Background. On January 1, 2020, the Centers for Medicare & Medicaid Services (CMS) began implementing a new Medicare payment system—“Patient Driven Groupings Model” (PDGM)—for home health services. Under PDGM, home health agencies have a new set … [Read more...] about Medicare Coverage of Home Health Care Has Not Changed Under the New Payment System (PDGM)
Search Results for: observation
Supreme Court Allows Harmful “Public Charge” Immigration Rule to Continue – For Now Accountable Care Organizations and Observation Status Medicare SNF Payment Model Creates Changes in Care and Admissions – What about Facility Assessments? … [Read more...] about CMA Alert – January 30, 2020
The new Medicare reimbursement system for skilled nursing facilities (SNFs) – the Patient-Driven Payment Model (PDPM) – fundamentally changes the financial incentives for facilities. With PDPM, Medicare now pays lower rates for residents needing … [Read more...] about Medicare SNF Payment Model Creates Changes in Care and Admissions – What about Facility Assessments?
Payment v. Coverage – Access to Care ThreatsUpdate on Home Health (Judy Stein and Kathy Holt)Including new payment model effective January 1, 2020 (Patient Driven Group Model)Update on Skilled Nursing Facilities (Toby Edelman)Including new payment … [Read more...] about January 2020 – Payment v. Coverage: Barriers to Medicare-Covered Care & Other Issues
Nursing Facilities and Medicare Advantage: If You Can’t Beat ’Em, Join ’Em . . . But What About the Medicare Beneficiaries? Free Webinar – Medicare Patient Driven Payment Model: What Does It Mean for Skilled Nursing Facility Residents? Elder … [Read more...] about CMA Alert – January 9, 2020
Skilled nursing facilities (SNFs) do not like the prior authorization requirements, limited lengths of stay for residents, and lower Medicare reimbursement rates that are associated with Medicare Advantage (MA) plans. Some SNFs are responding to … [Read more...] about Nursing Facilities and Medicare Advantage: If You Can’t Beat ’Em, Join ’Em . . . But What About the Medicare Beneficiaries?
As 2019 winds down, we took a look back at the CMA Alerts you were most interested in over the last twelve months. News about skilled nursing facilities featured highly, as did Medicare payment changes. Interest in Medicare coverage of oral health … [Read more...] about Most Read CMA Alerts (Plus, Webinars) of 2019
WAYS & MEANS COMMITTEE HEARING “CARING FOR AGING AMERICANS” November 14, 2019 STATEMENT FOR THE RECORD Statement of Toby S. Edelman Senior Policy Attorney Center for Medicare Advocacy 1025 Connecticut Avenue, N.W., Suite 709 Washington, … [Read more...] about Statement for the Record – Caring for Aging Americans Hearing – November 14, 2019
What does Medicare cover? When does Medicare cover skilled nursing facility care? Can a patient who is receiving non-skilled "custodial" services receive Medicare coverage in a SNF? What are examples of skilled services in a … [Read more...] about Nursing Home / Skilled Nursing Facility Care
(The views expressed in this Issue Brief and during the Alliance call are solely those of the Center for Medicare Advocacy.) I. ENROLLMENT PERIOD UPDATES Overview The Annual Coordinated Election Period (ACEP) – the period during which … [Read more...] about Issue Brief – November 2019 – Medicare Enrollment Period Updates & Other Issues