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2017 Pulse |
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Skilled Nursing Facility Quality Reporting Data Submission Deadline
The IMPACT Act of 2014 mandated the establishment
of the Skilled Nursing Facility (SNF) Quality Reporting
Program (QRP). |
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SPECIAL EDITION: FY 2018 SNF PPS Proposed Rule
On April 27, 2017, the Centers for Medicare & Medicaid
Services (CMS) issued a proposed rule outlining the
Fiscal Year (FY) 2018 Medicare payment rates and
quality programs for skilled nursing facilities (SNFs). |
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The Core Elements of Antibiotic Stewardship for Nursing Homes
On October 4, 2016, The Centers for Medicare and
Medicaid Services (CMS) published a Final Rule to
revise Medicare and Medicaid participation
requirements for nursing facilities. The Final Rule
requires that facilities establish an Antibiotic
Stewardship Program as part of the Infection Prevention
and Control Program (IPCP) by November 28, 2017. |
|
2017 Onsite HIPAA Audits
The Health Insurance Portability and Accountability
Act (HIPAA) Privacy regulations require health care
providers and organizations, as well as their business
associates, develop and follow procedures that ensure
the confidentiality and security of protected health
information (PHI) when it is transferred, received,
handled, or shared. |
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OIG Issues Final Rule On Exclusion Authority
On January 11, 2017, the U.S. Department of Health
and Human Services Office of Inspector General (OIG)
published its Final Rule establishing new standards for
excluding individuals and entities from participation in
federal health care programs. |
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2016 Pulse |
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CY 2017 New Therapy Evaluation Codes
For CY 2017, the Physician Fee Schedule final rule
includes a new 3- tiered current procedural terminology
(CPT) code system to replace the current single code that
covered all therapist evaluations. |
|
Office of Inspector General Publishes FY 2017 OIG Work Plan
The office of Inspector General (OIG) Work Plan for Fiscal
Year (FY) 2017 provides brief descriptions of activities that
the OIG plans to initiate or continue in FY 2017. |
|
CMS Publishes Reform of Requirements for
Long-Term Care Facilities Final Rule
The Centers for Medicare & Medicaid Services (CMS)
released the final rule “Medicare and Medicaid
Programs; Reform of Requirements for Long-Term Care
Facilities” on September 28, 2016. |
|
CMS Establishes Emergency Preparedness Requirements for
Healthcare Providers
The Centers for Medicare & Medicaid Services
(CMS) finalized a rule to establish consistent
emergency preparedness requirements for health
care providers participating in Medicare and
Medicaid, increase patient safety during
emergencies, and establish a more coordinated
response to natural and man-made disasters. |
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CMS Releases Final MDS 3.0 RAI Manual Update
On August 26, 2016 the Centers for Medicare and
Medicaid Services (CMS) released the final
revisions to the MDS 3.0 RAI Manual v1.14
effective October 1, 2016. |
|
CMS Issues FY 2017 SNF PPS Final Rule
On July 29, 2016, the Centers for Medicare & Medicaid
Services (CMS) issued the SNF PPS final rule outlining
fiscal year (FY) 2017 Medicare payment policies and
rates for the Skilled Nursing Facility Prospective
Payment System (SNF PPS), the SNF Quality
Reporting Program (SNF QRP), and the SNF Value-Based Purchasing (SNF VBP) Program. |
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New Quality Measures Impact Five-Star Quality Ratings System
The Centers for Medicare & Medicaid Services (CMS)
announced that five of the six new quality measures for
skilled nursing facilities will be phased into the Five-Star Quality Ratings system on July 27, 2016. |
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OIG FY 2016 Mid-Year Work Plan
The U.S. Department of Health and Human
Services (HHS) Office of Inspector General (OIG)
Published the fiscal year (FY) 2016 Mid-Year
Work Plan Update, summarizing new and ongoing
reviews and activities that OIG plans to pursue with
respect to HHS programs and operations during the
current fiscal year and beyond. |
|
CMS Publishes Draft MDS 3.0 RAI Manual
CMS released a draft copy of the Minimum Data Set (MDS)
3.0 RAI User’s Manual v1.14, which details the requirements
for the upcoming October 1, 2016, changes to the MDS. |
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Fiscal Year 2017 SNF PPS Proposed Rule
The Centers for Medicare & Medicaid Services (CMS)
released the Skilled Nursing Facilities proposed rule on
April 21, 2016, which outlines Medicare payment rates
and policy changes for Fiscal Year (FY) 2017. CMS
proposes a positive payment update of 2.1% for skilled
nursing facilities (SNFs). |
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New Quality Measures Coming to Nursing Home Compare, Five-Star Rating
New quality measures for skilled nursing facilities
will be introduced in April 2016 the Centers for
Medicare & Medicaid Services (CMS) officials
announced during an Open Door Forum on March
3, 2016. |
|
CMS Increases Site Visits to Medicare Providers
The Affordable Care Act (ACA) provided tools to
enhance the Centers for Medicare & Medicaid
Services’ (CMS) ability to screen providers and
suppliers upon enrollment and identify those that
may be at risk for committing fraud, including the
use of risk-based screening of providers and
suppliers. |
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CMS Launches Infection Control Pilot Program
The Centers for Medicare and Medicaid Services
(CMS) has begun a three-year pilot project to
improve infection control and prevention
assessments for nursing homes, hospitals and care
transitions between the two. |
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2015 Pulse |
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Bundled Payments for Care Improvement Initiative
The Bundled Payments for Care Improvement (BPCI)
initiative was developed by the Center for Medicare and
Medicaid Innovation. |
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Office of Inspector General Publishes FY 2016 OIG Work Plan
The office of Inspector General (OIG) Work Plan for Fiscal
Year (FY) 2016 provides brief descriptions of activities that
the OIG plans to initiate or continue in FY 2016. The
following key items are addressed in the FY 2016 work plan
for Nursing Homes. |
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The IMPACT Act of 2014 and Data Standardization
On September 18, 2014, Congress passed the Improving
Medicare Post-Acute Care Transformation Act of
2014 (the IMPACT Act). The Act requires the
submission of standardized data by Long-Term Care
Hospitals (LTCHs), Skilled Nursing Facilities (SNFs),
Home Health Agencies (HHAs) and Inpatient
Rehabilitation Facilities (IRFs). |
|
ICD-10-CM Transition Series Part 9
ICD-10-CM will be Implemented October 1, 2015
ICD-9-CM codes will not be accepted for services
provided on or after October 1, 2015. ICD-10-CM
cannot be utilized prior to October 1, 2015. |
|
Claims Submission Alternatives for Providers
Who Have Difficulties Submitting ICD-10 Claims
This article is intended for all physicians, providers, and
suppliers who submit claims to Medicare Administrative
Contractors (MACs), including Home Health & Hospice
MACs (HH&H MACs) and Durable Medical Equipment
MACs (DME MACs), for services provided to Medicare
beneficiaries. |
|
CMS Issues FY 2016 SNF PPS Final Rule
On July 30, 2015, the Centers for Medicare & Medicaid
Services (CMS) released the Fiscal Year (FY) 2016 Skilled
Nursing Facility (SNF) Prospective Payment System (PPS). |
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CMS Proposed Major Revisions to Regulations for Long-Term Care
On July 13, 2015, the Centers for Medicare & Medicaid
(CMS) issued a proposed rule that would revise the
requirements that long-term care (LTC) facilities must meet
to participate in the Medicare and Medicaid programs. |
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CMS Issues Guidance for Beneficiary Disenrollment by Nursing Facilities
The Centers for Medicare and Medicaid Services (CMS)
released guidance for Long Term Care (LTC) facilities, regarding
facility actions to dis-enroll beneficiaries from Medicare Advantage
plans or Medicare-Medicaid plans (MMPs) that serve Medicare-Medicaid (dually eligible) enrollees as part of the Financial
Alignment Initiative. |
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CMS Announces Payroll-Based Staffing Data Collection System
The Affordable Care Act (ACA) requires nursing
facilities to electronically submit direct care staffing
information (including agency and contract staff) based
on payroll and other auditable data. |
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Proposed FY 2016 SNF PPS Rule
On April 15, 2015, the Centers for Medicare & Medicaid
Services (CMS) issued a proposed rule outlining proposed
Fiscal Year (FY) 2016 Medicare payment rates for skilled
nursing facilities (SNFs). |
|
2% Sequestration Medicare Cuts Continue Through March 31, 2016
On April 1, 2013, The Centers for Medicare and
Medicaid Services (CMS) began to impose a mandatory
2% payment reduction in the Medicare Fee-For-Service
(FFS) Program – also known as “Sequestration.” |
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CMS Releases Updated Five-Star Rating System
On Feb. 20, 2015 the Centers for Medicare and Medicaid
Services (CMS) publicly released a revised Five-Star Quality
Rating System that CMS labeled Nursing Home Compare
3.0. |
|
ICD-10-CM Transition Series
ICD-10-CM will be implemented October 1, 2015. ICD
-9-CM codes will be required through September 30,
2015 but will not be accepted for services provided on
or after October 1, 2015. ICD-10-CM cannot be
utilized prior to October 1, 2015. |
| |
2014 Pulse |
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CMS Finalizes New Safeguards to Reduce Medicare Fraud
|
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Office of Inspector General Publishes FY 2015 Work Plan
|
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CMS Publishes Medicare Premiums & Deductibles for Calendar Year 2015
|
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Skilled Nursing Facility Certification and Recertification’s
|
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CMS Issues FY 2015 SNF PPS Final Rule
|
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CMS Announces Medicare Appeals without Administrative Law Judges
|
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MAOs Must Submit HIPPS Codes for SNF Encounters
|
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Proposed FY 2015 Payment and Policy changes for Medicare Skilled
Nursing Facilities
|
|
Congress Delays Medicare Reimbursement Cuts and Implementation of
ICD-10 in “Doc Fix” Bill
|
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The Centers for Medicare and Medicaid Services announced changes to
the Recovery Audit Program
|
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OIG Publishes FY 2014 Work Plan
|
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CMS Issues Final 2014 Physician Fee Schedule Rule
|
| |
2013 Pulse |
|
CMS Publishes Medicare Premiums & Deductibles
for Calendar Year 2014
|
|
CMS Issues Memo on CPR in Skilled Nursing Facilities
|
|
Federal Government Shutdown Impacts
Survey & Certification Activities
|
|
Transition for Implementation of FY 2014
SNF PPS MDS 3.0 Policy Changes
|
|
CMS Issues Final Rule for Hospital Inpatient
Admissions and Clarifies Use of Observation Stays
|
|
CMS Publishes QAPI Toolkit and Other Provider Resources
|
|
CMS Clarifies Therapy Caps and Use of Advance Beneficiary Notice of Non-Coverage
|
|
Proposed Fiscal Year 2014 Payment & Policy Changes
For Medicare Skilled Nursing Facilities
|
|
CMS Clarifies Delegation of Tasks by Physicians in Long-Term Care Facilities
|
|
Mandatory Payment Reduction in Medicare Fee-for-Service Program
|
|
CMS Announces Long Term Care Provider Participating in Bundled Payment Initiative
|
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Congress Passes Bill to Avert Cuts; Extends Therapy Cap Exception Process
|
| |
2012 and Older Pulse Issues |
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CMS Implements the Claims-Based Data Collection Requirement for Outpatient Therapy Services
|
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CMS Issues Final 2013 Physician Fee Schedule Rule
|
|
Office of Inspector General Posts Work Plan for Fiscal Year 2013
|
|
Manual Medical Review Process for Part B Therapy Claims
|
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CMS Announces FY 2013 PPS Payment Rates
|
|
CMS Releases 2012 Nursing Home Action Plan
|
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Redesign Updates to the Nursing Home Compare Website
|
|
Emergency Preparedness Office of Inspector General (OIG)
Examines Nursing Home
|
|
CMS Announces Initiative to Reduce Avoidable Hospitalizations
|
|
CMS National Conference Provides Updates, Clarifications
|
|
Congress Approves Therapy Cap Exception Process
|
|
New Quality Measures Scheduled for Release
|
|
Managing FY 2012 PPS MDS Changes
|
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CMS POSTS MEDICARE PREMIUMS & DEDUCTIBLES FOR CALENDAR YEAR (CY) 2012
|
|
The Office of Inspector General (OIG) Work Plan
for Fiscal Year (FY) 2012
|
|
CMS Publishes MDS 3.0 RAI Manual Updates
|
|
CMS Posts Transition Document for FY 2012 FINAL RULE
|
|
CMS has published parts of the RAI manual for MDS 3.0.
|
|
Coding of Flu Vaccine on the MDS
|
|
OIG Work Plan for Fiscal Year 2010 - Nursing Homes
|
|
Federal Guidelines Encourage Employers
to Plan Now for Upcoming Influenza
|
|
Priority Order of Quality Indicator Survey (QIS)
|
|
SPECIAL PRESENTATION—5 Star Quality Rating System
|
|
RAC Attack! Are you ready for a RAC Audit?
|
|
Proposed Changes to the Prospective Payment System and Rate Year 2010 Rates
|
|
Medicare Announces Sites for
Pilot Program to Improve
Quality as Patients Move
Across Care Settings
|
|
CMS Releases Updated Special Facility Focus List
|
|
Revised Quality of Care Guidance at F309
|
|
OIG Supplemental
Compliance Program Guidance for
Nursing Facilities
|
|
New HIPAA Privacy Rule Guidance for Providers
|
|
Revised Guidance to Surveyors - F325 & F371
|
|
2009 Medicare Premiums
Deductibles and Coinsurance
|
|
ICD-9-CM
ANNUAL UPDATE
|
|
Fiscal Year 2009
Skilled Nursing Facility
Prospective Payment System
(SNF PPS) Final Rule
|
|
Medicare Improvements for Patients and Providers Act, 2008
|
|
SPECIAL EDITION PULSE - Update on Therapy Caps
June 27, 2008 special edition
|
|
Therapy Cap Exception Process Update
June 25, 2008 edition
|
|
Exceptions to Therapy Caps Restricted July 1, 2008
June 11, 2008 edition
|
|
Assignment of Providers to MACs
May 5, 2008 edition
|
|
2008 Medicare
Deductible, Coinsurance and Therapy Caps
January 8, 2008 |
|
Fiscal Year 2008 OIG Work Plan
October 24, 2007 |
|
CMS Issues New Survey Tag F373 - Paid Feeding Assistants
August 23, 2007 |
|
Skilled Nursing Facility (SNF) Payment Rates for Fiscal Year 2008
August 10, 2007 |
|
Revised F-Tags 323 adnd 324 - Accidents and Hazards
|
|
CMS Announces NPI Data Dissemination Policy
June 13, 2007 |
|
CMS Proposes SNF Payment Increase for Fiscal Year 2008
May 10, 2007 |
|
CMS Issues Contingency Plan for the National Provider Identifier (NPI) Rule
April 11, 2007 |
|
Medicare Payment Advisory Commission (MedPAC) Recommendations to Congress
March 28, 2007 |
|
CMS Renames the Medicare/Medicaid Provider Number
March 13, 2007 |
|
NPI - Do You Have It? Are You Sharing It? Are You Using It?
February 23, 2007 |
|
Part B Therapy Cap Relief for 2007
January 3 , 2007 |
|
Physician Fee Schedule 2007 - Final Rule
November 9, 2006 |
|
Flu Season is Here -
Are you ready for the New Regulations and Quality Measures?
October 26, 2006 |
|
Medicare Nursing Home Payments to Increase in 2007
August 1, 2006 |
|
CMS Issues DRAFT Revision to Surveyor Guidance at F-Tag 309 - Pain
July 14, 2006 |
|
CMS Issues Guidance for Benefits Exhaust and No-Payment Bills
June 12 , 2006 |
|
Who, What, When, Why & How of the National Provider Identifier (NPI)
May 31 , 2006 |
|
New, Revised and Draft Guidance to Surveyors Apr. 19, 2006 |
|
Therapy Cap Exception Process Feb. 16, 2006 |
|
Outpatient Therapy Caps Return for 2006 Jan. 16, 2006 |
|
Rehab Plus Extensive Services – Criteria to Achieve and RUG Assignment Anomalies Dec. 16, 2005 |
|
Medicare Part D & Its Impact on Nursing Home Surveys Nov. 10, 2005 |
|
Revisions to the State Operations Manual for Long Term Care
Oct. 27, 2005 |
|
CMS FAQs Related to Hurricane Katrina Sept. 20, 2005 |
|
RUG Refinements Posed to Significantly Impact Your 2006 Budget
August 23, 2005 |
|
Hepatitis B Transmission in Nursing Homes July 11, 2005 |
|
New Independent, Expedited Review Process for SNF Notices of Non-Coverage June 15, 2005 |