WASHINGTON -- Medicare has proposed covering cardiac rehabilitation services for patients with chronic heart failure 4 years after saying there was little evidence to support doing so.
The proposed and projected coverage decision would expand access to rehab for a wider range of heart patients. Medicare currently covers rehab only for patients who have had an acute MI in the preceding year, coronary artery bypass surgery, heart or heart-lung transplant, or other major events.
The Centers for Medicare and Medicaid Services (CMS) came to the determination after extensively reviewing literature on the rehab service from 2006 to August 2013. It announced the decision online late last week.
"Since chronic heart failure often results from coronary artery disease and hypertension, evidence on behavioral interventions in the treatment of these conditions provide additional supportive evidence," the agency wrote. "With the accumulated evidence that supports the benefits of the individual components of cardiac rehabilitation programs, the evidence is sufficient to determine that participation in these multi-component programs improves health outcomes for Medicare beneficiaries with chronic heart failure."
Stay tuned.
Late November is often a time for gatherings with family and friends – Thanksgiving and Hanukkah, soon followed by Christmas and the New Year.
Nursing home residents often want to participate in these gatherings but may worry that they will lose Medicare coverage if they leave the facility to do so. Residents and their families have the right to do so, according to the Center for Medicare Advocacy which has issued a new Alert..
According to Medicare law, nursing home residents may leave the facility for holidays without losing their Medicare coverage. However, depending on the length of their absence, beneficiaries may be charged a "bed hold" fee.
Elizabeth Newman writing for McKnight's, recently quoted a report from the Commonwealth Fund, which attempts to draw a correlation (cause and effect) between the rate of skilled nursing discharges to hospitals based upon how well a state provides healthcare for low income people.
The report found that in many cases, low income populations in the top performing states receive better healthcare than high income populations in the lowest ranked states.
The data is meaningful especially in light of the rehospitalization issue for discharges from SNF's back to hospitals within a 30 day period from the initial admission to the facility from the hospital.
What is MDS?
MDS stands for Minimum Data Set which is a comprehensive assessment for patients and residents who are here for rehabilitation and long term care.
MDS, covers many areas of assessment, including the patients illness and history, how much assistance the patient needs, what the patient and and facility goals are for the 3 therapy disciplines, activity participation, therapy minutes, social service issues and more.
The assessments are done at intervals with more frequent assessments for Medicare patients. These assessments are used for the purposes of ascertaining the reimbursement schedule from Medicare and Medicaid, which is influenced by the acuity of the patient.
Pictured below is the MDS Coordinator for Regency Heritage, Christina Segro!
