Time is running out for skilled nursing facilities (SNFs). Come Oct. 1, 2019, time will be a thing of the past for such providers, as there will be a new payment methodology for SNFs: The Patient-Driven Payment Model (PDPM). Under PDPM, reimbursement for Medicare Part A patients in SNFs will be driven by patient condition, rather than by therapy minutes provided. Documentation is crucial to avoid a Recovery Audit Contractor (RAC) audit.
Reporting our lead story during this edition of Monitor Mondays will be healthcare attorney Knicole Emanuel.
Other segments to appear during the live broadcast include the following:
- CMS Report: The Centers for Medicare & Medicaid Services (CMS) is cracking down on bad actors: past and present fraudsters. Author, educator, and consultant Duane Abbey, president of Abbey and Abbey Consultants, Inc., reports on CMS efforts to identify those who are or have been affiliated with illegitimate providers.
- Surprise Balance Billing: While it once appeared to be a done deal leading into the August recess for members of Congress, legislative action on surprise balance billing has stalled out as stakeholders and lawmakers struggle with the details. An update on this now-contentious issue is presented by Matthew Albright, chief legislative affairs officer for Zelis Healthcare and former CMS official.
- SDoH Report: Ellen Fink-Samnick, a nationally recognized expert on the social determinants of health (SdoH), has latest news on this trending topic that is attracting significant media attention.
- Risky Business: Healthcare attorney David Glaser returns to Monitor Mondays with his popular segment, in which he reports on problematic issues facing providers.
- Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, makes his Monday Rounds with another installment of his popular segment.