Skilled-Care Providers

The Latest Zpic Target: Medicare Cost Reports

When Medicare was created in 1966, Medicare paid participating providers (e.g. hospitals and skilled nursing facilities) based on a portion of their costs. Medicare’s portion of costs was determined by multiplying total costs...more

Prospective and Retrospective Implications of the Jimmo Settlement Agreement for Skilled Care Providers

On January 24, 2013, the U.S District Court for the District of Vermont approved a Settlement Agreement in the so-called Medicare Improvement Standard case, Jimmo v. Sebelius. In addition to its impact on Medicare...more

ZPICs and Skilled Nursing Facilities: Medicare’s Wild Wild West

Fraud and abuse in the Medicare system undoubtedly increases healthcare costs for healthcare providers and healthcare beneficiaries. As such, healthcare providers, as a whole, can appreciate the efforts of the Department of...more

Proposed Medicare Settlement Clarifies CMS’s Position on “Skilled Maintenance Services”

On October 16, 2012, in the case of Jimmo v. Sebelius, Case No. 5:11-CV-17 (D. Vt. October 16, 2012), a class of Medicare beneficiaries and the United States Department of Health and Human Services agreed to a proposed...more