A final federal rule raising minimum staffing requirements for long-term care (LTC) facilities that receive Medicare or Medicaid funding becomes effective June 21, starting a staggered timeline for LTCs to create and...more
Summary -
The Centers for Medicare & Medicaid Services (CMS) recently published a proposed rule that, if finalized, will provide new minimum staffing level requirements for all long-term care facilities reimbursed by...more
In this episode, we discuss the Centers for Medicare and Medicaid Services’ proposed changes to the Medicare Advantage risk adjustment payment model, which will take effect in 2024 if finalized. We’re joined by special guest...more
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The Department of Health and Human Services Office of Inspector General (HHS OIG) has announced its intention to comprehensively review nursing home citations issued by the Centers for Medicare and Medicaid...more
3/1/2023
/ Audits ,
Centers for Medicare & Medicaid Services (CMS) ,
Citations ,
Department of Health and Human Services (HHS) ,
Health Care Providers ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
Medicaid ,
Medicare ,
Nursing Homes ,
OIG ,
Prescription Drugs ,
Skilled Nursing Facility
Summary -
The Centers for Medicare & Medicaid Services (CMS) released a proposed rule (Proposed Rule) intended to require additional disclosures related to the ownership and management of nursing facilities that accept...more
On January 30, 2023, CMS posted for inspection a final rule describing its Risk Adjustment Data Validation audit methodology (the Final RADV Rule). As we have discussed in prior alerts, the finalization of the RADV Rule,...more
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CMS has announced it is engaging in a new series of audits intended to address the agency’s concern that nursing homes could be miscoding schizophrenia to reduce their reported rates of antipsychotic use, and...more
Summary -
On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) published notice that it will postpone for another three months the finalization of a methodology to audit Medicare Advantage (MA)...more