The Centers for Medicare & Medicaid Services (CMS) is seeking billing specialists to participate in a focus group meeting on Medicare Fee for Service (FFS) compliance topics on October 5, 2018, 10AM-2PM, ET. Meeting discussion topics will include the following.
The Billers’ Association is seeking long-term care managers, revenue cycle enthusiasts, and billing professionals to join our growing ad-hoc list of experts interested in contributing to articles in our monthly publication, Billing Alert for Long-Term Care. This digital newsletter provides expansive regulatory coverage, including MDS changes, reimbursement issues, and expert advice and analysis to help improve job performance in all aspects of the revenue cycle management system.
CMS published the Final Rule to Reform Requirements for Long Term Care Facilities on October 4, 2016, with an effective date of November 28, 2016. Survey protocols and interpretive guidelines were published on March 8, 2017, in Appendix PP of the State Operations Manual. One of the new requirements for nursing facilities is to implement a compliance and ethics program in the last phase of the timetable for changes. Due to the time and resources needed to achieve compliance with the new requirements, surveyors will not begin surveying for compliance with this change until November 28, 2019.
Experts say care for dementia patients may get a boost now that the condition is being added to The Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation Medicare Advantage Value-Based Insurance Design (MA-VBID) model. “I definitely see it as a positive,” says Renee Kinder, MS, CCC-SLP, RAC-CT, director of clinical education for Encore Rehabilitation Services in Louisville, Kentucky.
In its final SNF PPS rule for fiscal year (FY) 2016, released in late July, CMS pushed the bulk of its payment and practice reform–driven proposals from April through to fruition. In fact, one expert finds the two iterations of the rulemaking almost too close for comfort.
“It appears that CMS was rushing to get everything done, and they just did not change anything, which I think was surprising,” says David Gifford, MD, senior vice president of quality and regulatory affairs at the American Health Care Association (AHCA), a national trade association for long-term care providers. “We were generally disappointed that they didn’t take into consideration any of the comments. There were some really thoughtful comments … from a number of people.”
While experts doubt the final rule will blindside SNFs, they also warn providers against taking the forward-focused provisions—and their more distant implementation dates—too lightly. When coupled with the recently proposed overhauls to the industry’s long-untouched Conditions of Participation, the regulatory document bodes major changes to payment and care approaches for nursing homes in the years ahead.
Editor's note: This month's "Q&A" was modified from the HCPro book ICD-10 Essentials for Long-Term Care, written by Karen L. Fabrizio, RHIA, CPRA. ICD-10 Essentials for Long-Term Care provides you with a three-step plan that takes you from understanding the differences between ICD-9 and ICD-10 to full-scale ICD-10 readiness at your facility. For more information or to order, call customer service at 800-650-6787 or visit www.hcmarketplace.com. To submit a question for upcoming issues, email Managing Editor Olivia MacDonald at email@example.com.