Safe Resident Handling and Movement Practices. The letter is a result of Senate Bill 1525 (SB 1525), which is codified in Texas Health & Safety Code, Chapter 256. What the statute requires is that a facility's Quality Assurance Comittee, shall adopt and ensure implementation of a policy to identify, assess, and develop strategies to control risk of injury to patients and nurses associated with the lifting, transferring, repositioning, or movement of a … [Read more...] about Update Your QAAC With Safe Resident Handling and Movement Practices
Sen. Grassley: “Beneficiaries have significant rights and protections under the new program.”
Several politicians weighed in on the new Medicare prescription drug benefit in The Hill, a Capitol Hill newspaper. (Medical News Today) Senator Chuck Grassley (pictured), the lone Republican in the group, says although some claim the new drug benefit program is complex, having choices will ensure that beneficiaries will get the best plan for their needs. Grassley added that the Medicare call center is available 24 hours a day. Senator John Kerry, the Democrat from Massachusetts, … [Read more...] about Sen. Grassley: “Beneficiaries have significant rights and protections under the new program.”
Japanese Company Cuts Benefits for U.S. Retirees
In a move that will likely be the subject of many angry letters and op-eds, Nissan, the Japanese car manufacturer, has announced it will cut health insurance and pension benefits for U.S. employees to "remain competitive." From Medical News Today: Nissan informed workers with manufacturing jobs that, starting at age 65, they will receive an annual stipend to supplement Medicare coverage instead of receiving supplemental health care coverage from the company. A Nissan spokesperson said … [Read more...] about Japanese Company Cuts Benefits for U.S. Retirees
NY Nursing Homes Launch Campaign to Preserve Medicaid
Representatives from 630 long term care providers across the state of New York met today to launch a campaign called PASS: Preserve Access to Senior Services. The campaign will give a voice to providers who oppose the state's Medicaid cuts and concerned about the impact cuts could have on long term providers. From the press release: "New York's nursing homes are fighting for survival, especially the not-for-profit, mission-driven and public organizations," said Carl S. Young , president … [Read more...] about NY Nursing Homes Launch Campaign to Preserve Medicaid
Bid to End Medicaid-funded Abortions Fails
In a controversial decision about a controversial practice, a judge in Kansas dismissed a lawsuit that would have forced the state to stop financing abortions for Medicaid beneficiaries. (Medical News Today) The case was unusual. The state attorney general in Kansas, Phill Kline, sued the governor and several other individuals in an effort to establish that life begins at conception so the unborn would be protected as individuals under the state constitution. The judge made no … [Read more...] about Bid to End Medicaid-funded Abortions Fails
HCSSA Pre-survey Conference Suspended
The Texas Department of Aging and Disability Services has advised Home and Community Support Services Agencies that the pre-survey conference is suspended for the months of March and April because Regulatory Services is revising the curriculum. The conference will resume in May. You can read the letter (PDF) by clicking this link. As you know, the pre-survey conference "provides a general overview of state licensure rules, including initial survey requirements (Title 40 Chapter 97) and … [Read more...] about HCSSA Pre-survey Conference Suspended
Kaiser Resources for Long Term Care Providers
KaiserEDU.org has posted information of interest to long term care providers: long term care financing and Medicaid 101. You may review the tutorials and Power Point slides at this link. The site also features a Q&A section for people with questions about Medicare. In light of Medicare's new prescription drug program, this web site should prove helpful. An excerpt Q: I've heard a lot about the "doughnut hole" in the new Medicare drug benefit. Can you help me understand what it is and how … [Read more...] about Kaiser Resources for Long Term Care Providers