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‘Patients Hung Out To Dry’: Report Shows Insurers Significantly Increase Rate Of Denials For Post-Acute Care

Home Health Care

This includes denying access to nursing homes, inpatient rehabilitation facilities and long-term acute care hospitals. It’s past time for legislators and regulators to hold plans accountable and protect patient care.” In May 2023, PSI launched an inquiry into the barriers facing seniors enrolled in MA in accessing care. “The

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FY2024 Inpatient Rehabilitation Facility Prospective Payment System Proposed Rule (CMS-1781-P)

Briggs Healthcare

In addition, the rule includes a proposal to revise and rebase the IRF market basket, as well as a proposal to modify its regulations to allow hospitals to open and begin billing Medicare for an excluded IRF unit anytime within the cost reporting year. This Fact Sheet discusses the provisions of the proposed rule.

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CY 2022 Home Health Prospective Payment System Rate Final Rule – AND MORE!

Briggs Healthcare

The corresponding CMS Fact Sheet provides these statements: “Today, the Centers for Medicare & Medicaid Services (CMS) acted to improve home health care for older adults and people with disabilities through a final rule that would accelerate the shift from paying for Medicare home health services based on volume to a system that pays for value.

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Five Individuals and Two Nursing Facilities Indicted on Charges of Conspiracy to Defraud the United States and Health Care Fraud

Briggs Healthcare

Also named in the Superseding Indictment were two nursing facilities operating in Western Pennsylvania, Comprehensive Healthcare Management Services, LLC d/b/a Brighton Rehabilitation and Wellness Center and Mt. Lebanon Rehabilitation and Wellness Center. Lebanon Operations, LLC d/b/a Mt.

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CalAIM: Leveraging Medicaid Managed Care for Housing and Homelessness Supports

NASHP

CalAIM: Leveraging Medicaid Managed Care for Housing and Homelessness Supports April 15, 2022 / by Allie Atkeson. Driven by challenges facing individuals with complex care needs, states are increasingly working to address the physical, behavioral, and social needs of their Medicaid beneficiaries. Download the report (PDF).

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The Direct Care Workforce

NASHP

State Medicaid-funded long-term services and supports (LTSS) systems are not well-positioned to compete for this shrinking pool of workers. Responsible for 43 percent of all LTSS expenditures , state Medicaid programs have a major role to play in responding to this crisis. These funds must be spent before March 31, 2024.

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CMS Revises Fiscal Year (FY) 2023 State Performance Standards System (SPSS) Guidance

Briggs Healthcare

The SPSS is aligned with CMS expectations for State Survey Agency performance in accordance with the §1864 Agreement and all related regulations and policies intended to protect and improve the health and safety of Americans such as the State Operations Manual, the Mission and Priority Document, survey procedure guides, and other relevant documents.