Healthcare, Senior Living, Economics
Within the normal news cycle, legislation often gets ignored, especially in this hyper volatile election cycle we have begun. I’m expecting very little in terms of reform or new legislation on important healthcare issues to come forward, and, so far, I’m right. With near gridlock due to small opposing majorities in both houses of Congress, … Read more
An issue that has been tied to AI (artificial intelligence) and specifically, to Medicare Advantage plans, involves coverage denials. I wrote about this in a post earlier this year at https://rhislop3.com/2023/05/01/medicare-advantage-part-d-final-rule/ Coverage denials have been a fairly hot topic around Medicare Advantage plans. The core of the issue is that Medicare Advantage plans are required … 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
Over the last six months or so, I’ve written a number of articles on the issue of SNFs, therapy contracts/contractors, and recent fraud settlements. I’ve also given a few presentations on the same subject, covering how fraud occurs, the relationships between therapy contractors, SNFs and Medicare, and the keys to avoiding fraud. A reader question based … Read more
Yesterday, the Speaker of the House (John Boehner) announced that a compromise is forthcoming to alleviate, for one year, the pending 24% payment reduction to the Physician Fee Schedule arising out of the current SGR formula. Ten days or so ago I wrote a post regarding a House bill that repealed the SGR but contained … Read more
As luck would have it, work interfered with my plans to have all of the industry outlooks for this year complete and published by February 1. Good news: Ground work is done now I just need to get to the writing and editing on a consistent basis. With any luck and a bit of fortitude, … Read more
I have a schedule or table if you prefer, of 2013 Part B Therapy Rates applicable to common SNF codes. It is applicable as user selects, for the entire U.S. As rates are only available on a “guesstimated” basis right now and somewhat subject to slight modifications, the version is not 100% guaranteed. I do … Read more
With the Holidays fast approaching and me, heading into a break and a brief vacation, the time is right to recap the current health policy landscape. As the title states, now it seems as if the industry is riding on the Healthcare Polar Express; head first into the dark, cold, snowy north. Fiscal Cliff: Wow, what … Read more
Full of turkey and the trimmings and avoiding any retail outlets, Black Friday seems perfect for a quick synopsis of what is happening with health policy. Fortunately, I’ve maintained a good inventory of “stuff” (not stuffing, though I have an inventory of that too) to cull for content. OIG on SNF Payments: This falls into my … Read more
With all of the election news blaring (thank goodness the end is soon here), some important health policy issues have been somewhat lost in the milieu. Below is a quick summary of what has caught my attention as of late (a heads-up for readers). Medicare/SNF Class Action Settlement: This is profound on a number of … Read more