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5 Key Steps to PDPM Implementation - Now Less Than 2 Weeks Away

On September 17, 2019 by Jeff Bostic

We are now less than two weeks from implementation of the new Patient-Driven Payment Model (PDPM) that will take effect for Medicare Part A skilled nursing facility clients on Oct. 1. LeadingAge MN has developed a number of key resources to help members with this transition. Below are five key steps for members to be sure they have taken before the new payment system goes into effect:  

PDPM: What Exactly Are NTAs and Why Are They So Important?

On September 10, 2019 by Sue Boyd

NTAs. You’re hearing a lot about them as part of the new Payment-Drive Payment Model that goes into effect Oct. 1. What are NTAs? Non-therapy ancillaries (NTAs) are a long list of diagnostic categories and clinical support services needed to care for residents in a skilled nursing facility that may be more medically complex or demonstrate a higher acuity. Under PDPM, 50 conditions and extensive services are considered for NTA classification.  

PDPM Implementation Moves Closer, New Tools Available

On September 3, 2019 by Jeff Bostic

We are now less than one month from implementation of the new Patient-Driven Payment Model (PDPM) that will take effect on Oct. 1.  LeadingAge MN has worked with other state affiliates and our national association to develop some new tools, including a rate calculator and case mix system, that are posted on our PDPM web page.  

Individualized Treatment/Therapy Mgmt Plan Tops MDH Survey Trends in Assisted Living Home Care

On September 3, 2019 by Sue Boyd

A recent analysis of Comprehensive Home Care licensed providers surveys for the past quarter (April 1, 2019 – June 30, 2019) revealed several trends. Of the top 10 correction orders written, Tag #1035 Individualized Treatment/Therapy Mgmt Plan has risen to the top of the 52 initial surveys conducted. 

CMS Posts Final Rule on PDPM Implementation

On July 31, 2019 by Jeff Bostic

The Centers for Medicare and Medicaid Services (CMS) earlier this week released the final Skilled Nursing Facility (SNF) Payment Rule, which is the last step before implementation of the new Patient-Driven Payment Model (PDPM) that will take effect on Oct. 1. In addition to transitioning to the new case mix system, the Oct. 1 rates also include an inflation update of 2.4%. The rule makes few changes from the proposed rule that come out earlier this year, but it does finalize a definition of group therapy that allows up to six clients to be part of a treatment group as well as updating some requirements around ICD-10 coding that is a major driver of rates under PDPM.  

Now Available: Medicare Rate Calculation Tool for Therapy Rate

On November 28, 2017 by Jeff Bostic

LeadingAge has updated its Medicare Part B Therapy calculators to help members assess and estimate the impact of payment changes. 

CMS Seeks More Comments on Therapy Pay Rules

On November 7, 2017 by Jodi Boyne

The Centers for Medicare & Medicaid Payment Services (CMS) is still accepting feedback form providers on a proposal to overhaul the current skilled nursing therapy reimbursement method. 

Lab and Radiology Declared Optional for PBJ Purposes

On May 3, 2016 by Jodi Boyne

The Centers for Medicare & Medicaid Services (CMS) has made some important updates to the Payroll Based Journal (PBJ) Policy Manual. Members are encouraged to access the Manual and review the changes marked in red.

OIG Report Calls for Re-Evaluation of Medicare Payments to Care Centers

On November 4, 2015 by Jodi Boyne

As reported in the Sept. 30 issue of Advantage, the Office of Inspector General (OIG) issued a report citing that skilled nursing facilities receive far more in Medicare payments than what it costs to provide care.

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