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
Last week I spoke at two joint provider-surveyor training conferences regarding QAPI or more specifically, how it really works and what it looks like in “real-time”. QAPI is a new survey requirement for SNFs; fully expanded to Quality Assurance, Performance Improvement. Up until recently, SNFs were required by federal conditions of participation to have a Quality Assurance function, … 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
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
Travel last week took me off schedule a tad so this post, normally scheduled for last Friday, didn’t make it on-line until Monday. Below is the list of what I am trending (watching) followed by last week’s Fall Outs (worth noting but not worth watching). Hospice Fraud Redux: This issue is one that I have … Read more
Back after a week of vacation (sort of) and then a week of scramble to catch up, here’s the latest that I am watching and that I find trending from readers and clients. Medicaid and Health Care Reform: Oddly, this has been a Medicaid week for me on a number of fronts. The Supreme Court decision … Read more
By popular request, I’ve created a new feature to this site to cover issues and topics “in brief” that I am watching or in some cases, directly tangential to by engagement. Weekly, my inbox is awash in “what have you heard?”, “are you seeing this?”, “what’s going on with?”, etc., type questions. I do try to answer them … Read more
Last week, Senators Kohl, Grassley and Blumenthal introduced an amendment to an existing FDA bill that would require the informed consent of nursing home patients or their legal surrogates before certain anti-psychotic/psychoactive medications were given. The target of this legislative initiative is to reduce the use of certain types of drugs commonly used to treat serious, chronic … Read more
Across a recent engagement that spanned a large system, wide geography and about a year’s worth of work, I had the chance to reflect numerous times on “what” has changed in the post-acute arena, particularly applicable to SNFs, over my 30 years. Below I’ve organized my thoughts in “eras” or periods of time. Cost Based/The … Read more