Healthcare, Senior Living, Economics
A topic that I receive queries about from time to time concerns the payment practices of Medicare Advantage (MA) plans as the same relates to traditional Med A coverage under the PPS system. Recently (earlier this year and then again in October, CMS issued some fairly vague guidance to the MA world regarding a requirement … Read more
Most of my readers know by now that I am an economist by training and formal education. My clients know this as well. The net result is that I’ve been queried, almost to death as of late, as to what this current round of Washington folly is really all about. Is it about the ACA? … Read more
An issue that continues to confound the hospital and SNF industry is the growing use and thus, referral and coverage (Medicare) ramifications of observation stays. Fundamentally, and observation stay by current definition is a non-inpatient stay – an extended residence in an outpatient status. Truly, this a bifurcated problem or issue; hospitals wishing to avoid … Read more
As a wrap to my two previous articles regarding recent fraud and False Claims Act suits and issues in the hospice industry, a concluding piece is warranted. As I have written before, the fraud issues and cases in the Hospice industry divide (though not equally) between the providers committing the fraud and an inferior Medicare Hospice Benefit … Read more
Over the past couple of months or so, I’ve watched rather intently, the developing storm clouds in the Hospice industry. Suffice to say, what is now apparent takes the form of a perfect storm. For industry “watchers”, the news regarding Vitas and the amalgamation of federal false claims act suits is a reflection on the … Read more
In spite of best intentions, wicked winter weather across the middle U.S. has kept me off-track a bit and thus, I haven’t quite met my goal of having these all published by Valentine’s Day. Below is my and my firm’s consensus Outlook on the Home Health industry for calendar year 2013 (part FY 2014). Summary … 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
Happy New Year! Now that I’m back in the saddle, so to speak, and semi-organized after a holiday break and vacation the time has come to take a look at where health care is and what is setting the stage for 2013 (at least near term). Getting started, Washington remains unbelievably mired in dysfunction. So much … 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
Lately I have fielded a growing number of questions regarding various applications/uses of the False Claims Act and Medicare billing inquiries. What is disconcerting about these inquiries is their source; too many from providers or provider organizations. One in particular arises out of an acquisition and this bears special note and comment which, I have … Read more