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Author Archives: mshepard

Federal law sets out few specific requirements for nurse staffing.  These requirements have not been revised since they were established by the 1987 Nursing Home Reform Law[1] and became effective on October 1, 1990.  Nursing Home Reform Law and Regulations Numbers of staff: The Reform Law requires that facilities employ a registered nurse (RN) for … Read more

The federal Nursing Home Reform law requires nursing facilities to have "sufficient" staff to meet their residents' needs.[1]  Sufficient nursing staff is universally recognized as a key requirement for making high quality of care possible and available for residents.  To determine whether nursing facilities are in compliance with nurse staffing (and other) federal standards of … Read more

June 26, 2014 Medicare's Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program was enacted by Congress as a cost and fraud protection measure.  From its inception, there have been questions about the program's complexity and fairness, and whether it would hinder beneficiary access to necessary DMEPOS items and services.  Background information about … Read more

Connecticut Passes Observation Notice Law On June 12, 2014, Connecticut Governor Dannel P. Malloy signed into law a requirement that, starting October 1, 2014, Connecticut hospitals give oral and written notice to patients placed on observation status for 24 hours or more.  Similar laws already exist in New York and Maryland.  Specifically, Connecticut's law requires: … Read more

Research suggests that medications that should be covered by the Medicare Hospice Benefit are sometimes paid for by Medicare Part D plans. In March, to prevent this from happening, the Centers for Medicare & Medicaid Services (CMS) issued a memorandum to Part D Plan Sponsors and Medicare Hospice Providers entitled, "Part D Payment for Drugs for … Read more

June 12, 2014 Quality Assessment and Performance Improvement (QAPI) In Nursing Homes: Diverting CMS Attention from Enforcement In the past few years, the Centers for Medicare & Medicaid Services (CMS) has focused considerable attention on Quality Assessment and Performance Improvement (QAPI) in nursing homes.  This focus, we fear, is diverting the agency's resources from enforcing … Read more

1.  MEDICARE’S COVERAGE OF CAPPED RENTAL ITEMS DURING PART A INSTITUTIONAL STAYS: LOSING ACCESS TO SPEECH GENERATING DEVICES (SGDs) CMS Changes Its Coverage of Speech Generating Devices Through a new interpretation of longstanding rules, CMS is currently leading an outright attack on coverage for Speech Generating Devices (SGDs).  SGDs are typically tablet-like units that allow … Read more

Technology can help the most vulnerable among us live with more capabilities than we would have considered possible, even a few short years ago.  Rather than encourage technological advances that promote independence and safety, however, the Centers for Medicare & Medicaid Services (CMS) is reducing access to technology in an ill-conceived effort to control short-term … Read more

The Center for Medicare Advocacy’s 'Rubber Stamp' suit highlights the fact that 98% of Medicare appeals are denied at the first two levels of review June 5, 2014 – The Center for Medicare Advocacy filed a complaint in United States District Court in Connecticut yesterday against Kathleen Sebelius, Secretary of Health and Human Services, on behalf … Read more

A Word from the Executive Director As you will see in this issue, Center staffers have been busy this month testifying before Congress and meeting with lawmakers and policy leaders to educate them about issues affecting access to health care for older people and people with disabilities. This CMA Community News highlights just a few … Read more