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Policy Snapshot
April 1, 2016

Over the last year, AMDA - The Society for Post-Acute and Long-Term Care Medicine has asked the Centers for Medicare & Medicaid Services (CMS) to clarify whether the Chronic Care Management (CCM) Current Procedural Terminology (CPT) code was billable in nursing facilities. The original descriptor per AMA CPT for CCM stated that “these [CCM] management and support services are provided to patients who reside at home or in a domiciliary, rest home, or assisted living facility” which left confusion about billing the code in skilled nursing facility and nursing facility (SNF/NF) settings....

Policy Snapshot
April 1, 2016

Tuesday, April 5 from 1:30 to 3 pm ET

To Register: Visit MLN Connects Event Registration. Space may be limited, register early.

During this call, CMS subject matter experts provide information on what you can do to prepare for the Medicare Shared Savings Program (Shared Savings Program) application process for the January 1, 2017, program start date. A question and answer session will follow the presentation.

We encourage call participants to review important information, dates, and...

Spotlight
April 1, 2016
Susan Levy, MD, CMD, AMDA—The Society for Post-Acute and Long-Term Care 2016-2017 President, looks forward to a hectic year working and traveling for her professional home. “This is my way of giving back to a profession and an organization that have given much to me over the years,” she said. “I am thrilled to have the opportunity to foster and support our members and their teams to work successfully in this setting and effectively navigate this ever-changing health care system.”
JAMDA
April 1, 2016

In this issue, Degenholtz et al1 describe a conceptual framework to better understand the potential uses of health information technology (HIT) in the nursing home setting to improve the care delivered to residents. The authors classified HIT into 6 functional domains: Communication, Clinical Information Systems, Medication Use Process, Quality Improvement, Regulatory Compliance, and Transfer of Data. These domains were selected by using the Nominal Group Technique (NGT) as a consensus-building process with a small group of interprofessional nursing home workers.

JAMDA
March 31, 2016

Dementia is recognized as a global health priority and has recently been identified as the single greatest cause of disability and the third leading cause of death in older Australians. Findings from a recent Australian Parliamentary Inquiry into early diagnosis and intervention in dementia highlighted that current care pathways for dementia diagnosis are not timely but instead complex and variable. This is not unique to Australia but common also in many developed countries. This has prompted a call within this Journal for earlier diagnosis of cognitive impairment.

JAMDA
March 31, 2016

The International Association of Gerontology and Geriatrics consensus conference paper calls for early detection of cognitive impairment as a patient's right and refers to emerging data supporting a combination of medical and lifestyle interventions as a potential way to delay or reduce cognitive decline.1 Screening calls for prevention or treatment. So what about physical activity?

Policy Snapshot
March 25, 2016

Last week, the Centers for Medicare & Medicaid Services (CMS) released survey and certification letter (S&C 16-13-NH) which reminds long-term care facilities that the mandatory submission period for electronic reporting on staffing begins on July 1, 2016. The Society for Post-Acute and Long-Term Care Medicine met with CMS and argued that the “on site” requirement for reporting Medicare Director hours could lead to...

Policy Snapshot
March 25, 2016

The Centers for Medicare & Medicaid Services (CMS) recently released a frequently asked questions document about bill advance care planning (ACP) services under Current Procedural Terminology (CPT) codes 99497 and 99498 billable under Medicare starting January 1, 2016. CPT Code 99497 includes “advance care planning including the explanation and discussion of advance directives such as standard forms (with completion of such forms, when performed), by the physician or other qualified health care professional; first 30 minutes, face-to-face with the patient, family member(s), and/or...

Policy Snapshot
March 25, 2016

The Centers for Medicare & Medicaid Services (CMS) will issue a national provider Comparative Billing Report (CBR) on Subsequent Nursing Facility Evaluation and Management (E/M) Services in April 2016. The CBR, produced by CMS contractor eGlobalTech, will focus on providers of all specialties who bill Current Procedural Terminology codes 99307 through 99310 to report subsequent nursing facility E/M services. CBRs contain data-driven tables with an explanation of findings that compare providers’ billing and payment patterns to those of their peers in their state and across the nation....

Policy Snapshot
March 25, 2016

On March 9, 2016, the Centers for Medicare & Medicaid Services (CMS) released a new dataset, the Skilled Nursing Facility Utilization and Payment Public Use File (SNF PUF).  This data set, which is part of CMS’s Medicare Provider Utilization and Payment Data sets, details information on services provided to Medicare beneficiaries by skilled nursing facilities.  The new data include information on 15,055 skilled nursing facilities, over 2.5 million stays, and almost $27 billion in Medicare payments for 2013.  The data is posted on the CMS website...