Nov 01, 2019
 | 
Billing Alert for Long-Term Care

CMS issued its final rule, Fiscal Year 2020 Payment and Policy changes for Medicare Skilled Nursing Facilities (CMS-1718-F), in July. The new payment rule aims to “strengthen the Medicare program by better aligning payment rates for these facilities with the costs of providing care and increasing transparency so that patients are able to make informed choices.” Within the rule are three major updated provisions that will affect the operation of SNFs: the Prospective Payment System (PPS) payment policy, the Value-Based Purchasing Program (VBP), and the Quality Reporting Program (QRP).

Oct 18, 2019
 | 
The Bottom Line

Find your copy of our exclusive AMBR Journal here. This quarter's issue contains in-depth features on:

MDS coordinators to take on quality
The onset of the PDPM marks another evolution for the MDS and MDS coordinators.

Experts uncover little-known risks and opportunities in PDPM
AMBR asked five long-term care experts to share key PDPM opportunities and risks that SNF providers may not have considered leading up to the transition.

Limit financial risk by enlisting billers to forecast profitability prior to admission
Determining and tracking the profitability of each potential new patient will be key to protecting the SNF’s bottom line in PDPM.

Consolidated billing made simple: Manage relationships
Proactively manage relationships with outside patients and external service providers to avoid costly consolidated billing mistakes

Sep 26, 2019
 | 
Billing Alert for Long-Term Care

CMS announced proposed changes to the Medicare long-term care requirements that would reform “unnecessary, obsolete, or excessively burdensome” requirements for SNFs on July 17. The proposed rule, “Medicare & Medicaid Programs; Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency and Transparency” (CMS-3347-P), fueled by the Trump administration, aims to reduce red tape surrounding SNF compliance and regulations.

Sep 19, 2019
 | 
The Bottom Line

CMS will hold an open door forum on September 19 for SNFs and LTCs. Discussions will focus on:

  • PDPM updates
  • PBJ updates
  • MS-6058-FC Medicare, Medicaid, and Children’s Health Insurance Programs; Program Integrity Enhancements to the Provider Enrollment Process
  • SNF QRP resource update

If you wish to participate, dial 1-888-455-1397. Conference ID: 4676500

Jul 25, 2019
 | 
Billers' Association for Long-Term Care

CMS has announced July 17 two new rules that, according to a CMS press release, will place more focus on SNF residents as a priority over paperwork by reducing unnecessary regulations and protecting their legal interests. The proposed rule would delay Phase 3 requirements, including QAPI and ethics and compliance standards. The final rule upends the ban on SNFs offering arbitration agreements to residents. These changes, fueled by the Trump administration, will modify previous rules set forth between October 2016 and June 2017.

Jul 25, 2019
 | 
Billing Alert for Long-Term Care

In nearly all provider segments of healthcare, revenue maximization and integrity are directly tied to compliance and quality ratings. In home health, submission of quality data via the OASIS (known as HHCAHPS) is required. Agencies that fail to submit the required data receive reimbursement reductions of 2%. For SNFs, reporting QRP data is required. Failure to meet the 80% threshold reporting requirement on quality measures equals a 2% payment reduction (beginning October 2019). The cutoff date to meet the compliance level for the period of October 1–December 31, 2018 was May 15, 2019; too late for facilities that underperformed.

Jul 19, 2019
 | 
The Bottom Line

CMS has announced yesterday two new rules that, according to a CMS press release, will place more focus on SNF residents as a priority over paperwork by reducing unnecessary regulations and protecting their legal interests. The proposed rule would delay Phase 3 requirements, including QAPI and ethics and compliance standards. The final rule upends the ban on SNFs offering arbitration agreements to residents. These changes, fueled by the Trump administration, will modify previous rules set forth between October 2016 and June 2017.

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Tuesday, October 6, 2020 - 07:00

2019 Revenue Integrity Symposium

The 2020 Revenue Integrity Symposium covers topics essential to revenue integrity, Medicare compliance, and the revenue cycle in acute care and long-term care settings.

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