Medicare officials are trying to determine whether to cover aducanumab or Aduhelm. Since last year, Medicare has been evaluating whether to pay for a new expensive drug to treat Alzheimer’s disease. The F.D.A. approved the “miracle” drug. However, aout 40% of patients who have taken it have suffered swelling or bleeding in the brain. Alzheimer’s disease is twice
For an industry where profit margins are widely discussed, financial transparency is nonexistent. For decades, the industry claims they cannot provide care under the old reimbursement models. However, the new Patient-Driven Payment Model (PDPM) model was not budget neutral. Therefore, the Medicare Payment Advisory Commission (MedPAC) suggested a modification to keep base payment rates budget
“Surprise bills” are extra charges from a medical provider whom patients didn’t choose. These medical bills add insult to injury. Surprise bills from anesthesiologists, radiologists, pathologists, assistant surgeons and laboratories were common before a new law “No Surprises Act” signed by Biden. As a nursing home attorney, we see clients shocked at the cost of medical bills.
Data Metrics CMS continues to rely on nursing home’s self-reported and unreliable data for adjustments to the Patient Driven Payment Model (PDPM). PDPM went into effect Oct. 1, 2019. It was the biggest change to the nursing home reimbursement system in 20 years. Colleen Muncy is with data analytics firm StarPro. She told McKnight’s Long-Term
Employment The Biden Administration will provide $500 million to the nursing home industry. The initiative will send strike teams to nursing homes to help with infection control and prevention efforts, and address staffing shortages. The strike team program will be a partnership between providers and inspectors that reduces the spread of infections at facilities. CMS
The Nursing Home Improvement and Accountability Act will improve the quality of care at nursing homes. The legislation will increase safety and maintain the health and well-being of America’s vulnerable adults. The legislation proposes minimum staffing requirements, increases Medicaid funding and bans mandatory pre-dispute arbitration agreements hidden in admission paperwork. HHS would apply the staffing minimums