One of the hardest hit industries during this COVID-19 pandemic is the nursing home industry. Nursing homes are doing the very best they can to prevent their residents and employees from getting this, in some instances, deadly corona virus.
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Our firm would like to take time to say a heartfelt thank you to all of our health care clients and all other health care workers during this stressful time. You are working endless hours to protect and care for the vulnerable and sick. You are putting yourselves at risk while you spend time away from your families to care for others.
The Centers for Medicare and Medicaid Services (CMS) advised in June that it was going to back off its prior position on prohibiting nursing homes from including arbitration provisions in admission contracts. CMS has reversed its prior position and is currently drafting a new rule, which would allow pre-occurrence arbitration agreements to stand. The Fair Arbitration Now Coalition, the AARP, and other elderly advocacy groups are against CMS’ new position.
CMS issued an update regarding what appears to be a sharp increase in the denial rate for Skilled Nursing Facilities (SNFs) as reported in the 2015 Comprehensive Error Rate Testing (CERT) Report. The CERT Report showed denials increasing from 6.9% reported in 2014 to 11% in 2015. What did CMS attribute as the cause of this significant increase? DOCUMENTATION Here are some documentation requirements that CMS reported for the increase in denials resulting from missing or incomplete certification/recertification including:
As a helpful reminder, clients need to be aware that the March 1, 2017 deadline for reporting 2016 HIPAA breaches is fast approaching. March 1, 2017 is the Deadline for Reporting 2016 HIPAA Breaches Affecting Fewer than 500 Individuals by Covered Entities to the OCR. Click here for a link to the OCR portal to file year end breach reports. Each year, covered entities are required to file a report within 60 days of year end if the covered entity experienced a breach during the prior year affecting fewer than 500 individuals.