The Revenue Integrity Symposium (RIS) will bring opportunities for financial professionals to gain knowledge in their field by learning about what other experts have to say and what best practices may be beneficial for the Patient-Driven Payment Model (PDPM) transition. This year’s symposium will be held October 15–16 in Orlando.
There are a variety of PDPM sessions that will be beneficial to finance professionals in the long-term care (LTC) continuum.
I will be speaking on changes to the LTC billing process PDPM brings, such as a focus on weekly Medicare meetings, a triple-check focus, diagnosis code reviews, rejected claims, and gap billing.
A class-action lawsuit filed by 14 SNF residents in 2011 challenging the Medicare three-day rule saw its first day in court on August 12. The lawsuit addresses the rule requiring residents to be admitted to an acute-care hospital for a minimum of three days prior to entering a SNF to receive Medicare coverage. The residents were unable to use their Medicare benefit because they had been under observation in the hospital, rather than admitted.
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.
This book with downloadable tools helps you navigate recent changes to the RAI and includes more than 100 customizable care plan templates, as well as the most up-to-date care area assessment (CAA) worksheets from CMS. With many updated regulations already in effect, this timely book covers Section GG, discharge planning, QAPI, person-centered care, and survey changes, as well as the changes resulting from the ICD-10 transition.
The state of New York is proposing a change in the way it calculates the case mix that sets Medicaid reimbursements for skilled nursing facilities — with the goal of realizing $246 million in net savings.