OIG Part D – Part A – Hospice Audit

Angie Szumlinski Case Study, News

Why OIG Did This Review In 2012, the OIG issued a report to the Centers for Medicare and Medicaid Services (CMS) indicating that during 2009, Medicare part D paid for prescription drugs that likely should have been paid for by hospice organizations under the Medicare Part A hospice benefit. They matched Part A and Part D data to identify occurrences …

Expect More RAC Audits

Angie Szumlinski Announcements, News

In 2021, Medicare is celebrating its 55th year of providing health insurance to Americans. The program was first signed into law in 1965 and began offering coverage in 1966. That first year, 19 million Americans enrolled in Medicare for their healthcare coverage. As of 2019, more than 61 million Americans were enrolled in the program. President Biden is broadening the …

Expect More RAC Audits

Angie Szumlinski News

In 2021, Medicare is celebrating its 55th year of providing health insurance to Americans. The program was first signed into law in 1965 and began offering coverage in 1966. That first year, 19 million Americans enrolled in Medicare for their healthcare coverage. As of 2019, more than 61 million Americans were enrolled in the program. President Biden is broadening the …

3 Day Hospital Stay

Angie Szumlinski News

The Center for Medicare Advocacy published an article regarding the 3-day inpatient hospital requirement for Medicare Skilled Nursing facility coverage. The article explains the process and makes an appeal to congress asking that this rule should be repealed for multiple reasons including: Medical care has changed in the past 55 years. Traditional Medicare and Medicare Advantage need to be aligned. …

What Price?

Angie Szumlinski Health, Studies

The cost of a fall among older adults requiring emergency services is unclear, especially beyond the acute care period. In a recent study, medical expenditures (costs) to 1 year among community-dwelling older adults who fell and required ambulance transport, including acute versus post-acute periods, the primary drivers of cost and comparison to baseline expenditures were evaluated. Results showed that the …

Head for the Hills?

Angie Szumlinski Featured, News

In the months leading to the implementation of a new Medicare payment model for skilled nursing facilities, various voices predicted an exodus of smaller, “mom-and-pop” operators who’d rather call it a career than adapt to a completely new reimbursement system. But only a few months after the Patient-Driven Payment Model (PDPM) took effect last fall, the effects of the COVID-19 …

Trump Administration Acts to Ensure Coverage of Life-Saving COVID-19 Vaccines & Therapeutics

Angie Szumlinski Announcements

A press release from CMS contains information about a set of toolkits meant to help healthcare systems administer a COVID-19 vaccine when available, new plans to remove regulatory barriers and ensure coverage, and established new rules about vaccine payments. Their toolkits also hold specific information for several programs like Medicare, Medicaid, private plans, and several others. Click below to read …

CMS – Telehealth Update – August 4, 2020

Angie Szumlinski Announcements, News

CMS is proposing changes to expand telehealth permanently, consistent with the Executive Order on Improving Rural and Telehealth Access that President Trump signed. The Executive Order and proposed rule advance our efforts to improve access and convenience of care for Medicare beneficiaries, particularly those living in rural areas. Additionally, the proposed rule implements a multi-year effort to reduce clinician burden …

National Incidence of Adverse Events Among Medicare Beneficiaries in Long-Term-Care Hospitals

Angie Szumlinski Health, News, Studies

The Inspector General performed an in-depth review of adverse events on a subset of people receiving care. A summary of their findings and recommendations is as follows: The Office of Inspector General (OIG) found that 21 percent of Medicare patients in Long-Term-Care Hospitals (LTCH) experienced adverse events, which are particularly serious instances of patient harm resulting from medical care.  The …