Healthcare, Senior Living, Economics
Information and discussion on general federal health policy and politics – including Medicare, Health Reform and all other subjects Fed.
In a series of news stories starting with a piece in the New Yorker published last November, hospices, particularly for-profit hospices in certain states, are being called-out for fraudulent activity. The New Yorker article headline begins, “It began as a visionary notion—that patients could die with dignity at home. Now it’s a twenty-two-billion-dollar industry plagued … Read more
The Medicare Payment Advisory Commission (MedPAC) via a report submitted to Congress on Thursday (yesterday) indicated that a single post-acute payment under Medicare is feasible but extensive policy procedural changes would be required to make it workable. The concept is that one uniform payment would apply to post-acute care delivered in home health, skilled nursing, … Read more
There are nearly 300 articles/posts on this site and from time to time, I’m going to repost an “oldie but a goodie” that is as applicable now as it was when I originally wrote it. This is from July of 2009. This follows well with Tuesday’s piece on OIG initiatives and SNFs…https://wp.me/ptUlY-BJ This seemed to … Read more
On the heels of a report released in January of this year, the Office of Inspector General for the Department of Health and Human Services has created a series of regulatory reviews/quality initiatives for SNFs. The report focuses on the SNF experience during COVID and what, in the opinion of the OIG analysts, regulatory interventions … Read more
This morning, the Supreme Court ruled that residents and their surviving heirs/family members can sue a publicly owned nursing home under the Federal Nursing Home Reform Act. The court upheld a lower court ruling against the Health and Hospital Corporation of Marion County (HHC). This organization operates publicly owned (governmental) SNFs in Indiana. A couple … Read more
Recently, CMS announced that its Medicare Audit Contractors (MACS) would soon commence (June 5) a five-claim audit process for every nursing home in the nation participating in the Medicare program. The reviews are set to occur on a rolling basis whereby each MAC in its region, will begin by pulling five Medicare claims from each … Read more
TGIF! This Friday, I’m focusing on three trends that I think, will have a major impact on healthcare and senior living for the balance of the year and likely, at least the first half of 2024. These trends are in no particular order. Banking and Credit Struggles: This past week, the Federal Reserve provided some … Read more
I’ve been in and around healthcare for three plus decades and a concept that has always been front of mind for me is care coordination. This is something that is so important for a patient’s well-being in terms of improved outcomes and satisfaction. It is also a real opportunity for cost improvement. Unfortunately, I’ve seen … Read more
On May 11, the COVID Public Health Emergency (PHE) is set to end and along with it, a whole slew of requirements end or change, and regulatory waivers applicable to the Public Health Emergency, the same (ending). The end of the PHE will have positive and negative impacts on providers of all types though some … Read more
Early in April, CMS released the 2024 Medicare Advantage/Part D Final Rule and within, there are a number of interesting policy shifts that could benefit providers. The rule addresses a common practice that has been frankly, often abused by Med Advantage plans – prior authorizations or more commonly known as, “prior auths”. The crux is … Read more