News & Analysis as of

Skilled Nursing Facility

CMS to Help SNFs Prepare for Value-Based Purchasing Program Rules (Nov. 16)

by Reed Smith on

A November 16, 2017 CMS call will focus on how the Medicare SNF Value-Based Purchasing Program will affect Medicare’s payments to SNFs beginning October 1, 2018. Among other things, the call will cover how CMS will translate...more

Inspector General Audit Could Impact Skilled Nursing Facilities

by Ruder Ware on

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

OIG Reports That CMS Has Inadequate System for Identifying SNF Abuse

by 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

Recent Insurer Victories in Indexed Annuity Class Actions

by Carlton Fields on

Recent federal court decisions effectively terminated two class action lawsuits challenging indexed annuity sales, seemingly ending an extended wave of class litigation in the federal courts against multiple insurers...more

CMS Issues Final Rule Outlining FY 2017 Medicare Payment Policies and Rates for SNF PPS

by Baker Donelson on

On July 29, 2016, the Centers for Medicare & Medicaid Services (CMS) released a final rule outlining FY17 Medicare payment policies and rates for the Skilled Nursing Facility Prospective Payment System (SNF PPS). The rule has...more

CMS Model Payment & Initiatives - The Growing Target of Quality & Care Improvement in Skilled Nursing Facilities

by Poyner Spruill LLP on

Like it or not, the Centers for Medicare & Medicaid Services (CMS) is expanding its strong commitment to focus on quality and care improvement as the basis for payment to providers throughout the continuum of care....more

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

by 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

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

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

by 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

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

by Baker Ober Health Law on

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

CMS Releases Final Rule on Medicare Shared Savings Program

by Foley & Lardner LLP on

This is the first post in Health Care Law Today’s Series on the final rule. The Centers for Medicare and Medicaid Services (“CMS”) released a final rule, on June 4, 2015, addressing changes to its Medicare Shared Savings...more

MedPAC Issues March 2015 Report to Congress on Medicare Payment Policies

by King & Spalding on

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

China Encourages Foreign Investment in Senior Care Services

by McDermott Will & Emery on

On 24 November 2014, the Ministry of Commerce (MOFCOM) and the Ministry of Civil Affairs (MCA) of China jointly issued the Announcement Encouraging Foreign Investors to Establish For-Profit Senior Care Institutions to Engage...more

CMS Releases Final Rule That Increases Difficulty of Medicare Enrollment

by 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

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

by 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

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

by 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

Worthless Services/Substandard Quality of Care Criminal Prosecutions May Be on the Rise

by Baker Ober Health Law on

If you are an operator of a skilled nursing facility (SNF), you might have faced the reality of insufficient medical staff and how it impacts your ability to deliver quality patient care to your residents. Or, you might have...more

Highlights of Proposed Rules for Skilled Nursing Facilities, Inpatient Rehabilitation Facilities, and Inpatient Psychiatric...

by Baker Ober Health Law on

On May 1, 2014, CMS released proposed payment and policy changes for Medicare Skilled Nursing Facilities (SNFs), Inpatient Rehabilitation Facilities (IRFs), and Inpatient Psychiatric Facilities (IPFs). Some of the key changes...more

Health Headlines: Also in the News - May 2014

by King & Spalding on

CMS Proposes Payment Changes for Hospice Providers, SNFs, IRFs and Inpatient Psych Facilities – Last week, CMS issued proposed rules that would make certain payment and policy changes to the payment systems for...more

CMS Announces Proposed SNF Reimbursement Rates for FY2015

by McDermott Will & Emery on

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

President Signs Medicare Physician Fee Schedule/SGR Patch with Numerous Health Policy Provisions

by Reed Smith on

In This Issue: - One-Year Medicare Physician Fee Schedule Fix - Valuation of Services Under the Physician Fee Schedule - ICD-10 Delay; LTCH Moratorium to Become Effective Immediately - Skilled Nursing...more

CMS Issues New Surveyor Guidance on Initiating CPR in Nursing Homes and Facility CPR/DNR Policies

by Poyner Spruill LLP on

In a highly publicized recent case in California, a registered nurse working in an independent living facility refused to initiate cardiopulmonary resuscitation (CPR) on an elderly resident who was experiencing respiratory...more

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

by Benesch on

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

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

by King & Spalding on

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

CMS Releases Proposed FFY 2014 SNF PPS Rule

by Baker Donelson on

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

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