Healthcare, Senior Living, Economics
Information and discussion on general federal health policy and politics – including Medicare, Health Reform and all other subjects Fed.
I follow Medicaid but don’t often get many inquiries around Medicaid policy or requests for articles in this subject area. Medicaid, however, is very important for providers, especially post-acute and senior living, as it is typically, a significant if not majority payer. During COVID and the public health emergency, Medicaid policy and CMS enacted requirements … Read more
On Friday, I wrote about expanding litigation due to increasing resident care needs found in senior living, assisted and independent living. Specifically, the issue is primarily around “acuity creep” or residents aging in-place, in environments that may not have the staff and infrastructure to meet their advancing care needs. Friday’s post is here: https://rhislop3.com/2023/12/01/friday-feature-senior-living-litigation-watch-risks-at-ccrcs-independent-living/ I’ve … Read more
A complex area for providers, especially with respect to their compliance programs, are the concepts of fraud and abuse. Central to current requirements for compliance programs, all post-acute providers are REQUIRED to have compliance programs that, Include policies and procedures to define, test for, and mitigate any issues pertaining to fraud and abuse. In this … Read more
Seema Verma, former CMS head, spoke out yesterday regarding the proposed staffing mandate (hours and type of staff, per resident per day) proposed rule, indicating her opinion that the approach was flawed. A recap article on her comments is here: https://www.mcknights.com/news/former-cms-chief-verma-regulators-over-their-skis-with-staffing-mandate/?utm_source=newsletter&utm_medium=email&utm_campaign=NWLTR_MLT_DAILYUPDATE_110223&hmEmail=IjP1GPaY%2BJ2uvsLxTJ79bVeRWY7ycbnr&sha256email=aa4cb7c695037c31a216b9562788596b6fcd012145d566f31440b6fcd139c8a9 Regular readers know that I have covered various topics on healthcare staffing, particularly as … Read more
In yesterday’s post, Mish-Mash Monday, in the section about the House Budget Committee’s Health Care Task Force, I offered some commentary regarding MedPAC (Medicare Payment Advisory Commission) and Medicare Advantage plans. I also included a letter from the senior living trade association LeadingAge to the Congressional task force that references MedPAC’s concerns regarding Medicare Advantage … Read more
Ten days ago, I wrote a post about COVID litigation and how it was not only mounting but also morphing in terms of scope. Cases were predominantly focused on responsibility for infections at the senior living end such as, my ‘family member’ caught COVID at XYZ Manor and died, so therefore XYZ Manor is responsible … Read more
Medicare Advantage plans or Medicare Part C and D plans continue to grow in popularity. I’ve written a number of posts on various Medicare Advantage topics, of late, coverage issues and denials, particularly for post-acute care stays. A recent post on that topic is here: https://wp.me/ptUlY-wI Medicare Advantage plans (Part C plans) include Parts A, … Read more
Yesterday’s post was related to the beginnings of COVID, particularly the Biden Administration’s pandemic response plan. Just as Biden entered office, his administration released the response plan and the post (yesterday) included a recording of a podcast I did on the plan, COVID vaccine rollouts, etc. Coming a bit closer to full circle, the pandemic … Read more
As COVID-19 has moved to an endemic phase (constant presence, not spreading out of control or taxing health care resources), I’ve started to look back at what transpired since early-2020 and what was learned, known, and now, embedded (perhaps) in our culture and our health care industry. Suffice to say, the review is somewhat mind … Read more
Lately, I’ve gotten quite a bit of 70s (1970s) deja vu. Yes, I’m old enough to vividly remember the 70s as I crossed the decade as a teenager, graduating high school and almost, college. If one has my memories, the 70s were pretty turbulent times, analogous to now. In 1973, Israel and the Arab (Egypt … Read more