Settlement Conference Facilitation (SCF), a pilot alternate dispute resolution process for certain Medicare Part B claims by long-term care providers, was announced by the Centers for Medicare and Medicaid Services (CMS). It will enable the providers to appeal certain Medicare
claims decisions without going through an Administrative Law Judge
(ALJ). LeadingAge believes that this is a good first step in reducing the huge backlog of claims at this level.
We have updated the Medicare Part-B rate calculation tool for final rates reflecting provisions of the Bipartisan Budget Act signed into law in December 2013. The law allowed for a 0.5% average increase in Medicare payment rates and extended the 2% sequestration cut for all health care providers for another 2 years. Access to this tool requires login via My.LeadingAge.
CMS has revised the Interpretive Guidelines and as needed, Investigative Protocols for the following F Tags to incorporate survey and certification policy memos issued from October of 2003 through May of 2014.
Today’s voluntary payment models -- bundled payments, shared savings and accountable care organizations -- provide an opportunity for acute and post-acute care providers to work together to better manage care across the continuum. This shift from traditional fee-for-service to risk-based payment models requires effective alignment among acute and post-acute care providers.
A new report from the RAND Corporation provides a policy blueprint for improving long-term services and supports (LTSS) for persons with dementia.