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...

MedPAC Releases 2010 Final Report Recommending Payment Updates for LTACHs and other FFS Providers

Posted by Jason Greis on March 1, 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”).  The purpose of the Final Report is to recommend annual Medicare payment updates for the following nine Medicare fee-for-service (“FFS”) payment systems:  hospitals, physicians, ambulatory surgery centers, outpatient dialysis services, hospices, skilled nursing facilities, home health services, inpatient rehabilitation facility services and long-term acute care hospital services.  Read More...

LTACHs and other Post-Acute Providers are Not Eligible for Funds to Implement EHR Technology under the HITECH Act

Posted by Jason Greis on August 7, 2009 under Articles | Be the First to Comment

Many LTACHs and other post-acute care providers have inquired whether they are eligible to apply for and receive incentive payments to adopt certified electronic health record (“EHR”) technology under the Health Information Technology for Economic and Clinical Health Act (the “HITECH Act” or the “Act”).  To put it simply, the answer appears to be “no.” Read More...

Health Care Legislation Update: The Impact on Post-Acute Care Providers and Physician-Owned Hospitals

Posted by Jason Greis on July 16, 2009 under Articles | Be the First to Comment

President Obama’s looming deadline to hold Congressional pre-conferences and floor votes on comprehensive healthcare reform legislation before Congress’s August recess has prompted a flurry of legislative activity this week.  On Tuesday, July 14, 2009, the House released the Tri-Committee health care reform bill, officially titled H.R. 3200, America’s Affordable Health Choices Act of 2009 (the “Tri-Committee Bill”), and with its party-line vote on Wednesday, July 15, 2009, the Senate Health, Education, Labor, and Pensions (“HELP”) Committee became the first congressional committee to approve a health care reform bill (a copy of which is attached by clicking here).  The Senate Finance Committee’s health reform bill may be released as early as next week. Read More...

Exploring the Potential Benefits and Drawbacks of Acute-Care and Post-Acute Care Payment Bundling

Posted by Jason Greis on April 3, 2009 under Articles, Whitepapers | Be the First to Comment

The current Congressional fervor to overhaul the U.S. health care system has some policy makers discussing how to change the way post-acute providers, including LTACHs, home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and outpatient-based hospital rehabilitation facilities are compensated for treating Medicare beneficiaries.  One solution proposed by President Barack Obama, the Congressional Budget Office, and certain congressional leaders is to bundle payments for acute care and post-acute care services provided within the first thirty days after being discharged from an acute care hospital.  This bundling model has been proposed many times since the early 1980s as a measure to control escalating post-acute care costs, decrease the number of preventable acute-care hospital readmissions, and increase Medicare cost savings but has never received broad support-until now. Read More...

CMS to Seek Recoupment of $25 Million from Acute-Care Hospitals (not LTACHs) under Medicare’s Post-Acute Transfer Policy

Posted by Jason Greis on March 20, 2009 under Articles | 2 Comments to Read

According to an audit report recently released by the Office of Inspector General of the Department of Health and Human Services (OIG), hospitals paid under the inpatient prospective payment system (IPPS) may have received an estimated $25 million in overpayments between fiscal years 2003 and 2005 as a result of noncompliance with Medicare’s post-acute transfer policy.  The purpose of this policy is to provide a disincentive for hospitals to discharge patients to another hospital, a skilled nursing facility, or a patient’s home early in a patient’s stay in order to minimize costs while still receiving a full diagnosis-related group (DRG) payment. Read More...