News from CMS: Expiration of Therapy Cap Exceptions
Posted: July 08, 2008
CMS issued the following information for therapy providers while the 2008 therapy caps are in effect without an exceptions process.

Financing Principles for Long-Term Services and Supports
Posted: April 14, 2008
The Medicare Payment Advisory Commission (MedPAC) voted this past Wednesday to recommend to Congress a revised PPS for SNFs. MedPAC staff has worked with researchers from the Urban Institute to improve the accuracy of SNF payments by revising the payment system, which establishes a separate payment for non-therapy ancillary (NTA) services, bases therapy payments on predicted care needs, and considers an outlier policy. The MedPAC Commissioners also recommended including nursing costs in Medicare cost reports, separately recording only the services rendered in the SNF, and including diagnoses and service dates on claims.

Financing Principles for Long-Term Services and Supports
Posted: April 4, 2008
In a historic step toward a healthier, more equitable and affordable system for financing long-term services and supports, the Leadership Council of Aging Organizations (LCAO) and the Consortium for Citizens with Disabilities (CCD) have agreed on a set of joint principles for reform. Together, the two coalitions represent over 150 organizations of elders, people with disabilities, and providers of health, housing and supportive services. Their consensus on a new direction for financing these services puts thousands of Americans behind the push for reform. We have a leadership role in the LCAO, and the principles adopted by the two coalitions accord with many of the recommendations of our own Long-Term Care Financing Cabinet.

Road Map for LTC Health Information Technology
Posted: March 28, 2008
We have collaborated with other long-term care organizations to release a Road Map for implementing health information technology in the long-term care field. The 2008 – 2010 road map addresses issues and topics specific to your operations, including consumer involvement, adopting health information technology in facilities, electronic prescribing, electronic health records, and research initiatives. The road map is an integral part of the fourth annual Long-Term Care Health Information Technology Summit coming up in Baltimore on June 9 and 10.
Click here to read the road map.
For more information on the conference Click here.

Financing Long-Term Care: A Framework for America
Posted: June 12, 2007
AAHSA's vision is for all Americans to receive the care they need, when they need it, in a place they call home. AAHSA leaders convened a Finance Cabinet in 2004 to recommend a position for future financing of long-term care. The result was a plan that would create a public insurance program to help people manage and pay for the services they need with cash payments based on level of disability. This document presents the Finance Cabinet’s recommendations and the rationale for its decisions.

GAO finds relatively few asset transfers
Posted: April 30, 2007
A Government Accountability Office report on asset transfers to qualify for Medicaid coverage of long-term care looked at 540 Medicaid applications from three states and found that over 90% of the applicants had resources totaling under $30,000 (excluding the value of their homes) and 85% had annual incomes under $20,000.

MedPAC Staff Recommends No 2008 Medicare Payment Update for SNFs/Home Health
Posted: Jan. 16, 2006
At the Medicare Payment Advisory Commission meeting on Dec. 7, 2006, staff recommended to the commissioners that payments to skilled nursing facilities and home health care providers should not increase in 2008. The commission will make its formal report to Congress in March.

NASI Study of Long-term Care Policy
Posted: Nov. 14, 2006
The National Academy of Social Insurance (NASI) presented this report on their research about long-term care policy and financing during AAHSA's 2006 Annual Meeting & Exposition in San Francisco.

3.1 Percent Payment Increase for 2007
Posted: July 28, 2006
CMS announces that SNF Medicare payment rates will increase by 3.1% as of October 1.

CMS Outlines New Medicaid Asset Transfer Rules
Posted: July 28, 2006
In a letter to state Medicaid directors, CMS outlines the new rules for determining Medicaid eligibility for individuals who havetransferred financial assets. Also, a document regarding new medicaid transfer of asset rules.

Long-Term Care Partnerships: CMS Guidance for States
Posted: July 28, 2006
In a letter to state Medicaid directors , CMS outlines the requirements for setting up long-term care partnership programs as authorized under the Deficit Reduction Act of 2005.

Help Senate Stop Provider Tax Reductions
Posted: July 24, 2006
Fifty senators now signed on to a letter to oppose Medicaid payment reductions, including the proposed provider tax reduction for nursing homes from 6% to 3%. Now is the time to use our sample letter to contact your senators and thank them for their support or urge them to act on efforts to maintain the current provider tax provisions and Medicaid spending levels.

New Medicaid Citizenship Rules Issued
Posted: July 11, 2006
On July 1, a new Medicaid rule went into effect requiring all current and future beneficiaries for proof of American citizenship for eligibility. To avoid current Medicaid recipients losing their coverage because they don’t have the U.S. citizenship documents required under the new law, CMS has issued an "Interim Final" rule (with comment period) clarifying that seniors and people with disabilities who have already proved citizenship to get Medicare or Supplemental Security Income (SSI) are not subject to the new Medicaid requirement, since they have already certified citizenship. Please let us know if you have residents or clients who are adversely affected by this rule.

Medicare Payments To Be Delayed at End of Fiscal Year
Posted: July 6, 2006
The Centers for Medicare and Medicaid Services have announced that Medicare claims for payments to all health care providers will be held up from September 22 to September 30 this year, as required under the Deficit Reduction Act.

CMS Directs Nursing Homes Not to Influence Residents’ Choice of Medicare Prescription Drug Plans
Posted: June 22, 2006
The Centers for Medicare and Medicaid Services (CMS) has issued a letter stating that “[u]nder no circumstances should a nursing home require, request, coach, or steer” residents to select a particular Medicare prescription drug plan.

AAHSA's Framework for Financing Long-Term Care
Posted: May 17, 2006
If the nation does nothing to change the current financing system, unsustainable pressure on state budgets and Medicaid will lead either to abandoning all other state responsibilities such as education or abandoning ever larger proportions of those with long-term care needs. There is no question, given demographics, that additional money will be needed. But a new system for raising it and paying for long-term care must be implemented to address both current and future problems in a manner that better shares the risks and provides for consumer choice and quality care.

MedPAC Reports Low Medicare Margins for Non-Profits
Posted: December 28, 2005
On Dec. 8, the Medicare Payment Advisory Commission (MedPAC) staff publicly reported the difference between for-profit and non-profit skilled nursing facilities' Medicare reimbursement margins for the first time. While for-profit margins were well over 10 percent, margins at non-profits approached zero. MedPAC could not provide conclusive evidence to explain this difference, but they did find that non-profits had higher cost per day than for-profits, possibly due to higher nursing and other care-related costs. Given that Medicare currently sets rates based on the average margin (estimated at 13.5 percent in 2006), regardless of the differential between for-profits and non-profits, the commissioners recommended a zero update factor for all nursing facilities. The commission also concluded, however, that the payment system is fundamentally broken. AAHSA will urge your legislators not to accept this recommendation because of the larger problem of Medicaid under-reimbursement, which MedPAC's charter does not allow the commission to consider.
Read the transcript.

GAO Reports on Asset Transfers for Medicaid
Posted: October 7, 2005
A report just issued by the Government Accountability Office attempts to quantify the extent to which individuals transfer assets in order to qualify for Medicaid coverage of long-term care.