The bipartisan Provider Reimbursement Stability Act (H.R. 8163), introduced by Reps. Greg Murphy, MD (R-NC) and Tom Suozzi (D-NY), aims to modernize Medicare clinician payment by updating outdated budget neutrality rules and improving stability for practices and patients.
The most fundamental principle in geriatric and long-term care medicine: ensure every treatment order aligns with the resident’s values and goals of care—eliciting these is a core skill for long-term care physicians. Many residents have multimorbidity, and a substantial proportion are at the end of life. E...
Medicaid is the largest payer of nursing home (NH) care in the United States, yet Medicaid payments are not required to cover the full cost of care. Little is known about the relationship between Medicaid payment adequacy and Care Compare's star ratings. This study examined the association between Med...
The COVID-19 pandemic revealed fundamental problems with the structure of long-term care financing and payment in the United States. The piecemeal system that exists suffers from several key problems, including underfunding, fragmentation across types and sites of care, and substantial variation in payment...
Without congressional action, the budget neutrality requirements mandated by the CY 2025 Medicare Physician Fee Schedule (MPFS) Proposed Rule will cause the Conversion Factor (CF) to decrease from approximately $33.29 to $32.36 starting January 1, 2025. This 2.8% reduction marks the fifth consecutive year ...
The Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS,) is taking action to support providers and suppliers impacted by Hurricane Helene within the Federal Emergency Management Agency disaster zones under the president’s major disaster declarations...
Historically, fee-for-service Medicare reimbursed long-term care hospital (LTCH) stays as a lump-sum payment, which was substantially reduced for discharges before the diagnosis-specific short-stay outlier (SSO) threshold day, leading to large spikes in discharges on the threshold day. The objective of thi...
The Centers for Medicare & Medicaid Services (CMS) has released a new MLN Matters aimed at enhancing payment accuracy for physician services provided in skilled nursing facilities (SNFs). Effective July 1, 2025, these measures will address common misclassifications of Place of Service (POS) codes that ...
The skilled nursing facility (SNF) patient-driven payment model (PDPM) is intended to align payment with patient clinical characteristics to more accurately compensate complex and resource intensive care. However, it is unclear whether and how SNFs shifted their admission practices to align PDPM's fin...