In 2021, New York enacted a state law requiring facilities to spend 70% of their revenue on resident care, including 40% of resident-facing care, and limiting profits to 5%. The law has not been implemented.The nursing home industry filed two … [Read more...] about Two Courts Reject Nursing Home Industry Challenges to New York Law Requiring Minimum Spending on Care and Caps on Profit
Archives for February 2024
Greetings & Goodbyes for the Center for Medicare Advocacy Board
The Center for Medicare Advocacy is thrilled to announce the addition of three new members to its Board of Directors. We wholeheartedly welcome:As we welcome these three incredible women and honor their commitment to advocacy and social justice … [Read more...] about Greetings & Goodbyes for the Center for Medicare Advocacy Board
Lucille Chiplin Johnson – Member, Board of Directors
Lucille Chiplin Johnson, MBA, MPA is the former Assistant to the Executive Director, Manager of Economic Development and Public Affairs, North Central Texas Council of Governments (NCTCOG)Lucille recently retired from NCTCOG, a regional planning … [Read more...] about Lucille Chiplin Johnson – Member, Board of Directors
Karen Campbell – Member, Board of Directors
Karen Campbell, Principal at Campbell Law Group of North Florida, P.A, is Executive Director of the North Florida Office of Public GuardianMs. Campbell's career is devoted to improving the lives of vulnerable adults and people with disabilities. … [Read more...] about Karen Campbell – Member, Board of Directors
Regina Blye – Member, Board of Directors
Regina Blye is the Chief Program and Policy Officer for the National Paralysis Resource Center of the Christopher & Dana Reeve Foundation. As the Chief Program and Policy Officer, Regina oversees operations of the National Paralysis Resource … [Read more...] about Regina Blye – Member, Board of Directors
Medicare Advantage Plans Under Scrutiny by Department of Justice and Office of Inspector General
As discussed in a recent CMA Alert (Feb. 22, 2024), the Centers for Medicare & Medicaid Services (CMS) has issued proposed Medicare Advantage (MA) and Part D payment rates for 2025, comments to which are due March 1, 2024. MA plans are … [Read more...] about Medicare Advantage Plans Under Scrutiny by Department of Justice and Office of Inspector General
Know Jimmo | CMS Reminder to MA Plans
In a February 2024 memo, the Centers for Medicare & Medicaid Services reminded Medicare Advantage organizations that the Jimmo Settlement...clarified that the Medicare program covers skilled nursing care and skilled therapy services under … [Read more...] about Know Jimmo | CMS Reminder to MA Plans
Know Jimmo | Skilled Nursing Facility Policy
Medicare Benefit Policy Manual, Chapter 8 – Skilled Nursing Facility ServicesSection 30Coverage of nursing care and/or therapy to perform a maintenance program does not turn on the presence or absence of a patient’s potential for improvement … [Read more...] about Know Jimmo | Skilled Nursing Facility Policy
Medicare Advantage Proposed Payment for 2025 and Other Updates
The Centers for Medicare & Medicaid Services (CMS) has issued proposed Medicare Advantage (MA) and Part D payment rates for 2025. As discussed below, the insurance industry is already trying to pressure the agency to increase their payment in … [Read more...] about Medicare Advantage Proposed Payment for 2025 and Other Updates
CMS Must Strengthen Federal Criteria for Certifying Nursing Homes for Medicare and Medicaid Reimbursement
One of the best predictors of quality is past performance. If an operator provides poor care in its facilities, it is likely to provide poor care in any additional facilities that it may purchase or operate. As a result, one of the most effective … [Read more...] about CMS Must Strengthen Federal Criteria for Certifying Nursing Homes for Medicare and Medicaid Reimbursement