As a result of the Budget Control Act of 2011 , mandatory federal spending cuts, commonly known as “sequestration,” are required. This law is expected to generate spending cuts of $109 billion in the first year and $1.2 trillion through 2021. Sequestration was originally expected to begin January 2, 2013, but was postponed for two months through the American Taxpayer Relief Act of 2012 , passed on December 31, 2012.
The long-term care (LTC) mergers and acquisitions (M&A) market had an outstanding year in 2012, generating 189 deals worth $9.2 billion. The high transaction volume for the year makes 2012 the most active year in LTC M&A since the late 1990s, with approximately 60 percent more transactions than the annual average over the previous four years.
On March 1, 2013, the Centers for Medicare & Medicaid Services (CMS) released Change Request 8214, which outlines rules related to the extension of the Low Volume Adjustment (LVA) and Medicare Dependent Hospital (MDH) regulations, as authorized by the American Taxpayer Relief Act of 2012 . The Federal Register notification related to these extensions, CMS 1588-N, was released on March 4, 2013, and officially published March 7, 2013. Hospitals will need to move quickly to take full advantage of the LVA extension, and they may be surprised by some of the requirements of the MDH extension
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Although the hospital industry has weathered difficult conditions in the past, widespread challenges continue to push change within the sector. Widely reported regulatory changes and the need to obtain operational and financial scale and scope in the health care industry have combined with other auxiliary issues to compound the need for further change within the sector
The results of recent recovery audit contractor (RAC) automated reviews of hospital services were outlined in the January 2013 Medicare Quarterly Provider Compliance Newsletter, Volume 3, Issue 2 . Among the hot topics discussed was a significant issue for physician providers: the RACs identified that inappropriate current procedural terminology (CPT) codes were being assigned for related professional evaluation and management (E/M) services “rendered in swing bed facilities (with nursing facility levels of care)” in the same episode of care as an acute inpatient stay, when the patient was not “on a leave of absence from the hospital.” Specifically, inpatient hospital CPT codes, i.e
The last day of the 90-day reporting period for the 2012 program year for an Eligible Professional (EP) was December 31, 2012. The EP’s payment year runs on a calendar year instead of the federal fiscal year like the Eligible Hospital’s (EH) payment year. The last day of the EH’s 90-day reporting period for the 2013 program year will be September 30, 2013.
On January 1, 2013, Congress passed the American Taxpayer Relief Act of 2012 , which the president has signed. The act delays sequestration for two months, but assumes the remaining sequestration will resume on March 1, 2013. This means that, for two months, health care providers have avoided the 2 percent cuts in Medicare payments scheduled to take place January 1.
On November 1, 2012, the Centers for Medicare & Medicaid Services (CMS) released the final 2013 Medicare Physician Fee Schedule (MPFS) and its updated conversion factor.
Although compliance programs for skilled nursing facilities (SNFs) are not a new concept, the Patient Protection and Affordable Care Act , enacted March 23, 2010, requires nursing facilities to have a compliance and ethics program in operation by March 23, 2013, that effectively prevents and detects criminal, civil and administrative violations under the Social Security Act of 1935 and promotes quality of health care.