Calculating Reimbursement Under PDPM

The new Patient Driven Payment Model (PDPM) goes into effect October 1st, 2019. While staff will continue to rely on computer software to convert MDS assessment data to calculate reimbursement rates, it will be vital to fully understand the rate calculation methodology to properly identify opportunities to maximize reimbursement and accurately project revenue.
In this FREE special report, our industry experts are providing the inside scoop on how you can prepare for these significant changes. We’re …

LTC Institute is asking for your complaints

The TRECS Institute, a non-profit dedicated to improving the care of seniors, with support from the Leonard Davis Institute of Health Economics (LDI) has announced the launch of a national, grassroots initiative designed to identify and address “No Brainers” within our long-term care system.
The goal of this initiative is to identify “No Brainers,” defined as any practice that negatively effects the quality of care in long-term care facilities, and to estimate the overall negative economic …

Providers worry that proposed rule could cut Medicaid revenue

Source: Bottom Line
The CMS is drafting a proposed rule that would give states greater flexibility in paying (or not paying) for non-emergent medical transportation (NEMT) for Medicaid beneficiaries. This proposed rule aligns with CMS’ repeated intentions to create “a new era for the federal and state Medicaid partnership where states have more freedom to design programs that meet the spectrum of diverse needs of their Medicaid population,” as stated in a letter from HHS secretary …

CMS final rule makes changes to how physicians are paid, delays E/M coding reform

From The Bottom Line.
As part of a final rule published by CMS yesterday to reduce provider burnout, the implementation of coding reforms for physician services known as “Evaluation and Management” (E/M) visits–requirements that haven’t been updated in 20 years–were delayed until 2020 to allow for continued stakeholder engagement. For CY 2019 and CY 2020, CMS will continue the current coding and payment structure for E/M office/outpatient visits and practitioners should continue to use either the …