With the new year upon us, the long-term care industry is looking ahead to more changes and clarifications. Billing Alert for Long-Term Care reached out to advisors and consultants in the industry to take broad look at what billing departments need to prepare for in the coming year and the overall state of the industry. Let's take a look at what they said to look out for in 2013.
CMS announced in August that it would release comparative billing reports (CBR) to SNFs, and by September, 5,000 facilities received reports that provided comparative data with other providers in the same field.
Section 6102 of the Resident Protection Affordable Care Act dictates that SNFs and nursing facilities must have implemented a compliance and ethics program by March 23, 2013. The compliance program should act as a vehicle to detect criminal, civil, and administrative violations.
Prepayment and postpayment reviews may present a challenge for SNFs, but it's important to remember that a claim review is neither the end of the world nor the end of the game-you do have options under the Medicare appeals process.