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
Major Health Groups Chime in on Medicare Access and CHIP Reauthorization Act (MACRA) Payment System
MACRA now in its first year of implementation in 2017, has established a new framework for physician payment focused on quality and value using two distinct payment paths. The Centers for Medicare & Medicaid Services (CMS) Quality Payment Program (QPP) includes the following pathways: the Merit-Based Incentive Payment System (MIPS) and the Alternative Payment Model (APM) Incentive program. MACRA replaced the Sustainable Growth Rate (SGR) formula that gave the ability to determine Medicare … [Read more...] about Major Health Groups Chime in on Medicare Access and CHIP Reauthorization Act (MACRA) Payment System
CMS Launches New Hospice Care Website for Families, Physicians and their Patients.
In a new press release, Centers for Medicare & Medicaid Services (CMS) officially announced the opening of their Hospice Compare website. The website which focuses on palliative and end of life care was designed to improve transparency, the consumer experience and empower patients. giving families, patients and the physicians who care for them a reliable resource and "snapshot" of the quality of care a hospice facility provides, as well as information related to health care decisions. The … [Read more...] about CMS Launches New Hospice Care Website for Families, Physicians and their Patients.
CMS & CBO Report different numbers on possible effect of AHCA in the healthcare market
The Republican led U.S. House of Representatives approved the American Health Care Act of 2017 last may and now the Office of the Chief Actuary of the Centers for Medicare and Medicaid Services released its report on the Estimated Financial Effect of the “AHCA .” According to reports from the Health Affairs Organization:"The headline from the Actuary’s report that is likely to receive the most attention is that the CMS Actuary sees the AHCA as increasing the uninsured by 4 million for 2018/2019 … [Read more...] about CMS & CBO Report different numbers on possible effect of AHCA in the healthcare market
Challenges Continue for LTC Regarding Change of Therapy Documentation
Nursing facilities continue to battle Medicare denials because of documentation issues:Untimely certifications, missed or incorrectly billed Change of Therapy documentation, and lack of documentation supporting a signed physician order for skilled therapy are among the top reasons facilities are battling Medicare claims denials, an expert said in late April.Check your systems for communication between your MDS people and the therapy providers. … [Read more...] about Challenges Continue for LTC Regarding Change of Therapy Documentation
Ban on nursing home arbitration agreement officially lifted by CMS.
Ban on nursing home arbitration agreement officially lifted by CMS.Upheld by the Centers for Medicare & Medicaid Services under the Trump Administration, according to reports, the ban on nursing home arbitration clauses has been lifted. CMS Issued the 'Proposed Revision Requirements for Long-Term Care Facilities’ Arbitration Agreements on its website. Obama-era regulation previously stopped nursing homes from forcing patients and their families to sign binding arbitration agreements, … [Read more...] about Ban on nursing home arbitration agreement officially lifted by CMS.
Nursing Facility Providers Must Allow (DADS) surveyors complete access to their records
Provider Letter No. 17-20 – Electronic Health RecordsNursing Facilities may use the system of medical records that best suits their needs whether it is paper or an electronic system. As directed in the DADS released provider letter, a provider must grant access to any EHR when requested by the surveyor. During the entrance conference, surveyors will verify with the provider the process they will follow in order to have unrestricted access to a resident’s medical records. Please note that … [Read more...] about Nursing Facility Providers Must Allow (DADS) surveyors complete access to their records
