CMS Rule Expands Long-Term Care Facility Administrators’ Responsibility to Report Facility Closures

Posted by Jason Greis on March 2, 2011 under Articles | Be the First to Comment

On February 18, 2011, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule (Interim Rule) implementing Section 6113 of the Patient Protection and Affordable Care Act (PPACA).  The Interim Rule, which becomes effective March 23, 2011, requires administrators of long-term care facilities (LTCF), including skilled nursing facilities (SNF) eligible for reimbursement under Medicare and nursing facilities (NF) eligible for reimbursement under Medicaid, to submit prior written notification of an impending LTCF closure to the Secretary of the U.S. Department of Health and Human Services (Secretary), the state’s long-term care ombudsman and residents of the facility and their legal representatives or other responsible parties.  LTCF administrators that do not comply with the new notice requirements may face sanctions, including civil monetary penalties of up to $100,000 and exclusion from participation in Federal health care programs.  In addition, LTCFs must have related policies in place to avoid being cited for survey deficiencies. Read More...

ACOs and the Shared Savings Program – Part II: Unanswered Questions

Posted by Jason Greis on October 12, 2010 under Articles | Comments are off for this article

In addition to the numerous misconceptions about Accountable Care Organizations (ACOs) and the Shared Savings Program, there are a number of unknowns regarding implementation, including permitted legal structures, payment amounts, and performance measurement. This article identifies and discusses some of the more significant unanswered questions about ACOs and the Shared Savings Program.  Read More...

ACOs and the Shared Savings Program: Some Common Misconceptions

Posted by Jason Greis on October 2, 2010 under Articles | Be the First to Comment

Section 3022 of the Patient Protection and Accountable Care Act (the Act) creates the Shared Savings Program for Medicare. Under the Shared Savings Program, which is to take effect no later than Jan. 1, 2012, Accountable Care Organizations (ACOs) that meet certain requirements established by the Secretary of Health and Human Services will be eligible to receive additional payments from Medicare where certain performance guidelines are met and cost-savings targets are achieved. The amount of the additional payment will be a percentage of the difference between the estimated per capita Medicare expenditures for patients assigned to the ACO and the cost-savings per capita Medicare expenditures threshold. Read More...

CMS Issues Proposed Rule on Changes to Stark In-Office Ancillary Services Exception

Posted by Jason Greis on August 12, 2010 under Articles | Be the First to Comment

Section 6003 of the Patient Protection and Affordable Care Act, Public Law 111-148 (H.R. 3590) (PPACA) makes a change to the “in-office ancillary services” exception to the Stark physician self-referral law that impacts physician practices providing certain radiology services in their offices. In short, the change requires physicians making a referral for magnetic resonance imaging (MRI), positron emission tomography (PET), and computed tomography (CT), or certain other radiology services in their offices, to make a disclosure to the patient that such services can be provided elsewhere and to include a list of alternative providers. Read More...

McGuireWoods 2010 North Carolina Healthcare Provider Conference and Post-Acute & Senior Care Conference

Posted by Jason Greis on June 22, 2010 under eNewsletter, Events | Be the First to Comment

2010 North Carolina Healthcare Provider Conference and Post-Acute & Senior Care Conference Read More...

From Hospitals to Home: Paying for the Next Evolution of Post-Acute and Senior Care

Posted by Jason Greis on July 26, 2009 under Articles, Events, Industry News | Read the First Comment

From Hospital to Home: Paying for the Next Evolution of Post-Acute and Senior Care Read More...