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  2017 Pulse
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).
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).
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.
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.
  2016 Pulse
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.
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.
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.
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.
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).
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.
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.
  2015 Pulse
Bundled Payments for Care Improvement Initiative
The Bundled Payments for Care Improvement (BPCI) initiative was developed by the Center for Medicare and Medicaid Innovation.
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.
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).
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.
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.
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.
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.”
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

CMS Finalizes New Safeguards to Reduce Medicare Fraud
Office of Inspector General Publishes FY 2015 Work Plan
CMS Publishes Medicare Premiums & Deductibles for Calendar Year 2015
Skilled Nursing Facility Certification and Recertification’s
CMS Issues FY 2015 SNF PPS Final Rule
CMS Announces Medicare Appeals without Administrative Law Judges
MAOs Must Submit HIPPS Codes for SNF Encounters
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
The Centers for Medicare and Medicaid Services announced changes to the Recovery Audit Program
OIG Publishes FY 2014 Work Plan
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
Congress Passes Bill to Avert Cuts; Extends Therapy Cap Exception Process
 

 

2012 and Older Pulse Issues

CMS Implements the Claims-Based Data Collection Requirement for Outpatient Therapy Services
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
CMS Announces FY 2013 PPS Payment Rates
CMS Releases 2012 Nursing Home Action Plan
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
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
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