The CMS Interoperability and Prior Authorization Rules
Podcast — Drug Pricing: How Are Payers Responding to the IRA?
Findings from Gibbins’ Annual Healthcare Bankruptcy Report
A Fond Farewell: Musings on the End of the Medicare Advantage Hospice Carve-In Demonstration
Video: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – Thought Leaders in Health Law
Hospice and Home Health Survey Perspectives: A Conversation with Kim Skehan, VP of Accreditation at CHAP
Transparency and the Open Payments Program
Taking the Pulse, A Health Care and Life Sciences Video Podcast | Episode 173: Improving rural health care with Dr. Kevin Bennett, the Director of the Research Center for Transforming Health and the
Counsel That Cares - The Private Payer's Perspective on Value-Based Care
Podcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care
A Very “Special” Episode: Amid Controversy, CMS Launches the Hospice Special Focus Program
Grace from CMS: Unexpected Good News on HIS and CAHPS Appeals
This Bandwagon Has a Broken Wheel: OIG Joins the Inconsistent Approach to Hospice GIP Claims
Behind the Curtain: Enhanced Provider Enrollment Oversight
Survey Woes: CMS Ramps Up Hospice Survey Program and Consequences
Inflation Reduction Act’s Drug Price Negotiation Provisions – What Now? – Diagnosing Health Care Podcast
A Glimpse Into the Other Side: Understanding the Perspective of Government Enforcers
I Understood There Would Be No Math: Audits, Extrapolations, and a New Set of Rules
Podcast: Inflation Reduction Act’s Drug Price Negotiation Provisions – What’s Next? - Diagnosing Health Care
Quick Takeaways From the 2024 Proposed Hospice Wage Index Rule
On July 31, 2024, CMS issued a final rule (the Final Rule) for fiscal year (FY) 2025 updating Medicare payment policies and rates for skilled nursing facilities (SNFs) under the SNF Prospective Payment System (PPS). Under the...more
On March 28, 2024, CMS issued a proposed rule (Proposed Rule) for fiscal year (FY) 2025 that would update Medicare payment policies and rates for skilled nursing facilities (SNFs) under the SNF Prospective Payment System...more
On July 31, 2023, CMS issued its final rule updating the rates and Medicare payment policies under the Skilled Nursing Facility Prospective Payment System (SNF PPS) for FY 2024 (the Final Rule). The Final Rule also includes...more
With the Medicare Comprehensive Error Rate Testing program projected error rate for skilled nursing facilities (SNFs) showing a significant increase in 2022 (15.1%, up from 7.9% in 2021), the Centers for Medicare and Medicaid...more
On April 11, 2022, the Centers for Medicare & Medicaid Services (CMS) released the FY 2023 Medicare Proposed Rule for Skilled Nursing Facilities (SNFs). Key policy changes include a proposed recalibration of the Patient...more
On April 11, 2022, CMS issued its FY 2023 Skilled Nursing Facility (SNF) Prospective Payment System (PPS) proposed rule updating Medicare payment policies and rates for SNFs. The proposed rule also includes proposals for the...more
- CMS estimates its proposal will result in a decrease of $320 million in Medicare Part A payments to skilled nursing facilities. - CMS is seeking stakeholder input on the effects of direct-care staffing requirements for...more
On July 29, 2021, CMS issued final rules for FY 2022 in its yearly update to Medicare payment policies under the Skilled Nursing Facility (SNF) prospective payment system (PPS), Inpatient Rehabilitation Facilities (IRFs) PPS,...more
On April 8, 2021, CMS issued proposed rules for the Fiscal Year (FY 2022) Skilled Nursing Facility (SNF) Prospective Payment System (PPS) and FY 2022 hospice payments. CMS estimates that the aggregate impact of the payment...more
On August 5, 2020, CMS issued its final rule updating FY2021 payment rates used under the prospective payment system (PPS) for Skilled Nursing Facilities (SNFs). The FY 2021 payment rates will be implemented to reflect the...more
On July 31, 2020, CMS issued Final Rule CMS-1737-F for fiscal year 2021, in its yearly update to Medicare payment policies for SNFs (the Final Rule). In addition to updating Medicare payment rates under the SNF prospective...more
Our Virtual Regional Healthcare Compliance Conferences provide updates on the latest news in regulatory requirement, compliance enforcement, and strategies to develop effective compliance programs. Watch, listen, and ask...more
Starting Oct. 1, per diem payments to skilled nursing facilities (SNFs) will be more generous on the first few days of a Medicare beneficiary’s stay, and then drop as the stay continues. That’s one of the changes under the...more
Comments are due on June 18 for the FY2020 skilled nursing facility prospective payment system (SNF PPS) proposed rule. The rule, which was published on April 25, includes discussion of the standard annual payment updates. In...more
On May 8, 2018, in its Fiscal Year 2019 (FY 2019) Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Proposed Rule, Centers for Medicare & Medicaid Services (CMS) proposed a new case-mix classification system...more
On May 8, 2018, in its FY2019 SNF PPS Proposed Rule, CMS proposed a new case mix classification system that drives Medicare reimbursement for SNF inpatient services. The new system would go into effect on October 1, 2019. CMS...more