Expiration of the Long Term Care Hospital Development Moratorium: A Lasting Development Opportunity?

Posted by Jason Greis on January 5, 2013 under Articles | Be the First to Comment

Under the Medicare, Medicaid and SCHIP Extension Act of 2007 (the Act), as amended, Congress imposed an initial three-year moratorium on the establishment of new Long Term Care Hospitals (LTCH), on LTCH satellite facilities and on increases in the number of beds in existing LTCH facilities, unless an exception to the moratorium applied. This moratorium was subsequently extended for two years by the Patient Protection and Affordable Care Act (ACA).  The Centers for Medicare and Medicaid Services (CMS) recently announced, in its Final Rule updating fiscal year (FY) 2013 Medicare payment policies and rates for inpatient stays at general acute care hospitals and LTCHs that the LTCH development moratorium would expire as of Decem ber 29, 2012.  The moratorium has since sunsetted. Read More...

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...

Health Reform: Is the Hospital Industry Misapplying Congressional Intent?

Posted by Jason Greis on October 13, 2010 under Articles | Be the First to Comment

Thunder rolled down from Capitol Hill last week when Sen. Charles Grassley (R–Iowa) claimed that certain hospital systems and associations were misapplying the intent of Section 501(r)(5)(B) that prohibits the use of gross charges under the Patient Protection and Affordable Care Act. In their comments to the IRS regarding implementing regulations, the American Hospital Association (AHA) urged the IRS to apply a “gross charges” basis to charge those who do not qualify for financial assistance, and to use it as a starting place for calculating assistance to those who do. Read More...

Virtues and Vices of Medicare Episode of Care Payment Bundling: A Look at PPACA’s Pilot Program

Posted by Jason Greis on April 30, 2010 under Presentations | Be the First to Comment

The attached presentation addressing the potential benefits and drawbacks of CMS’s Pilot Program under PPACA to develop an episode of care bundled payment model for acute care, post-acute care, physician and outpatient services was presented at the Chicago Bar Association on Friday, April 30, 2010.  Please feel free to contact me if you have any questions. Read More...

Patient Protection and Affordable Care Act – Provisions Impacting Institutional Providers

Posted by Jason Greis on under Articles | Be the First to Comment

The below CMS e-mail alert was distributed via grouplist on Thursday, April 22, 2010 and impacts LTACHs, among other institutional providers. Read More...

When MedPAC Speaks Congress Listens: What the Inclusion of MedPAC Health Care Delivery Reform Proposals in Health Care Reform Legislation Means for Physicians

Posted by Jason Greis on March 28, 2010 under Articles | Be the First to Comment

On March 1, 2010, the Medicare Payment Advisory Commission (“MedPAC” or the “Commission”) released its 2010 Report to the Congress: Medicare Payment Policy (the “Final Report”) recommending annual Medicare payment updates for Medicare fee-for-service (“FFS”) payment systems, including among others, hospitals (including both general acute care and long term care hospitals) and physicians.  MedPAC is an independent congressional agency established by the Balanced Budget Act of 1997 to formulate recommendations to Congress to address quality and cost-containment issues affecting the Medicare program and its beneficiaries.  Two reports, issued in March and June each year, are the primary outlets for MedPAC’s policy and payment system updates, which change base rates paid by Medicare for a unit of service provided by a FFS provider—for example, a hospital admission or a physician visit or procedure.  Recommended payment system updates are based on an assessment of payment adequacy that takes into account beneficiaries’ access to care, supply of providers, quality of care, providers’ access to capital and Medicare margins.  Read More...