Apr 26, 2022 | Skilled Nursing Facilities (SNF)
CMS Proposes Net -0.7% Decrease in FY2023 SNF Payments: CMS proposed payment policy changes that would result in an overall $320M decrease in payments to SNFs for FY2023. The decrease is driven by a required budget neutrality adjustment of -4.6% to account for overpayments from the transition to the Patient Driven Payment Model. Click to read more.
Apr 22, 2022 | Managed Care Friday
86: No, not the painful year for Red Sox fans when that ball scooted through Billy Buckner’s legs, but the portion of Aetna Medicare Advantage members in Florida who reported less loneliness, thanks to Aetna’s partnership with Papa, a platform connecting members with people for companionship, transportation and assistance with everyday tasks. The partnership began in 2020 after observing that 80% of eligible members felt lonely or depressed. By 2021, 62% of Aetna PPO members and 52% of Aetna DSNIP members reported feeling less lonely and happier overall after using the companionship...
Apr 19, 2022 | BRG Publications
The BRG Healthcare Transactions and Strategy quarterly compliance bulletin compiles noteworthy developments in the healthcare sector related to compliance, program integrity, and enforcement activities. In the first quarter of 2022, we have taken note of: DOJ/HHS activity OIG Medicare Hospice Services Analysis Three Comparative Billing Reports One GAO report OCR activity Approved and proposed additions to the RAC audit list Click to read more.
Apr 15, 2022 | Managed Care Friday
518: The number of “available” pediatric psychiatric residential beds in South Carolina, though state agency leaders say that about half of those are actually occupied by children from outside the state. This means South Carolina children with immediate psychiatric needs are waiting days and even weeks for care, and many end up traveling to other facilities across the state line. This strange phenomenon largely occurs due to different Medicaid rates between states. Kaiser Health News recently reported that about 90 children covered by Medicaid in Montana are at psychiatric facilities across...
