With the recent July 2024 refresh to Care Compare, CMS has changed the staffing case mix adjustment to a model based on the PDPM, essentially using the nursing case mix groups to adjust for acuity. Other important changes include: The gap period used in defining termed staff has increased from 60 days to 90 days…
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Published March 6, 2024
October 2023 brought the long-term care industry many changes, specifically with the release of MDS 1.18.11. One of the most impactful changes has been the removal of Section G and updates to Section GG. The update to the MDS resulted in updates needing to be made to the Quality Measures (QMs). The following QMs were updated/replaced due to the change from Section G to Section GG:
Published February 23, 2024
CMS has authorization to revoke Medicare billing privileges under certain conditions. Regulation 42 CFR §424.535(a)(8)(ii) states CMS has the authority to revoke a currently enrolled provider or supplier’s Medicare billing privileges if CMS determines that the provider or supplier has a pattern or practice of submitting claims that fail to meet Medicare requirements.
Published February 13, 2024
Annual Certification Statement for Provider Billing Medicaid – A provider adopting and maintaining an effective compliance program will now attest to this as part of their annual “Certification Statement for Provider Billing Medicaid.” This Form must be completed and returned to NYSDOH by the enrollment anniversary date.
