The Texas Nursing Home Upper Payment Limit (UPL) could result in significant financial benefits for nursing home operators and many Texas governmental hospitals. Here is an update on the program’s status and key action steps. In October 2012, the Centers for Medicare & Medicaid Services (CMS) approved a Texas State Plan Amendment allowing for a nursing home Intergovernmental Transfer (IGT)/UPL program
Recent changes to Medicare Part A mean skilled nursing facilities (SNFs) and their therapists must remain vigilant to make sure therapy services are provided consistently. The Centers for Medicare & Medicaid Services clarified an End of Therapy Other Medicaid Required Assessment (OMRA) must be completed for Medicare Part A patients who miss three consecutive days of therapy services, using an assessment reference date (ARD) of the first, second or third day after the last therapy treatment. The approaching holidays may create difficulties delivering therapy services on a regular schedule as therapy staff take time off or skilled residents spend extra time with family.
Two significant updates to Medicare Part A claims for skilled nursing facilities (SNFs) and hospital swing-bed providers will occur with dates of service beginning August 1, 2011. The Centers for Medicare & Medicaid Services (CMS) is making the following changes through Change Request 7339 : Any Part A claim reporting an End of Therapy Other Medicare Required Assessment (OMRA) must include Occurrence Code 16 and the date of the last therapy service