THE FINAL RULE 2021

  • 29 Oct 2021
  • 12:00 - 14:00
  • webinar

Registration

  • As we end the second year of Patient Driven Payment Model (PDPM), Centers for Medicare and Medicaid Services (CMS) has proposed changes to neutralize the significant payment increases providers enjoyed during the first year after implementation. This session will focus on changes that impact Skilled Nursing Facilities (SNFs) from a compliance, clinical, and reimbursement perspective as well as strategies to mitigate payment decreases. It will provide an in-depth look at the challenges SNFs are currently facing, updates to the Value-Based Purchasing (VBP) and SNF Quality Reporting Program (QRP) and changes to the PDPM case-mix indexes that will impact payment in future years. We will discuss strategies for continued success and compliance, and the use of Medicare notices such as the Notice of Medicare Non-Coverage (NOMNC) and the Advance Beneficiary Notice of Non-Coverage (ABN), and tools such as PEPPER reports, Medicare Triple Check, and audits like Targeted Probe and Educate (TPE) Audits, Recovery Audit Contractor (RAC) Audits and more.



    Session Learning Objectives:



    1): Understanding the FY2022 SNF PPS Proposed Rule changes and challenges SNFs are facing from an industry perspective as we adapt to the “new normal.”

    2): Review changes to the SNF QRP and changes to PDPM classifications and case-mix indexes, and help find opportunities to maintain adequate reimbursement despite future payment reductions.

    3): Provide strategies for continued success and compliance, including understanding Medicare Notifications, PEPPER reports, Medicare Triple Check, Target Probe and Educate (TPE) Audits, Recovery Audit Contractor (RAC) Audits, etc.
  • As we end the second year of Patient Driven Payment Model (PDPM), Centers for Medicare and Medicaid Services (CMS) has proposed changes to neutralize the significant payment increases providers enjoyed during the first year after implementation. This session will focus on changes that impact Skilled Nursing Facilities (SNFs) from a compliance, clinical, and reimbursement perspective as well as strategies to mitigate payment decreases. It will provide an in-depth look at the challenges SNFs are currently facing, updates to the Value-Based Purchasing (VBP) and SNF Quality Reporting Program (QRP) and changes to the PDPM case-mix indexes that will impact payment in future years. We will discuss strategies for continued success and compliance, and the use of Medicare notices such as the Notice of Medicare Non-Coverage (NOMNC) and the Advance Beneficiary Notice of Non-Coverage (ABN), and tools such as PEPPER reports, Medicare Triple Check, and audits like Targeted Probe and Educate (TPE) Audits, Recovery Audit Contractor (RAC) Audits and more.



    Session Learning Objectives:



    1): Understanding the FY2022 SNF PPS Proposed Rule changes and challenges SNFs are facing from an industry perspective as we adapt to the “new normal.”

    2): Review changes to the SNF QRP and changes to PDPM classifications and case-mix indexes, and help find opportunities to maintain adequate reimbursement despite future payment reductions.

    3): Provide strategies for continued success and compliance, including understanding Medicare Notifications, PEPPER reports, Medicare Triple Check, Target Probe and Educate (TPE) Audits, Recovery Audit Contractor (RAC) Audits, etc.

Registration is closed

TOPIC: THE FINAL RULE 2021

As we end the second year of Patient Driven Payment Model (PDPM), Centers for Medicare and Medicaid Services (CMS) has proposed changes to neutralize the significant payment increases providers enjoyed during the first year after implementation.   This session will focus on changes that impact Skilled Nursing Facilities (SNFs) from a compliance, clinical, and reimbursement perspective as well as strategies to mitigate payment decreases.  It will provide an in-depth look at the challenges SNFs are currently facing, updates to the Value-Based Purchasing (VBP) and SNF Quality Reporting Program (QRP) and changes to the PDPM case-mix indexes that will impact payment in future years.  We will discuss strategies for continued success and compliance, and the use of Medicare notices such as the Notice of Medicare Non-Coverage (NOMNC) and the Advance Beneficiary Notice of Non-Coverage (ABN), and tools such as PEPPER reports, Medicare Triple Check, and audits like Targeted Probe and Educate (TPE) Audits, Recovery Audit Contractor (RAC) Audits and more.

 Session Learning Objectives:

 1): Understanding the FY2022 SNF PPS Proposed Rule changes and challenges SNFs are facing from an industry perspective as we adapt to the “new normal.”

2): Review changes to the SNF QRP and changes to PDPM classifications and case-mix indexes, and help find opportunities to maintain adequate reimbursement despite future payment reductions.

3): Provide strategies for continued success and compliance, including understanding  Medicare Notifications, PEPPER reports, Medicare Triple Check, Target Probe and Educate (TPE) Audits, Recovery Audit Contractor (RAC) Audits, etc.

PRESENTERS

Kristopher Pattison, RN, RAC-CT

Senior Manager, Clinical Consulting Services

Kris has been in the long-term care industry for twenty‐one years. He has worked as a CNA, charge nurse, nursing supervisor, clinical support nurse, and as an MDS Coordinator, giving him a broad scope of insight into the internal functioning of the nursing department in a skilled nursing facility. His experience includes MDS management, Medicare PPS, Medicaid Case Mix Index optimization, Five‐Star Rating optimization, and Quality Measure Management. He has provided complete training for new RNACs and education to other staff on documentation, care planning, Medicare and Medicaid reimbursement, MDS, and other topics. His knowledge of state and federal regulations has enabled him to provide support throughout the survey process, including writing plans of correction and monitoring for compliance. Kris has also worked on the development of new policies, protocols, and best practices and has experience working with the Five‐Star Quality Rating System, Value‐Based Purchasing, SNF Quality Reporting Program, and ICD‐10 diagnostic coding. Kris is a Registered Nurse and graduated from Sewickley Valley Hospital School of Nursing in 1999. In addition, he holds professional certification as a Resident Assessment Coordinator. Professional memberships include the American Association of Assessment Coordinators, Pennsylvania Association of Nurse Assessment Coordinators, and LeadingAge PA.

Richard Snyder

Consultant - Billing and Reimbursement Services

Richard (Rick) Snyder is a Billing and Reimbursement Consultant with Arnett Carbis Toothman LLP’s Health Care Services Team. He has over 20 years of post‐acute health care billing, reimbursement, and operational experience. Rick’s background as a post‐acute health care billing and reimbursement specialist includes Skilled Nursing Facility billing
(Medicare, Medicaid, Medicare Advantage, VA, and Private pay), Personal Care Home billing, Home Health billing (Medicare,
Medicaid, Medicare Advantage, and VA), Hospice billing (Medicare and other insurance), and Home Care billing (Private, Medicaid Waiver, VA, and County related services). Rick also has experience preparing monthly accounts receivable reports. Also, he prepared and submitted the nursing home bed assessment, maintained the annual Medicare bad debt log, provided information for facilities Medicare and Medicaid cost reports, verified insurance coverage, facilitated and maintained comprehensive contracts for third‐party insurance companies, provided follow‐up on accounts receivable aged accounts, submitted annual Rent Rebates for eligible residents, and maintained working relationships with local County Assistance Offices. Rick also provided administrative functions at a Skilled Nursing Facility. He submitted the Payroll Based Journal, participated in the central safety committee, quality, corporate compliance, ethics and risk management meetings, attended meetings with the contracted service providers (Therapy, Pharmacy, and Dining services) and sent in third‐party audit requests and followed‐up on responses as needed. Rick has also participated in Medicare’s Target Probe and Education programs for both skilled nursing facilities and home health agencies. He has been through many Utilization Management Reviews for Medical Assistance billing at skilled nursing facilities.  Rick is a graduate of Clarion University with a Bachelor of Science degree in Secondary Education with a concentration in Mathematics.


DISCLOSURES

1 Contact hour has been requested for this continuing nursing education activity. Criteria for successful completion include attendance for the entire event and submission of the evaluation form.

CONFLICTS OF INTEREST

There is no conflict of interest for anyone with the ability to control content for this activity.  

CONTINUING EDUCATION APPROVER

This nursing continuing professional development activity was approved by the Ohio Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.  (OBN-001-91)

ACCESS

When: Oct 29, 2021 12:00 PM Eastern Time (US and Canada)

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