Medicare to Look More Closely at Antipsychotic Use in Nursing Homes
MedPage Today | By Joyce Frieden
WASHINGTON -- The Centers for Medicare & Medicaid Services (CMS) announced actions on Wednesday that would put greater scrutiny on antipsychotic prescribing in nursing homes as well as let consumers know about citations the homes are disputing.
"President Biden issued a call to action to improve the quality of America's nursing homes, and HHS is taking action so that seniors, people with disabilities, and others living in nursing homes receive the highest quality care," HHS Secretary Xavier Becerra said in a press releaseopens in a new tab or window. "No nursing home resident should be improperly diagnosed with schizophrenia or given an inappropriate antipsychotic. The steps we are taking today will help prevent these errors and give families peace of mind."
CMS said that beginning this month, it will "conduct targeted, off-site audits to determine whether nursing homes are accurately assessing and coding individuals with a schizophrenia diagnosis. Nursing home residents erroneously diagnosed with schizophrenia are at risk of poor care and prescribed inappropriate antipsychotic medications," which are "especially dangerous" to nursing home residents because the side effects can be devastating, and can even lead to death.
Chris Laxton, executive director of AMDA -- The Society for Post-Acute and Long-Term Care Medicine, an association of nursing home medical directors, told MedPage Today that while his group has "always supported accountability around the appropriate use of antipsychotic medications," capturing overall antipsychotic use is a crude measure of appropriate care.
"We know that no two facilities are alike in terms of their patient population," Laxton said. "Some may have a greater need for appropriate antipsychotic prescribing."
He added that there "are patients with dementia and psychosis for whom antipsychotics are helpful and not categorized as inappropriate." He also warned that facilities may become hesitant to take patients with legitimate diagnoses and need for antipsychotics because it will make their overall rate go up and cause increased scrutiny.
"There's certainly a question about inappropriate diagnoses of schizophrenia and antipsychotic prescribing," Laxton said. "On the other hand, we need measures that don't create a situation where nursing homes refuse to accept patients or where diagnoses are driven by a desire not to be penalized."
David Gifford, MD, MPH, chief medical officer of the American Health Care Association/National Center for Assisted Living (AHCA/NCAL), said in a statement that antipsychotic use in nursing homes has fallen by 40% over the last decade, and noted: "In many cases, physicians not directly affiliated with the long-term care facility are diagnosing patients and prescribing these medications."
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CDC Launches Website to Help Consumers Find Free COVID-19 Testing Sites
Today CDC launched the COVID-19 Testing Locator website, which will allow consumers to search for free COVID-19 testing sites near them. The locator is part of the CDC Increasing Community Access to Testing (ICATT) program, which provides access to COVID-19 testing, focusing on communities at a greater risk of being impacted by the pandemic, people who do not have health insurance, and surge testing in state and local jurisdictions.
Tests offered may include laboratory-based nucleic acid amplification tests (NAATs), including polymerase chain reaction (PCR) tests, and rapid antigen point-of-care (POC) testing. Results are typically provided within 24–48 hours. Testing is available at pharmacies, commercial laboratory sites, community sites, and retail locations.
COVID-19 testing is available at no-cost at ICATT sites to people with or without health insurance who are experiencing symptoms or have been exposed to someone with COVID-19. The tests are billed to third-party payers, such as Medicare, Medicaid, and private health insurers. People without health insurance do not have to pay for COVID-19 testing at ICATT locations. Consumers can access the Testing Locator at testinglocator.cdc.gov. |
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2023 Fee Schedule Calculator Now Available to APTA Members
APTA
Changes to the 2023 Medicare Physician Fee Schedule made by U.S. Centers for Medicare & Medicaid Services will directly affect the calculations used to determine payment. To help you navigate the new landscape, APTA has updated one of its most popular resources — the outpatient therapy fee schedule calculator.
This tool helps participating and nonparticipating PTs determine 2023 Medicare payment and compare rates with the previous year. Presented as spreadsheet, the calculator incorporates the new conversion factor values, the 50% multiple procedure payment reduction, sequestration-related adjustments, and Merit-based Incentive Payment System factors.
Getting Up to Speed on the 2023 Fee Schedule
The revised calculator is just one indication that, for better or worse, the dust is settling around the 2023 physician fee schedule, which was finalized in November and partially adjusted by Congress in late December.
Need to catch up? Here are a few APTA resources that can help.
Final 2023 Fee Schedule: What You Need to Know
Part 1: Payment — cuts, therapy thresholds, updated calculations, and more
Part 2: Remote monitoring, supervision, telehealth skin substitutes, chronic pain management
Part 3: MIPS, quality measures, MIPS Value Pathways, and more
Adjustments to the Fee Schedule Made by Congress
Our Dec. 20, 2022, article summarizes the ways the fee schedule and other issues were affected by the omnibus spending package approved by Congress and signed into law on Dec. 29.
APTA Statement on the Need to Reform the Fee Schedule
APTA President Roger Herr, PT, MPA, describes how continued payment reductions in the fee schedule — and Congress' insufficient response in 2022 — point to the need for an overhaul of the entire system. |
Colorado (Again) Changes Rules on How Employers Must Compensate Employees Using Paid Leave
Littler Publications | Dec 20, 2022
Effective January 1, 2023, regulations under Colorado’s Healthy Families and Workplaces Act (HFWA) will again change how employers calculate the rate of pay when employees use paid sick and safe leave and/or public health emergency leave. Although employers might welcome certain changes to the pay rate calculation rules, the fact is that these new regulations amount to the third time that Colorado’s Department of Labor & Employment (CDLE) has revised the pay rate calculation rules since the HFWA first took effect in mid-2020. Thus, pay rate calculations under the HFWA are a moving target, making compliance a challenge. Learn More |
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