…us Health and Rehabilitation Center vs. Mutual of Omaha Insurance Issue Whether CMS properly denied the Provider's request for an exemption from the Medicare skilled nursing facility (SNF) routine cost limits (RCL) as a new provider under 42 CFR 413.30(e) based on CMS' determinat…

On September 20, 2018, CMS issued a notice of proposed rulemaking (NPRM) to revise the emergency preparedness program requirements. Most notably, the proposed rule would allow nursing homes to review their emergency preparedness programs and to train staff to carry out those plan…

…suspended since March 2020, to gather, and make publicly available, information about temporary nurse aides with minimal training who have been working in nursing facilities during the pandemic, and to ensure that temporary aides fully meet training requirements (i.e., prohibit “…

…onal Medicare. According to MedPAC, these higher payments to MA plans result in about $13 billion in additional Part B premiums paid by all Medicare beneficiaries in 2024, including those not enrolled in MA plans. And not necessarily for MA enrollees. According to the Commonwealt…

…es billions of dollars. [1] The Center for Medicare Advocacy has before written about antipsychotic drug use in nursing facilities. See CMA, “Off-Label Drug Use Is Common and Hurts Nursing Home Residents” (March 25, 2010), https://www.medicareadvocacy.org/InfoByTopic/SkilledNursi…

… – admitting patients who didn't need hospital care.” Observation status is not about care, it is about money, and it is an outdated coding system. Jonathan Blum, the former Medicare director at CMS, suggests another fix in the article: Get rid of the three-night requirement alto…

…als process did exist, but that Mr. Back had not been given correct information about how to access it. Accepting the Secretary’s allegation as true, the Court declared the case moot and advised Mr. Back to avail himself of the purported procedure. At this point, four years had p…

…d and Drug Administration (FDA) gave its highest level of warning to the public about antipsychotic medications and warned that older people with dementia who were prescribed these drugs are at greater risk for death and other serious harm. [2] Since then, recommendations of expe…

…issues a regulation granting it official legal status. For complete information about, and access to, our official publications and services, go to About the Federal Register on NARA's archives.gov. The OFR/GPO partnership is committed to presenting accurate and reliable regulato…

…for Medicare Advocacy criticized the Centers for Medicare & Medicaid Services' (CMS') response to the report, [21] which focused solely on the plan to incorporate the OIG's recommendations in new rules that the agency intends to promulgate for Quality Assessment and Performance I…

…an or equal to an increase in their Part B premiums up to the full 2018 amount. About 28 percent of all Part B enrollees are subject to the hold harmless provision in 2018 and will pay less than the full monthly premium of $134, because the increase in their Social Security benef…

…sed. As we’ve previously reported , the Senate Finance Committee held a hearing about the appeal problems, focusing on the terrible backlog at the ALJ level on April 28, 2015. At the hearing, Ranking Member Ron Wyden highlighted the story of one of the Center for Medicare Advocac…