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OIG Screening Requirements
Sex Offender Screening
Advanced Copy: Dementia Care in Nursing Homes: Clarification to Appendix P State Operations Manual (SOM) and Appendix PP in the SOM for F309 - Quality of Care and F329 - Unnecessary Drugs
Thursday June 20, 2013
Guidance - This memo conveys clarification to Appendices P and PP related to nursing home residents with dementia and unnecessary drug use. • Training - Mandatory surveyor trainings are available online at
Quality of care
Release of Mandatory Surveyor Training Program on Care of Persons with Dementia and Unnecessary Antipsychotic Medication Use - Release of Third Video
Thursday June 20, 2013
S&C: 13-34-ALL Memo
Release of Training Materials:The Survey and Certification Group (SCG) is providing the third and final training program on the care of persons with dementia and unnecessary antipsychotic medication use. The first two programs were made available in January 2013; the third program will be released after May 31, 2013.
Program Content and Design:The third program is a video-streaming that discusses how to cite severity. The first program provides survey basics related to care of persons with dementia and unnecessary medications. The second program is an interactive self-study with video clips that walks through portions of an actual nursing home survey. • Target Audience: These three programs are mandatory for all State and Regional Office surveyors and optional for other interested personnel. Surveyors have until August 31, 2013 to view the final training. The deadline to view the first two programs was April 30, 2013.
American Health Care Association Quality Improvement Toolkits and Webinars
Friday June 21, 2013
AHCA has available and free to all AHCA members the 4 Key Strategies to Retain New Hires and Reduce Employee Turnover (toolkit and webinar) and the Clinical Considerations of Antipsychotic Management (Toolkit and webinar): http://qualityinitiative.ahcancal.org. This resource uses a process framework, based on the Nursing Process, to identify care objectives and expectations. It identifies tools and resources to help providers successfully manage antipsychotic medication use at the resident and facility level. The guide focuses on 7 critical steps needed to ensure quality outcomes that are successful and continuous.
Members will need to log-in to access the toolkits, as it is a
. If log-in information is needed, please contact your facility Administrator or State Association and they can give you the information you need.
OIG - Comparing Lab Test Payment Rates: Medicare Could Achieve Substantial Savings
Friday June 21, 2013
June 2013 OEI-07-11-00010
In 2011, Medicare paid between 18 and 30 percent more than other insurers for 20 high-volume and/or high-expenditure lab tests. Medicare could have saved $910 million, or 38 percent, on these lab tests if it had paid providers at the lowest established rate in each geographic area. State Medicaid programs and 83 percent of FEHB plans use the Medicare CLFS as a basis for establishing their own fee schedules and payment rates, although most pay less. However, unlike Medicare, FEHB programs incorporate factors such as competitor information, changes in technology used in performing lab tests, and provider requests in their payment rates. Some State Medicaid programs and FEHB plans required copayments for lab tests, which, in effect, lowered the costs of lab tests for the insurer.
The OIG recommend that the Centers for Medicare & Medicaid Services (CMS) seek legislation that would allow it to establish lower payment rates for lab tests and consider seeking legislation to institute copayments and deductibles for lab tests. In its comments, CMS stated that it is exploring whether it has authority under current statute to revise payments for lab tests consistent with OIG's recommendation and that a proposal to establish "deductibles and coinsurance" for lab tests is not included in the fiscal year 2014 President's Budget.
To read the complete report click on the pdf below.
Gallagher Monthly Minute - June 2013
Wednesday June 26, 2013
Tips to Control the Risk with Communication