By Patrick Conway, CMS Principal Deputy Administrator and Chief Medical Officer “Today’s launch of the Comprehensive Care for Joint Replacement Model (CJR) is a major step toward transforming care delivery in Medicare. Why? Because this model looks to improve care and quality for the most common procedures that Medicare beneficiaries have, hip and knee replacements. In 2014, more than 400,000 Medicare beneficiaries received a hip or knee replacement, costing more than $7 billion for the hospitalizations alone. Despite the high…..
A new payment model released by the Centers for Medicare & Medicaid Services on Thursday aims to reduce avoidable hospitalizations by amping up the medical treatments skilled nursing facilities are able to provide. Physicians would also receive increased payments to perform comprehensive assessments for residents in SNFs. Currently, Medicare pays physicians less to conduct assessments at SNFs than it does for those conducted at hospitals. Boosting those payments should help remove barriers to quality SNF care, reduce avoidable hospitalizations and…..
HIPAA (Health Insurance Portability and Accountability Act ) OCR (Office of Civil Rights) The first phase of the audits of compliance with HIPAA were conducted as a pilot program in 2011 and 2012, and focused solely on healthcare providers. This round will cover providers, as well as their business associates and contractors. “The audits present an opportunity to examine mechanisms for compliance, identify best practices, discover risks and vulnerabilities that may not have come to light through OCR’s ongoing complaint…..
Excerpt from article written by Steven Littlehale is a gerontological clinical nurse specialist, and executive vice president and chief clinical officer at PointRight Inc. “Actions providers take now will make or break their Five-Star Quality Rating experience in July. That’s because the Centers for Medicare & Medicaid Services has changed quality measures in a way that will affect all nursing homes. CMS held a SNF Open Door Forum conference call on March 3 to explain the potential impact on long-term care providers……
Ultra High therapy billing prompts investigation, HHS/CMS (Centers of Medicare and Medicaid Services) says: The Skilled Nursing Facility Utilization and Payment Public Use File, released Wednesday, shows Ultra High therapy billing accounted for the highest Medicare payments to SNFs, total therapy days, beneficiaries served and average Medicare payment per beneficiary in 2013. Concerns over skilled nursing facility residents receiving the highest levels of therapy in huge amounts have driven the Centers for Medicare & Medicaid Services to turn the issue…..
According to McKnight’s news: “Long-term care providers can receive additional technology funding under a new initiative announced by the Centers for Medicare & Medicaid Services on Wednesday. The initiative seeks to make interoperable technology attainable for a “broader universe” of Medicaid-certified healthcare providers, CMS Acting Administrator Andy Slavitt and National Coordinator for Health Information Karen DeSalvo said in a blog post. States will be able to request 90% enhanced matching funds from CMS to allow a greater variety of healthcare…..
Republicans have indicated repealing Obama Care will be the trigger point for their universal health care program. We have yet to get a definitive plan from any candidate to answer to the question … what is needed and what is affordable? Therefore, instead of repeal I propose amending it for the pork and replace those improprieties with the real meat? Pork: Insurance exchanges are State run insurance agencies generating higher and higher deductibles and coinsurance. This will reduce access to services due…..
CMS has “refused” to clear up confusion that remains among providers following the Jimmo settlement, Stein says Plaintiffs’ counsel in Jimmo v. Sebelius was back in court Tuesday to file a motion that would force the Centers for Medicare & Medicaid Services to adhere to the settlement of the landmark lawsuit. The case involved Medicare beneficiary Glenda Jimmo, who was denied coverage for treatment of her chronic, diabetes-related conditions because she was “unlikely to improve”. The settlement for the class-action…..
Quoted from McKnights News February 19, 2016 … “A bill that aims to ease the overwhelming backlog of Medicare appeals would cost the federal government more than a billion dollars, according to a cost estimate released Tuesday. The Audit & Appeals Fairness, Integrity, and Reforms in Medicare Act (AFIRM Act) of 2015 would cost $1.7 billion over the next ten years if it is passed in 2016, the Congressional Budget Office estimated in its report. The bill was formally introduced…..
A recent posting in McKnights daily news states: Each facility’s data “story” should have cost analysis, payments, length of stay, outcomes and discharge site for specific diagnosis codes, comorbidities and physicians. The skilled nursing facilities that use data to positively differentiate themselves will perform best under advanced payment models, Chris Murphy, CPA, a partner at BKD Consulting said. Once providers have their data story ready to share, Murphy advises sharing it with the hospital’s chief nursing officer, chief financial officer…..
Recent Posts
- IN AMERICA WHO PAYS ALL THE TAXES?
- DEBUNKING MEDICARE FOR ALL (A REAL POLITICAL “FREE FOR ALL”) Fifth in a series of articles regarding Medicare for All
- DEBUNKING MEDICARE FOR ALL (A REAL POLITICAL “FREE FOR ALL”) Fourth in a series of articles regarding Medicare for All
- DEBUNKING THE GREEN NEW DEAL (A real political “Free for All) Third in a Series of Articles re: Socialized Medicare and Climate Change for All
- DEBUNKING MEDICARE FOR ALL (A REAL POLITICAL “FREE FOR ALL”) Second in a series of articles re: Medicare for All – Boon or Bane
Recent Comments
- how to buy actos without a prescription on DEBUNKING MEDICARE FOR ALL (A REAL POLITICAL “FREE FOR ALL”) Fifth in a series of articles regarding Medicare for All
- generic lopressor on DEBUNKING MEDICARE FOR ALL (A REAL POLITICAL “FREE FOR ALL”) Fifth in a series of articles regarding Medicare for All
- rx zovirax on DEBUNKING MEDICARE FOR ALL (A REAL POLITICAL “FREE FOR ALL”) Fifth in a series of articles regarding Medicare for All
- generic losartan on DEBUNKING MEDICARE FOR ALL (A REAL POLITICAL “FREE FOR ALL”) Fifth in a series of articles regarding Medicare for All
- can i buy generic tadacip for sale on DEBUNKING MEDICARE FOR ALL (A REAL POLITICAL “FREE FOR ALL”) Fifth in a series of articles regarding Medicare for All
