This January, the Office of Inspector General (OIG) at the U.S. Department of Health and Human Services (HHS) in conjunction with the Administration for Community Living (ACL) and the Office for Civil Rights (OCR) at HHS issued a report which detailed that "health and safety policies and procedures were not being followed. Failure to comply with these policies and procedures left group home beneficiaries at risk of serious harm. These are not isolated incidents but a systemic problem – 49 … [Read more...] about HHS OIG Releases Report Regarding Group Homes and Critical Incident Reporting
2019 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part D Payment Policies
The Centers for Medicare & Medicaid Services (CMS) released Part I of the 2019 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part D Payment Policies (the Advance Notice), which contains key information about proposed updates to the Part C Risk Adjustment Model and the use of encounter data. According to the Press release: The 2019 Advance Notice is being published in two parts this year due to requirements in the 21st Century Cures Act, which mandated … [Read more...] about 2019 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part D Payment Policies
CMS Launches Data Submission System for Clinicians in the Quality Payment Program
In a press release, CMS announced that doctors and other eligible clinicians participating in the Quality Payment Program can begin submitting their 2017 performance data using a new system on the Quality Payment Program website (qpp.cms.gov). The Quality Payment Program has two tracks you can choose:Advanced Alternative Payment Models (APMs) orThe Merit-based Incentive Payment System (MIPS)The data submission system is an improvement from the former systems under the CMS legacy programs, which … [Read more...] about CMS Launches Data Submission System for Clinicians in the Quality Payment Program
Medicare program’s penalty protocols for Nursing homes change under Trump Administration
In 2016, the nursing home industry requested the change in the Medicare program's penalty protocols and now, according to reports, a new policy from the Trump administration will roll back fines against nursing homes cited for mistreatment or neglect. The New York Times research found that nearly 6,500 nursing homes in the U.S. have received at least one citation for a serious violation since 2013 and about two-thirds of those have been fined by Medicare.According to this New York Times excerpt … [Read more...] about Medicare program’s penalty protocols for Nursing homes change under Trump Administration
The New Senate Tax Bill and its effect on Medicare costs
The Senate Tax Bill (HR 1 )recently passed will expand the break for high medical costs. According to reports, the bill preserve the deduction for medical expenses and lower the threshold for claiming it to 7.5% of adjusted gross income, from the current 10% but this would be temporary. By 2019 the threshold would return to 10% effectively only lasting 1 year. People aged 65 and older who previously had a medical expense deduction of 7.5% will now see it rise to 10% with the Affordable Care … [Read more...] about The New Senate Tax Bill and its effect on Medicare costs
CMS Finalizes Policies that Reduce Provider Burden, Lower Prescription Prices
The Centers for Medicare & Medicaid Services (CMS) issued a final rule this month for the 2018 Physician Fee Schedule and final rule with comment period for the Quality Payment Program (QPP). According to a news release by CMS, Seema Verma, Administrator of CMS explained that:“These rules move the agency in a new direction and begin to ease that burden by strengthening the patient-doctor relationship, empowering patients to realize the value of their care over volume of tests, and … [Read more...] about CMS Finalizes Policies that Reduce Provider Burden, Lower Prescription Prices
(CMS) requires that Medicare-certified home health agencies (HHAs) meet the Medicare Conditions of Participation (CoPs)
Provider Letter 17-35 DADS released the latest Provider Letter 17-35 – Determination of Separate Entities which replaces PL 01-46 & PL 02-05 for Medicare Certified Home and Community Support Service Agencies. The letter details that the Centers for Medicare and Medicaid Services (CMS) requires that Medicare-certified home health agencies (HHAs) meet the Medicare Conditions of Participation (CoPs) for all clients being served by the agency, regardless of a client’s payment source. The … [Read more...] about (CMS) requires that Medicare-certified home health agencies (HHAs) meet the Medicare Conditions of Participation (CoPs)
Texans to face new obstacles as Obamacare open enrollment nears with government cuts
On November 1st, the open enrollment period for the Affordable Healthcare Act (ACA) begins. The 2018 open enrollment runs from November 1st to December 15th and is a crucial time to reach a critical number of under and uninsured individuals in order to get them covered. With enrollment during that period coverage would start on January 1, 2018. This years period is shorter than the 3-month period last year and has been reduced to 6 weeks. According to reports, government cutbacks in the form of … [Read more...] about Texans to face new obstacles as Obamacare open enrollment nears with government cuts
Hospice Care Website lists 777 Hospice Agencies in Texas
For terminally ill patients and their loved ones, finding the right Hospice care can be a daunting decision. Options for quality and strength of the facility providing end-of-life care in the Texas depends on the hospice chosen, according to data released from Medicare data released by Centers for Medicare and Medicaid Services. (CMMS). Now available to the public, the “Hospice Compare” website — at medicare.gov/hospicecompare — displays information on almost 3,900 hospices nationwide.The … [Read more...] about Hospice Care Website lists 777 Hospice Agencies in Texas
CMS, HHS Roll out Emergency Efforts Help Texas and Louisiana with Hurricane Harvey Recovery
According to reports Hurricane Harvey 25 dumped trillions of gallons of water which required evacuation of thousands of residents from over 95 nursing centers and assisted living communities in Texas. A public health emergencies has been declared in both Texas and Louisana and healthcare providers are temporarily waiving or modifying certain Medicare, Medicaid and Children’s Health Insurance Program (CHIP) requirements to provide immediate relief to hurricane Harvey’s victims in flood devastated … [Read more...] about CMS, HHS Roll out Emergency Efforts Help Texas and Louisiana with Hurricane Harvey Recovery
