American Jobs and Closing Tax Loopholes Update

Prior to the Memorial Day recess (holiday), the House passed its re-shaped version of the bill.  The re-shaping primarily involved spending constraints; reaction to wide-spread criticism (public) of current (and recent) Congressional deficit spending binges as well as a realization that fall elections draw ever closer.  Specifically, what the House did was: Abandoned any additional … Read more

American Jobs and Closing Tax Loopholes Act – HR 4213

Funny title that is rather misleading given the gravity of the health care/post-acute care provisions that are included in this bill.  As is the case in Washington, especially these days, important health care provisions not addressed in the PPACA are coming forward in other bills; particularly bills involving unemployment benefits and COBRA benefits, etc.  Such is … Read more

Health Reform Implications for Institutional Providers

My last post covered CMS’ proposed rule affecting LTAcHs in fiscal year 2011 (October 1, 2010).  In this post I noted that CMS’ proposed rule included a disclaimer that  any impacts related to the PPACA (health reform) were not included and as a result, CMS would from time to time, release updates providing additional guidance.  … Read more

CMS Proposed Policy and Rate Changes for LTAcHs

Yesterday, the Centers for Medicare and Medicaid Services (CMS) released its proposed rule for rates and other policy changes for FY 2011 (October 1, 2010) as applicable to Medicare inpatient stays within long-term acute care hospitals (LTAcH).  The entire rule can be found at http://www.federalregister.gov/inspection.aspx#special.  In their release, CMS noted that the proposed rule does … Read more

Part B Therapy Rate Reductions Return

With Congress on recess, the temporary extension of the Part B therapy rate cuts ended on March 31.  As of today, with Congress still on “holiday”, the Part B therapy rate cuts remain in effect.  Best knowledge has it that Congress is working on another temporary extension that would retro to April 1 and last through April 30.  … Read more

Health Care Reform and Assisted Living

In a bit of an indirect manner, Assisted Living got a boost from health care reform, albeit in a typical governmental fashion.  With the Feds willing to use Medicaid as the vehicle for expanded coverage programs for underinsured (those within 150% of the poverty limit with high-deductible plans) and the uninsured, coupled with additional funding for Home … Read more

Health Care Reform Implications: Home Health Care

I’m a tad behind where I hoped to be in terms of getting these posts out.  Its been a bit  busy over the last ten days or so but headed into the Holiday weekend, a break in the schedule affords me the opportunity to “maybe” get caught up. Of all of the industry sectors touched by … Read more

Medpac Report to Congress: 2011

Earlier this week, Medpac (Medicare Payment and Advisory Commission) released its report to Congress.  Primary among Medpac’s duties is its provision of recommendations regarding payment updates under Medicare.  Below, I have broken out and summarized the recommendations. Hospice (the points below the first bullet are continued recommendations from 2009) 2011 rate is the market-basket less a … Read more

Hospital Observation Stays Impacting Medicare SNF Admissions

An issue that I am fielding a fair number of inquiries about lately involves Medicare patients spending more than three days in a hospital, subsequently ‘discharged’ to a SNF and the SNF learning later that the patient was never technically admitted to the hospital.  Mostly, the inquiries I am getting are along the line of “what’s … Read more

CMS Releases Hospice Stats

Within the past two weeks, CMS released data from 1998 to 2008 for length of stay and diagnosis trends.  What is interesting to note is the utilization trends (length of stay and numbers) over the period as well as the diagnosis correlated to utilization.  For CMS and in particular MedPAC, the prevailing concern has been … Read more