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Post-Acute Advisor

Bill introduced to lower Medicaid beneficiary “churn”

 

Millions of individuals eligible for Medicaid or CHIP are disenrolled from these programs every year due to small changes in income or issues with paperwork. This phenomenon is referred to as “churn,” and it has led to worse health outcomes as a result of care interruptions, higher costs to taxpayers, and increased barriers for residents and patients, providers, and health plans.

 

 

CBO releases updated cost estimate, Medicaid cuts a concern

 

After the Congressional Budget Office’s (CBO) release of their updated cost estimate of the American Health Care Act, many -- including Senators and long-term care providers -- are voicing their concerns over severe Medicaid cuts, 14 million more people to be uninsured in 2018 (a number that will rise to 23 million by 2026), and rising premiums if the estimate is accepted.

 

 

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Five secrets to better scheduling of mobile workers for in-home healthcare

 

Mobility matters, especially in healthcare. Learn what other healthcare organizations already know -- the secrets to improving mobile workforce scheduling so you can deliver a wide range of services in a cost-effective, highly productive way for healthcare professionals and patients.

 

 

Hospices CAHPS survey updates: New Chinese survey, technical corrections, and exemption reminder

 

The CAHPS Hospice Survey team announced May 26 that it has released updated versions of survey mail materials in traditional and simplified Chinese.

 

 

SNF Quality Reporting deadline June 1

 

June 1 was the deadline for all SNFs receiving Medicare funding to have all their MDS forms for admissions/discharges happening between October 1, 2016 and December 31, 2016 completed. This requirement must be met in order to remain compliant with the SNF Quality Reporting Deadline. SNFs that do not comply with this requirement risk losing 2% of their Medicare fee-for-service rate beginning October 1, 2017.

 

 

 

Requirement clarification for resident transfer and discharge

 

In a S&C letter released by CMS on May 12, 2017, the agency outlined specific requirements for transfers and discharges. As part of revisions to requirements of participation last October, facilities must notify the resident and resident’s representative(s) of the transfer or discharge in writing, including the reason for the change, as well as send a copy of the notice to a representative of the Office of the State Long-Term Care Ombudsman.

 

 

Americans less confident they’ll be able to age at home

 

According to a new survey from SCAN, a California-based group offering a large non-profit Medicare Advantage plan, older Americans are less confident they’ll be able to stay in their home as they age.

 

 

Other Post-Acute News

 

New in the June issue of PPS Alert for Long-Term Care: RCS-1 CMS case-mix pre-rule: Get ready for big changes

 

Changes are coming to the SNF Prospective Payment System (PPS) -- possibly the largest changes the industry has seen since the implementation of RUGs in July 1998. PPS Alert for Long-Term Care has the scoop.

 

 

Ensuring an effective & efficient triple check process

 

The triple check process verifies claims for accuracy and compliance with Medicare regulations before billing. Since the Office of the Inspector General published a report that over a billion dollars of inappropriate payments were paid to skilled nursing facilities in 2009, many facilities have adopted the triple check process as a critical operational strategy to mitigate the risk of improper payments and triggering a Medicare audit.

 

Pressing “refresh” on your activities program

 

The Centers for Medicare & Medicaid Services’ latest revised Conditions of Participation place a stronger emphasis on person-centered care and resident preferences, a realm where activities serve as a core concept. However, current residents are more discerning than ever before and have different interests than they used to. Planning and designing new activities that fit diverse resident needs, all while keeping residents active and engaged, is a major challenge for long-term care professionals.

 

SNF therapy contracts: Your risks and what you need to know

 

The use of contracted therapists in your SNF immediately increases your citation and criminal risk in terms of billing and liability. These facilities must understand how to limit such risk under Medicare due to improper treatment and coding of your therapy contractor, including how to implement a shared risk arrangement with your therapy contractor while outlining a strategic way to monitor such risk within your SNF.

 

Put Your QAPI Plan Into Action, Prepare for CoPs, Achieve 5-Star Rating

 

CMS has granted home health agencies six additional months to prepare the Conditions of Participation—so don’t waste any more time. Implementing the CoPs is a huge time and cost burden so the sooner agencies begin to put policies and procedures into place, the better off they’ll be on Jan. 13, 2018.
 

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Attendees will be able to return to their facility with the tools they need to understand the latest billing and reimbursement regulations, plus how to navigate the many billing processes to ensure their SNF is receiving appropriate reimbursement for services provided.

 

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Upcoming CMS Events

 

 

Thursday, June 15, 1:30pm – 3:00pm ET - National Partnership to Improve Dementia Care and QAPI Call

 

Wednesday, July 5 - Home Health, Hospice, and Durable Medical Equipment Open Door Forum

 

Thursday, June 29, 1:00 – 3:00 ET - Improvements to the Medicare Claims Appeal Process and Statistical Sampling Call

 
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