Coding for treatment of certain conditions has surged substantially, and as the Centers for Medicare and Medicaid Services ...

Nursing homes have forced Medicare to realign its spending on patients with higher medical complexity, including those with a primary diagnosis of congestive heart failure, Alzheimer’s disease and ...

After much hype, trepidation and, for some providers, feverish planning, the Patient Driven Payment Model (PDPM) took effect in October. There has been much speculation about how the new system, ...

The patient-driven payment model (PDPM) has revolutionized health care for providers and their patients. These systems heighten treatment accuracy and ensure clients receive accurate billing for their ...

2025 SEP 17 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News-- Investigators publish new report on Managed Care. According to news reporting out of Providence, Rhode Island, by ...

Skilled nursing facilities must navigate upcoming 2026 requirements, including strict quality reporting deadlines, Medicare payment rate updates, documentation changes, and new AI-powered tools.

The Centers for Medicare & Medicaid Services (CMS) issued the proposed rule on April 11, 2025, for the skilled nursing facility (SNF) prospective payment system (PPS) fiscal year (FY) 2026 update (the ...

CMS contracted with Acumen, LLC for SNF reform and Abt Associates for HHA reform. The goal in both cases was to develop an alternative case-mix adjustment methodology, in which Medicare payments would ...

Coding intensity and Medicare expenditures increased at skilled-nursing facilities after the implementation of the Patient Driven Payment Model in October 2019, according to a study published July 21 ...

On April 11, 2022, the Centers for Medicare & Medicaid Services (CMS) released the FY 2023 Medicare Proposed Rule for Skilled Nursing Facilities (SNFs). Key policy ...

The landscape of long-term care reimbursement is tightening in 2026. CMS has finalized new PDPM ICD-10 code mappings and ...