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Medicare Skilled Nursing Facility

BakerHostetler

Healthcare Industry Team 2023 Year in Review

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As we approach the conclusion of another transformative year, we are excited to present our comprehensive year-end review, shedding light on the trends shaping the healthcare market in 2023. Our team’s keen insights and...more

King & Spalding

CMS Final Rule Updates Medicare Payment Rates and Quality Programs for SNFs

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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

Holland & Hart - Health Law Blog

CMS Issues Final Rule for Hospitals & Home Health Agencies for Patient Discharge Planning

On September 26, 2019, the Centers for Medicare and Medicaid Services and Department of Health and Human Services published commentary and its final rule affecting how hospitals, including critical access hospitals (“CAHs”),...more

Bradley Arant Boult Cummings LLP

CMS Finalizes Redesign of Medicare Shared Savings Program - Healthcare Alert

On December 31, 2018, the Centers for Medicare and Medicaid Services (CMS) published a Final Rule that redesigns the Medicare Shared Savings Program (MSSP). The rule implementing this redesign, titled “Pathways to Success,”...more

Bass, Berry & Sims PLC

Healthcare Fraud & Abuse Review 2017

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A LOOK BACK... A LOOK AHEAD - While the uncertainty associated with legislative efforts to repeal the Patient Protection and Affordable Care Act (PPACA) dominated most of the headlines for the healthcare industry last year,...more

Ruder Ware

Inspector General Audit Could Impact Skilled Nursing Facilities

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Skilled nursing facilities (SNF) may see even more scrutiny from the Centers of Medicare and Medicaid Services (CMS) because of a recent audit conducted by the Office of Inspector General of the U.S. Department of Health and...more

Holland & Knight LLP

OIG Reports That CMS Has Inadequate System for Identifying SNF Abuse

Holland & Knight LLP on

The U.S. Department of Health & Human Services Office of Inspector General (OIG) has issued an “Early Alert” regarding the preliminary results of an ongoing study of potential abuse or neglect in Medicare-certified skilled...more

Polsinelli

Coming Soon to a Hospital near You: Mandatory Bundled Payments for Common Surgeries

Polsinelli on

Recent action by the Centers for Medicare and Medicaid Services (CMS) announces significant change in reimbursement methodology for high volume orthopedic surgical procedures in many markets nationwide. Affected stakeholders...more

Arnall Golden Gregory LLP

OIG Issues New Report On SNF Billing For Therapy Services

On June 5, 2015, the Department of Health and Human Services Office of Inspector General (OIG) released another study in its continuing scrutiny of skilled nursing facilities (SNFs) and therapy services: Skilled Nursing...more

Polsinelli

CMS Encourages Continued Participation in Medicare Shared Savings Program with Final Rule

Polsinelli on

In This Issue: - ACO Eligibility Requirements - Establishing and Maintaining the ACO Participation Agreement - Data Sharing and Assignment of Beneficiaries - Shared Savings and Losses - Waivers of...more

Baker Donelson

Medicare Shared Savings Program - 2015: What's Changed, What's New, and What's to Come?

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The most recent Shared Savings Program final rule, published in the Federal Register on June 9, 2015, finalizes a number of the revisions to the original November 2011 final rule that CMS proposed on December 8, 2014. In...more

King & Spalding

MedPAC Issues March 2015 Report to Congress on Medicare Payment Policies

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On March 13, 2015, the Medicare Payment Advisory Commission (MedPAC) issued its annual report to the Congress on Medicare payment policies (Report). The Report includes recommendations for inflation updates and payment...more

Cozen O'Connor

CMS Releases Final Rule That Increases Difficulty of Medicare Enrollment

Cozen O'Connor on

In early December, CMS released a final rule that implements certain provider (i.e., Hospitals, SNFs, physicians, etc.) and supplier (i.e., DME companies, etc.) enrollment requirements (“Rule”). The goal of CMS’...more

Williams Mullen

Proposed Federal Legislation Will Provide Relief to Hospitals and Medicare Patients in Need of Post-Acute Care

Williams Mullen on

The Center for Medicare and Medicaid (CMS) announced that the new RAC contracts in North Carolina should be ready by the end of the year. This means that, next year, RAC audits on hospitals and other providers will...more

Poyner Spruill LLP

Nursing Facility Survey Trends - Directed Plans of Correction, Privacy Violations and FTag 520 Quality Assurance Committee...

Poyner Spruill LLP on

Directed Plans of Correction, or DPOCs, have long been part of the arsenal of enforcement sanctions available to the Centers for Medicare & Medicaid Services for survey deficiencies, just like civil money penalties (CMPs);...more

McDermott Will & Emery

CMS Announces Proposed SNF Reimbursement Rates for FY2015

On May 1, 2014, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would include payment and policy changes for skilled nursing facilities (SNFs) (Proposed SNF Rule). The Proposed SNF Rule would...more

Benesch

CMS Directs MACs to Reject Part B Ambulance Claims for SNF to SNF Transfers

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On November 6, 2013, CMS issued Transmittal No. 1311 which instructed Medicare Administrative Contractors (“MACs”) to reject claims for SNF to SNF ambulance transfers that are billed separately under Part B. According to CMS,...more

King & Spalding

CMS Releases FY 2014 Medicare Final Skilled Nursing Facility Payment Regulations and Rates

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On July 31, CMS released a final rule that will increase payments to skilled nursing facilities (SNFs) by 1.3 percent, or $470 million, in Fiscal Year 2014. ...more

Baker Donelson

CMS Releases Proposed FFY 2014 SNF PPS Rule

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CMS has released its proposed federal fiscal year (FFY) 2014 prospective payment system (PPS) rule for Medicare Skilled Nursing Facilities (SNFs). The rule projects a net increase in operating payments to SNFs in the amount...more

Baker Donelson

Recent PRRB and CMS Administrator Decisions: A Summary for Providers

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In recently released decisions, the PRRB and the CMS Administrator addressed a number of issues of interest to many providers. Short summaries of those decisions are provided below. ...more

King & Spalding

OIG Finds That More Than $1 Billion in Inappropriate Medicare Payments Were Made to SNFs in 2009

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The OIG recently issued a report (OEI-02-09-00200) concerning improper skilled nursing facility (SNF) Medicare payments in calendar year 2009 (the Report). The OIG reviewed a stratified random sample of SNF claims from 2009...more

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