LTC Pharmacy News
September 2019
The healthcare industry is in the beginning of massive change and the long term care pharmacy industry will be affected by this change. LTCPharmacy.net is your guide to understanding this process, the legislation and regulation that will implement this change and the key to adjusting your approach to succeeding in this new environment. We will try to not just tell you the "what" of this change, but the "how" as well.
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Final Medicare Parts C and D Rates and Call Letter for 2020
CMS has published the final 2020 Medicare Advantage and Part D rate information and call letter. For a summary, please go here.
CMS Publishes Final SNF PPS Rule for 2020
The SNF PPS Final Rule is out and Elise has gone through the tome with a fine-toothed comb. No surprises, but Elise takes us from where we've been on PDPM to where we are now; ready to go!

CMS Releases Draft RAI Manual
A critical element of the move to PDPM is the creation of the Resident Assessment Instrument (RAI). This document will provide guidance to SNFs on the creation of resident assessments that will determine how a SNF resident is classified under the new payment systems. In this post Elise
gives us a peek into what CMS will expect facilities to consider in the creation of care plans.


Elise Unpacks the Proposed Rule for SNF PPS
Elise has gone through the SNF PPS Proposed Rule for 2020 with a fine-toothed comb and comes away with insights into the Patient Driven Payment Model and all the adjustments CMS has proposed for FY 2020.
You won't want to miss this!
Keeping up with PDPM
Having trouble following all the developments in the implementation of the new SNF PPS payment system scheduled for implementation in October? Fear not, Elise cuts through the fog and lays out the current state of implementation, SNF industry reaction and the likely list of winners and losers. Read about it here.
More Elise Smith Insights
The list of Elise's publications was getting too lengthy to continue listing on the newsletter, so we have created her own page on the LTC Pharmacy News site. See it all now.

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Federal Agency News
CMS Publishes SNF PPS Final Rule: All Clear for PDPM
CMS posted the Final Rule for the FY 2020 SNF PPS. The rule is essentially unchanged from the proposed rule and sets the stage for the implementation of the Provider-Driven Payment Model and bids farewell to RUGs on October 1.
See Elise Smith's brief on the contents of the rule and the CMS Press Release.

Looking for Health Data? HRSA Can Help
The Health Resources Services Administration has introduced a series of videos on how to navigate its data website to find the information you may be looking for, including fact sheets, health center locations and shortage areas. 


Parkinson Disease Mortality
The CDC has published an updated report on mortality statistics for sufferers of Parkinson disease. Top line results show a 50 percent increase in deaths associated with Parkinson over the past 20 years.


CMS Blog: Ensuring Safety and Quality in Nursing Homes: Five Part Strategy Deep Dive
We at CMS bear the responsibility to develop and enforce quality and safety standards across the nation’s health care system, and we are deeply committed to that job. Every nursing home resident deserves to be treated with dignity and respect, and all of our nursing home work at CMS is predicated upon that single goal.


ACL Issues Brief on Assistive Technology
The Administration for Community Living published a briefing document on the role of assistive technology in community living, including the role of assistive technology in helping people live full and independent lives in the community. The brief also provides information on public sources of funding for assistive technology.


Free AHRQ Webinar on the Role of Health IT to Improve Care Transitions
On September 26 The Agency for Healthcare Research and Quality from 2 to 3:30 p.m. ET to discuss how health IT can improve care transitions for patients with complex conditions. Presenters will discuss their work on smartphone-based applications to improve care coordination, an interactive patient-centered discharge toolkit to promote self-management, and the role of clinical decision support in improving care transitions for patients with multiple chronic diseases. This webinar is ideal for healthcare researchers, physicians, physician assistants, nurses, pharmacists, and other health care professionals, health IT researchers and vendors.


CMS Issues Bulletin on Medicaid DUR
The Center for Medicaid and CHIP Services has issued a bulletin providing guidance to states on implementing the drug use review requirements included in the recently-passed Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT).


OIG: Medicare Part D Paying for Hospice Drugs Covered by Part B
The HHS Inspector General reports that in 2016 Medicare Part D may have paid as much as $160 million for drugs that should have been paid for by hospice organizations under Medicare Part B. 


GAO: Patient Options for Safe and Effective Disposal of Unused Opioids
An estimated 11.1 million Americans misused a prescription pain reliever, including opioids, in 2017. One of the ways government agencies and others have attempted to address misuse is by facilitating safe disposal of these drugs.


ReThink Podcast #14: CMS Chief Medical Officer Kate Goodrich
As the Medicare program's top clinical official, Dr. Kate Goodrich has played a major role in the wave of nursing home regulatory scrutiny coming from Washington and Baltimore over the last few years.


Recruiting Underway for Technical Expert Panel
Abt Associates is currently recruiting a wide range of hospice stakeholders—for example, providers, patients, and quality improvement experts—to participate in a Technical Expert Panel (TEP) to provide input on an assessment instrument and corresponding quality measures for hospice care.
Policy and Industry Notes
Senators Question CMS About Managed Medicaid and LTSS
Senators Chuck Grassley (R-IA) and Bob Casey (D-PA) sent a letter to CMS Administrator Seema Verma asking her to respond about CMS oversight of Medicaid managed care in the delivery of Long Term Services and Supports.


Nursing Home CFOs More Concerned About Managed Care
A recent survey of nursing home Chief Financial Officers reveals slightly less optimism about the ability of their companies to compete in the current environment and about the impact of managed care on their financial health


A New Crop of Entrepreneurs: Over the Age of 65
Reading the daily news, you might think that starting a business is a young person's game. Prepare to think again as you take a look at a non-profit community that caters to the entrepreneurial pursuits of seniors


Blood Test for Alzheimer's 94% Accurate
Medscape reports on a blood test that highly correlates with a diagnosis of Alzheimer's disease, offering hope for a tool for early diagnosis and treatment.
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