Proposed payment rule suggests higher-than-expected increase for SNFs

A proposed rule filed by CMS on April 19, 2019 and scheduled to be published in the Federal Register on April 25 suggests that SNFs be paid at an increase of $887 million, or 2.5%, for FY2020 compared to FY2019. The increased payment amount is a result of a 3.0% market basket increase with a 0.5%-point reduction.
Additionally, the rule includes the following proposals:

Minor revisions to the regulation text to reflect the revised assessment schedule under …

Palmetto GBA provides updates on TPE

Source: Home Health Line
by: Josh Poltilove
Medicare Administrative Contractor Palmetto GBA has posted Q&As from its recent teleconference on targeted probe-and-educate (TPE) reviews.
Among other things, Palmetto leaders addressed when it will reach out to providers with questions.
Palmetto encouraged agencies to include the name of their designated contact person when responding to additional documentation requests (ADRs).
“Not all providers will receive a call during the review process,” Palmetto officials note. “The medical reviewer will only reach out during …

CMS releases April quarterly OASIS Q&As, new GG items again dominate guidance

Source: Home Health Line
by: Kirsten Dize
In the second set of quarterly OASIS Q&As that CMS issued since the revised assessment took effect Jan. 1, items new to OASIS-D again took center stage.
CMS posted the Q&As on April 15.
The release includes 15 questions and answers, 14 of which deal with items new to OASIS-D. The guidance applies to GG0110 (Prior device use), GG0130 (Self-care), GG0170 (Mobility), J1800 (Any falls since start of care (SOC)/resumption of care …

CMS to make abuse and inappropriate antipsychotic use easily identifiable on NHC

In a blog post dated April 15, 2019, CMS announced plans for strengthened oversight of state surveyor agencies’ (SSA) performance during nursing home surveys to reduce variation across SSA guidance. This includes “updating Nursing Home Compare to make it easier for consumers to identify specific instances of non-compliance related to abuse or inappropriate antipsychotic medication use,” states the agency.
Mark Parkinson, President and CEO at the American Health Care Association (AHCA) issued a statement in response …