Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

Weekly Alert

CMS Proposes Updates to Medicare Part A Reimbursement for Skilled Nursing Facilities

The Centers for Medicare & Medicaid Services’s (CMS) proposed annual update to Medicare Part A reimbursement for skilled nursing facilities, published at 88 Federal Register 21316 (Apr. 10, 2023), includes a number of significant changes to … [Read more...] about CMS Proposes Updates to Medicare Part A Reimbursement for Skilled Nursing Facilities

Inspector General Audit: Care Compare Did Not Accurately Report Deficiencies at Two-Thirds of Nursing Facilities

Using a random sample of 100 nursing facilities, identified as of August 2020, the HHS Office of Inspector General (OIG) reports in CMS Did Not Accurately Report on Care Compare One or More Deficiencies Related to Health, Fire Safety, and Emergency … [Read more...] about Inspector General Audit: Care Compare Did Not Accurately Report Deficiencies at Two-Thirds of Nursing Facilities

Investigation Finds Some California Nursing Facilities Experienced “Substantial Increase” in Profits

Although nursing home admission and occupancy rates declined in California nursing facilities between 2019 and 2020, a clinical investigation of data from 828 nursing facilities in 2019 and 887 nursing facilities in 2020 finds that “Some but not all … [Read more...] about Investigation Finds Some California Nursing Facilities Experienced “Substantial Increase” in Profits

Federal District Court Denies Nursing Home Chain’s Motion to Dismiss Federal Government’s “Worthless Services” Case

In June 2022, the Department of Justice sued American Health Foundation, Inc., subsidiaries, and three nursing facilities (Cheltenham Nursing and Rehabilitation Center in Pennsylvania, The Sanctuary at Wilmington Place in Ohio, and Samaritan Care … [Read more...] about Federal District Court Denies Nursing Home Chain’s Motion to Dismiss Federal Government’s “Worthless Services” Case

CMS Issues Final Medicare Advantage Payment Rates for 2024 and Final Rule Addressing Prior Authorization, Marketing, and Other Issues

The Center for Medicare Advocacy has long-highlighted concerns relating to Medicare Advantage (MA) overpayments, as well as access to care issues, including MA plans’ widespread and inappropriate use of prior authorization and on-going denials.  … [Read more...] about CMS Issues Final Medicare Advantage Payment Rates for 2024 and Final Rule Addressing Prior Authorization, Marketing, and Other Issues

Medicaid and Nursing Homes: Don’t Believe Owners and Operators That All Medicaid Rates Are Too Low

Owners and operators of nursing homes, and their trade associations, invariably argue that Medicaid rates are too low. They claim that Medicaid rates must be increased if the Centers for Medicare & Medicaid Services (CMS) imposes mandatory nurse … [Read more...] about Medicaid and Nursing Homes: Don’t Believe Owners and Operators That All Medicaid Rates Are Too Low

Elder Justice “No Harm” Newsletter | Volume 5, Issue 1 Now Available

In the Elder Justice Newsletter, we highlight citations, including deficiencies related to abuse, neglect, and substandard care, that have been identified as not causing any resident harm. The goal of this brief newsletter is to shed light on … [Read more...] about Elder Justice “No Harm” Newsletter | Volume 5, Issue 1 Now Available

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