Effective October 13, 2022, the U.S. Department of Health and Human Services renewed the PHE determination for 90 days. This renewal means 3-Day Qualifying Stay and Benefit Period Waivers have been extended through January 12, 2023. To prepare for post-pay audits, providers should ensure supportive documentation is captured when using available SNF 1135 waivers. Celtic … Continue reading
Connecticut Providers- Three days remain to submit assessments to be included in Preliminary Case Mix Roster reports. All MDS assessments must be submitted and accepted by 11:59pm on Saturday, October 15th to be included in the Preliminary Time-Weighted Case Mix Index Resident Roster reports. Celtic assists clients to identify opportunities to enhance case mix system … Continue reading
The Centers for Medicare and Medicaid Services (CMS) announced it will issue another round of updates to QM point thresholds in October, keeping with its plan (QSO-19-08-NH) to increase thresholds every six months. Updates resumed in April 2022 after being on hold due to the pandemic. Increased point requirements will make it more challenging to … Continue reading
Connecticut Providers- Are your CMI weights what you expected? Final CMI Resident Roster reports are available to retrieve from the Myers and Stauffer portal. Celtic assists clients to identify opportunities to enhance case mix system processes. We’ve helped our clients improve capture of CMI data and increase CMI rates. Let’s discuss options to achieve your … Continue reading
Post-pay auditing has begun for skilled nursing facility (SNF) claims which utilized the 3-Day Stay Waiver allowed by the Centers for Medicare and Medicaid Services (CMS) in response to the public health emergency (PHE). Providers who used the waiver to cover in-house residents are most at risk for audit. Noridian, as the national Supplemental Medical … Continue reading
The Secretary of Health and Human Services, Xavier Becerra, renewed the Public Health Emergency (PHE) determination on July 15, 2022, effective through October 15, 2022. Hospital stay and benefit period waivers remain in effect. Further, Becerra recently committed to providing a 60-day notice before ending the PHE. With resources recently released [8/18/22], the Centers for … Continue reading
Due to the delayed release of Preliminary Q2 2022 Resident Roster reports, the cut-off for transmission of MDS data for Final Q2 2022 Time- Weighted CMI Resident Roster reports is now 8/24/22. Final Resident Roster reports will continue as scheduled, to be posted on 9/9/22. Take this opportunity to ensure your MDS assessments captured the … Continue reading
FY 2023 SNF VBP program August 2022 Performance Score Reports (PSRs) are available now in the QIES/CASPER system. The August 2022 PSR includes: Risk-Standardized Readmission Rate for Baseline Period Risk-Standardized Readmission Rate for Performance Period Because the ongoing effects of the COVID-19 PHE inhibited CMS’s ability to make fair national comparisons, CMS suppressed the use … Continue reading
Breaking News for CT Providers- Preliminary Q2 2022 Resident Roster reports scheduled for release today [7/29/22] have been delayed. Providers will be notified via email when their Preliminary Resident Roster reports are available to retrieve. An updated cutoff date to submit corrections will be communicated with the notification. Follow Celtic for updates on the latest … Continue reading
As Medicare Advantage Organizations continue to issue improper payment denials, providers question if admitting MA patients is worth it. Maureen McCarthy, President and CEO, spoke with McKnight’s Long-Term Care News, warning we may see some providers reject MA patients over payment denials. Would you like to learn where to verify reasons for payment denial and … Continue reading