Understanding the Centers for Medicare & Medicaid Services: A Comprehensive Guide
Most healthcare conversations center on coverage, premiums, and benefits. Behind all of that, however, is a federal agency whose decisions quietly shape almost every dollar that moves through the health system for older adults, people with disabilities, and low‑income families. That agency is the Centers for Medicare & Medicaid Services (CMS). Whether you run a […]
Understanding the Centers for Medicare and Medicaid Services (CMS)
If you work in healthcare long enough, especially in home health, hospice, therapy, or other outpatient settings, you quickly realize that many of the rules shaping your day-to-day operations trace back to a single agency: the Centers for Medicare & Medicaid Services, also commonly known as CMS. Not only does CMS administer benefits, but it […]
Florida Nurse Registry License: Understanding the Financial Requirements
Understand Florida’s nurse registry license financial requirements and how to prepare AHCA’s Proof of Financial Ability to Operate for your application.
Understanding MACs
Medicare Administrative Contractors: Their Role and Importance If you work with Medicare long enough, whether you’re running a home health agency, hospice, therapy practice, or outpatient clinic, you eventually realize that much of your day-to-day interaction with the Medicare system doesn’t happen directly with the federal government. Instead, it runs through a less visible but […]
Understanding the Home Health Agency Cost Report (CMS-1728-20)
Home health agencies rely on Medicare reporting to keep reimbursement accurate and predictable. Each year, this data submitted informs financial planning and helps the Centers for Medicare & Medicaid Services (CMS) evaluate the real cost of providing care in the home. At the center of this work is Form CMS-1728-20, the Home Health Agency Cost […]
Medicare Reimbursement Guide
Medicare Reimbursement Guide for Healthcare Providers Medicare reimbursement touches almost all healthcare organizations, and its importance is especially felt by small and mid-sized ones such as home health agencies, hospices, physical therapy providers, outpatient clinics, and independent medical practices. While Medicare often gets discussed in the context of hospitals, the same rules, codes, timelines, and […]
Understanding Medicare DRG: Key Insights for Better Healthcare Costs
Since the early 1980s, Medicare’s prospective payment systems have transformed how healthcare providers are reimbursed for patient care. Central to that evolution is the Diagnosis Related Group, or DRG, system, a framework designed to standardize hospital payments and encourage efficiency. While the DRG model began in hospital settings, its logic now extends to nearly every […]
Understanding Medicare PPS: What Healthcare Providers Need to Know
In 1983, Medicare introduced a fixed payment model for hospitals known as the inpatient prospective payment system (IPPS). That change marked a turning point as it shifted reimbursement from cost-based to diagnosis-based payments. Over the decades, that same concept has been extended into the post-acute and community setting: skilled nursing facilities (SNFs) in 1998, home […]
SNF Related Party Cost Reporting: Insights and Guidance
Beyond the immediate demands of resident care, running a skilled nursing facility (SNF) today requires mastering complex financial reporting. This reporting is not mere bookkeeping; it directly determines Medicare reimbursement and compliance status. Among the most scrutinized areas is the proper disclosure and handling of related party transactions. These common transactions occur between an SNF […]
How SNF Cost Reports Impact Medicare Reimbursement: Key Insights
Running a skilled nursing facility (SNF) means balancing patient care, staffing pressures, and an increasingly complex reimbursement system. Among the many compliance responsibilities, few are as consequential as the SNF cost report. This annual filing meets a CMS requirement and determines how much a facility is reimbursed under Medicare, affects audit outcomes, and plays a […]