Healthcare, Senior Living, Economics
The Department of Justice (DOJ) announced that the agency recovered $2.9 billion in resolutions to federal False Claims Act allegations for 2024 (fiscal year ending September 30). This is a slight increase from the historic $2.7 billion recovered in fiscal year 2023. Office of Public Affairs | False Claims Act Settlements and Judgments Exceed $2.9B … Read more
Back in 2019, CMS issued revisions to Appendix Q of the State Operations Manual pertaining to Immediate Jeopardy considerations (on the part of surveyors) and ultimately, citation decisions. This guidance was relevant for all provider and supplier types participating in Medicare (hospitals, home health, SNFs, etc.). In late October, CMS issued guidance on penalties. What … Read more
The mandatory Transforming Episode Accountability Model (TEAM) will advance CMS prior work on value-based care models, including bundled care initiatives. The TEAM model (participation) will be mandatory for selected hospitals and participation “optional” for post-acute care providers. Transforming Episode Accountability Model (TEAM) | CMS The Transforming Episode Accountability Model (TEAM) is set to be a … Read more
Last week, a report from NIC (National Investment Conference) dropped covering the fourth quarter (2023) lending activity in senior living. As in prior quarters, capital access remains challenged. Data for the report came from 17 lenders, including banks, commercial real estate services, financial services companies, government sources, investment management firms, and real estate investment trusts. … Read more
Just announced this morning, CMS has finalized two hotly debated proposed rules into final rules. The final rules involve the SNF staffing mandate proposed last year and the Medicaid Access Rule, requiring 80% of payments for Medicaid HCBS programs go to compensation for direct care workers. The Medicaid Rule follows the original proposed rule while … Read more
Monday, Fitch Ratings dropped a Non-Rating Commentary about staffing challenges in Life Plan and SNF organizations. Per the release, “Though growing for some time, payrolls for U.S. life plan communities (LPCs) and skilled nursing facilities (SNFs) are still well off the pace needed to reach a full post-pandemic recovery.” Bureau of Labor Statistics (BLS) data … Read more
Happy Eclipse Monday! The post title is meant as a bit of fun but there is a bit of relevancy as well. Billing fraud occurs via a process of hiding what actually has transpired (or should have) with the care of a patient. The most typical fraud is overbilling or charging the government for care … Read more
Bunches (pun intended) of economic data the past two weeks and as readers can tell from the title, I’m getting a little “punchy” with all the data. Anyone about my age should recall a celebrity known as Tiny Tim. His fame, short-lived as it should have been, including playing the Ukulele and signing in a … Read more
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
Yesterday, the American Health Care Association and the National Center for Assisted Living plus the National Assocation of ACOs released a white paper that includes a set of recommendations for CMS, designed to increase the participation of long term and post-acute care (LTPAC) providers in accountable care organizations (ACOs). The white paper is available here: AHCA … Read more