Uncategorized Archives - Page 5 of 11

Ready, Set, Go…away MMQ! MassHealth announces the transition to a case mix acuity system for Medicaid payments.

Effective 10/1/23, MassHealth will shift to a Minimum Data Set (MDS 3.0) based Medicaid reimbursement system. Management Minutes Questionnaire (MMQ) will finally be eliminated! The Medicaid reimbursement system will be based on a Patient Driven Payment Model (PDPM) system and utilize the MDS 3.0 assessment as the acuity measurement tool to determine payment for MassHealth … Continue reading

FY 2024 SNF VBP Program March 2023 Quarterly Reports available

How did you perform? FY 2024 SNF VBP Program March 2023 Quarterly Reports are available to download. March 2023 Interim Quarterly Confidential Feedback Reports for Fiscal Year (FY) 2024 SNF Value Based Purchasing (VBP) program are available to download in the QIES/CASPER reporting system. Reports include interim stay-level data for the SNF 30-Day All-Cause Readmission … Continue reading

MDS Assessment Submissions Are Transitioning to iQIES Next Month

MDS assessment submissions are transitioning to iQIES next month. Crucial Points: Failure to register for a new iQIES account before the go live date will impact your ability to submit MDS records. MDS assessment submission and reporting functionality will transition to the Internet Quality Improvement and Evaluation System (iQIES) on 4/17/23. The QIES Assessment Submission … Continue reading

CMS Plans Offsite MDS Audits of Schizophrenia

Providers brace for schizophrenia MDS audits; potential for Five-Star rating downgrades and Quality Measure (QM) rating suppression penalties. CMS released memo QSO-23-05-NH, addressing QM ratings based on erroneous schizophrenia coding and processes for posting citations under dispute.CMS has identified a trend of MDS coding residents as having schizophrenia, without supportive documentation. The Five-Star QM percentage … Continue reading

Kepro appeal notification process changes

Beginning next week, Kepro appeal notification process changes for post-acute care providers in 29 states. On 1/17/23, post-acute care facilities and Medicare health plans will receive notifications when a new appeal has been filed by FAX ONLY and will no longer receive phone calls for appeal notifications. Notifications will be faxed to the number used … Continue reading

CT Providers- Final CMI Resident Roster Reports Available

Connecticut Providers- Did your Case Mix index (CMI) averages hit the mark? Final Time Weighted Case Mix Index 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. Let’s discuss options to improve capture of CMI data and increase CMI … Continue reading

SNF VBP Quarterly Reports Released

SNF VBP Quarterly Repots released; providers have a short window to submit corrections that will impact FY 2024 incentive payments. December 2022 Quarterly Confidential Feedback Reports for FY 2024 SNF VBP program are available now in QIES/CASPER. The reports released 12/1/2022 include SNF 30-Day All-Cause Readmission Measure (SNFRM) results for FY 2019, which will be … Continue reading

CT Providers-MDS transmissions due by 11/15/22 for Final Resident Roster Reports

CT Providers- MDS transmissions due by 11/15/22 for Final Resident Roster Reports. Cut-off to submit corrected MDSs for the Final Resident Roster Report is tomorrow (11/15/22). Take this opportunity to ensure your MDS assessments captured the most accurate CMI for resident care to optimize Medicaid revenue for future payments. Celtic supports our clients by identifying … Continue reading

CT Providers- Preliminary Resident Roster Reports Are Available

CT Providers- Preliminary Resident Roster reports are available to retrieve from the Myers and Stauffer portal. You have until 11/15/22 to submit corrections. Are you capturing optimal CMI data? Celtic supports our clients by identifying opportunities to enhance case mix system processes through analysis, targeted education and mentorship. We’ve helped clients in multiple states improve … Continue reading

SNF QRP Preview Reports Released

With new data included, SNFs preview their outcomes for January 2023 refresh. If a provider disagrees with the quality measure results displayed in Preview Reports, they can request CMS review data used. Cutoff to view reports and request review is November 14th. Data within preview reports includes: Quality assessment data submitted for Q2 2021-Q1 2022 … Continue reading

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