Today the Centers for Medicare & Medicaid Services (CMS), in order to promote Medicaid and Medicare program efficiency, transparency, and burden reduction, proposed new rules that revise the applicable conditions of participation (CoPs) for providers and conditions for coverage (CfCs). The link of this rule will be republished in the Federal Register on Sept. 20. According to the fact sheet summary excerpt: This proposed rule would reform Medicare regulations that are identified as … [Read more...] about Medicare and Medicaid Programs – CMS, HSS Proposed Regulatory Provisions Fact Sheet
Multiple Bipartisan Healthcare Bills Head to Congress
The series of bipartisan healthcare bills are being considered expedited rules that require two-third votes for approval. One bill H.R. 3635, amends title XVIII (Medicare) of the Social Security Act to revise the process by which Medicare administrative contractors (MACs) issue and reconsider local coverage determinations (LCDs) that: (1) are new, (2) restrict or substantively revise existing LCDs, or (3) are otherwise specified in regulation. According to reports, it would provide … [Read more...] about Multiple Bipartisan Healthcare Bills Head to Congress
CMS Introduction to the Hospice Quality Reporting Program (HQRP)
The Hospice Quality Reporting Program (HQRP), mandated by the Affordable Care Act of 2010 directs the Secretary to establish quality reporting requirements for hospice programs. A new CMS webinar was scheduled to explain the basics of the Hospice Quality Reporting Program (HQRP). According to the National Hospice and Palliative Care Organization (NHPCO) reported that the HQRP Requirements are as follows: Hospices are required to comply with requirements for two HQRP program components that … [Read more...] about CMS Introduction to the Hospice Quality Reporting Program (HQRP)
CMS Proposes Improvements in Managing the Medicaid program in Partnership with States
The Medicaid Review Process and Approval times are at the forefront of CMS effort to "implement changes resulting in faster processing of state requests to make program or benefit changes to their Medicaid program through the state plan amendment (SPA) and section 1915 waiver review process. According to reports, SPAs allow states to change their Medicaid program policies or operational approaches, while 1915 waivers let states develop home and community-based services for individuals who … [Read more...] about CMS Proposes Improvements in Managing the Medicaid program in Partnership with States
Trump Signs Electronic Visit Verification (EVV) Into Law
With no opposition from the House or Senate, the U.S. Senate unanimously approved legislation of the H.R.6042 bill delay the nationwide deadline for electronic visit verification (EVV) or ( in-home health service bill) in Medicaid-reimbursed personal care services until 2020. President Donald Trump signed Rep. Brett Guthrie’s health care bill into law on July 30th. According to news reports, the 21st Century Cures Act, initially signed into law in 2016 under the Obama Administration, … [Read more...] about Trump Signs Electronic Visit Verification (EVV) Into Law
Daily Care Service Authorization Necessary for the (PASRR) Specialized Services Authorization
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
PPAT Notice-Proposed Changes to the ICF/IID Administrative Penalties Rules
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
New Version of Pre-Claim Review for Home Health Proposed by CMS
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
American Health Care Association/National Center for Assisted Living Announce Quality Improvement Goals for Nursing Providers
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
Medicare Extra for All Plan: A Universal Healthcare plan backed by Progressives and Conservatives.
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.
