Bulletin Board
Bulletin Board
OIG: Medicare Errs in Paying for Some Skilled Nursing Care
Medicare is erroneously paying for skilled nursing facility care for beneficiaries who did not spend three nights in an acute-care hospital, the U.S. Department of Health and Human Services’ Office of the Inspector General has concluded. Based on a limited sampling, the OIG estimates that Medicare spent $84 million on such ineligible services from 2013 through 2015. A new report from the OIG explains that We attribute the improper payments to the absence of a coordinated notification mechanism among the hospitals, beneficiaries, and SNFs to ensure compliance with the 3-day [...]
Nursing Home Occupancy Down
Nursing home occupancy fell from 83.07 percent in 2013 to 80.24 percent at the end of 2017, according to a new report. The amount of time patients spend in nursing homes is falling as well. Declining occupancy and length of stay and shrinking reimbursement have led to nursing home closings and a six percent decline in cash on hand between 2013 to 2017. Learn more about some of the challenges facing skilled nursing facilities in the McKnight’s Long-Term Care News report “Dwindling reimbursement, occupancy numbers chipping away at skilled nursing [...]
Surprise Balance Billing Emerges as Issue in DC
Lawmakers on both sides of the political aisle are expressing interest in addressing the problem of surprise balance billing: when insured individuals receive unexpected medical bills from providers for services for which they believe they are insured. Surprise balance bills have been a problem for years, with a number of proposals offered in the past to address the problem. Now, bipartisan support for a solution appears to be growing in Congress. In a new report, the journal Health Affairs describes the issue, outlines balance billing proposals offered in the recent [...]
Hospitals Continue to Employ More Docs, Buy Physician Practices
Between 2012 and 2018, the proportion of U.S. physicians employed by hospitals and health systems rose from 25 percent to 44 percent. And between 2016 and 2018, 14,000 physicians left private practice behind to work for hospitals and health systems while those hospitals and health systems purchased 8000 physician practices. One reason health systems employ physicians and purchase physician practices is enhanced reimbursement: Medicare pays more for services provided in hospital outpatient settings than in private physician offices, although Medicare has been taking steps in recent years to reduce or [...]
States Taking Different Paths to Pay for Medicaid Expansion
With the federal share of Medicaid expansion falling to 90 percent next year, states that expanded their Medicaid programs under the Affordable Care Act are now exploring new ways to raise the money to pay for the 10 percent for which they will soon by responsible. Some are implementing hospital or insurer taxes while others are increasing existing taxes on hospitals and health insurers. New Hampshire is directing part of the proceeds from a liquor tax for this purpose and other states have introduced cigarette taxes. Some are charging premiums [...]