CMS PUBLISHES NATIONAL LIST OF POOR-PERFORMING NURSING HOMES

The Centers for Medicare & Medicaid Services (CMS) today released the first ranking of the nation's poor-performing nursing homes.

Release of the national list of facilities, identified as special focus facilities (SFFs), is expected to offer powerful new information on nursing homes.

See link:

http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2672&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

CMS: MEDICARE CONTINUES TO REDUCE IMPROPER CLAIMS PAYMENTS

The Centers for Medicare & Medicaid Services (CMS) announced today that aggressive oversight efforts have resulted in a further reduction of the number of improper Medicare claims payments, which declined from 14.2 percent in 1996, to 4.4 percent in 2006, to 3.9 percent in 2007. This solid improvement is a result of continued efforts initiated by CMS and its contractors to use detailed data analysis in targeting areas where erroneous claims processing, inaccurate billing and provider error result in waste, fraud and abuse.

The decline in improper payments reflects our emphasis on identifying and eliminating waste, fraud and abuse in all CMS programs. It is critical that we ensure every dollar is spent wisely so that the program is affordable for taxpayers and future generations of beneficiaries,� said CMS Acting Administrator Kerry Weems. The Medicare fee-for-service (FFS) error rate has declined from 14.2 percent in 1996, when the Medicare improper payment rate was first reported, to the current 3.9 percent in 2007. During the past three years, recent error rate reductions have led to approximately $11 billion less in improper payments. CMS pays more than 1 billion fee-for-service claims each year.

CMS conducted detailed reviews of randomly sampled Medicare FFS claims submitted between April 1, 2006 and March 31, 2007. Approximately 140,000 claims spanning all types of Medicare FFS payments were included in the Medicare error rate testing program. By providing accurate statistical information to its personnel and contractors, CMS can identify where problems exist and target improvement efforts to address the problems.

This year's results show the commitment to use more detailed data and analysis to identify and eliminate improper payments is working. Protecting the integrity and ensuring the accountability of CMS programs is one of our fundamental responsibilities, and we�re pleased with the improvement to the program, said Weems.

For addtional info:
http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2633&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

Company Profile: Healthcare Collateral Consulting, LLC

Healthcare Collateral Consulting, LLC offers outsourced due diligence services including field examinations, credit, underwriting, risk analysis and account management for healthcare lenders, including banks, asset-based lenders, private equity and institutional investors. HCC's associates have extensive healthcare experience in credit, collateral, underwriting, audit, workout management, operations, and account management.

Healthcare Collateral Consulting, LLC has mission to provide superior, cost effective, value added services to our clients. HCC is committed to establishing strong relationships with its clients and providing innovative outsourcing solutions with the highest quality of service.

HCC's services are designed to provide a customized solution and include:

Remote Performance & Loan Compliance Reviews: For many lenders, account executives and portfolio managers simply do not have the time or resources to review a borrower's performance and track record. So, if a site visit is not practical or warranted, Healthcare Collateral Consulting, LLC can perform a thorough remote review of the borrower's performance and any changes in its collateral. HCC can provide our clients with quarterly, semi-annual, or annual credit memorandums. This review can also include the spreading and analysis of financial statements, compliance with loan covenants, and trend analysis of key performance metrics.

Underwriting/Due Diligence: When an influx of new business exceeds the resources available to expeditiously underwrite and process the transaction, all or a portion of the underwriting and due diligence can be outsourced to Healthcare Collateral Consulting, LLC. HCC can manage the due diligence process including collateral audits, financial spreading, preparation of credit request documents and the gathering of legal information.

Collateral Exams: Healthcare Collateral Consulting, LLC executes comprehensive independent exams on prospective borrowers in the Healthcare industry. HCC will evaluate the prospective borrower's collateral, perform reimbursement tests, analyze trends, review systems and operations, review financial reporting, as well as several other targeted areas that assist our clients in making sound credit decisions. Our objective is to provide our clients with a report that is tailored to their needs and relevant to each individual deal.

Remote Financial Assessments: Financial Assessments consist of a remote review of a borrower's overall credit risk. Rather than performing the time consuming tests and reconciliations, typically associated with a collateral audit, these reviews focus on financial performance and trends, collateral trends, operations, management, policies and procedures, and any other material pre-funding deal points. Financial assessments are typically less costly and time consuming and reports are shorter and less cumbersome than full Collateral Exam Reports.

Scheduling Engagements & Staffing: Healthcare Collateral Consulting, LLC can accommodate our clients with quarterly, semi-annual, or annual exams. Often times, Account Executives are too busy to schedule and staffing recurring exams. HCC relieves that burden from our clients by preparing a detailed schedule of exams that is approved by all parties involved. Once on site, HCC will perform the necessary testing to ensure the client is fully aware of their borrower's collateral position and financial well being. The result is a detailed report that is presented in a timely manner.

UCC Research: Healthcare Collateral Consulting, LLC can provide its clients UCC searches with greater reliability and security while helping to increase productivity through potential time and cost savings. HCC has access to an extensive database which allows customizable searches at listed prices to our clients. Public information from every state and in every field - UCC, real property, corporate charter, bankruptcy, tax liens and judgments are all covered. HCC can save time by accelerating the loan approval process and can increase productivity by centralizing UCC search function. HCC can search, manage and track the activity for you.

Monitoring Healthcare Facility Survey Results: Healthcare Collateral Consulting, LLC can offer its clients facility survey results as a likely time saving opportunity. HCC can also recognize potential collateral issues with a revolving line of credit if the facility is non-compliant from its survey results. HCC has access to the Surveys, Certifications, and Reporting database – this includes facility characteristics and health deficiencies issued during the most recent state inspection and recent complaint investigations. Healthcare facilities are required to be in compliance with the State and Federal regulations, to receive payment under the Medicare or Medicaid programs. HCC can save its clients the burden of identifying non-compliant facilities and alerting them of any impending collateral issues. Healthcare Collateral Consulting, LLC can increase visibility and productivity by centralizing this survey monitoring function.

Best Practices Analysis: Healthcare Collateral Consulting, LLC will perform a comprehensive analysis of a company's financial health, and its systems, operations, policies and procedures. HCC will then make detailed recommendations leading to improved profitability, more efficient operations, or the company's ability to obtain additional funds from untapped collateral.

Revolving Line of Credit Simulation: Healthcare Collateral Consulting, LLC can perform a complete analysis of a prospective borrower's proposed RLOC terms and fees. Using the lender's term sheet and historical data for the last 12 to 24 months, HCC can give the prospective borrower insight into the true cost of the revolving line of credit and allow the prospective borrower to test different fee schedule scenarios. HCC can also offer a collateral simulation to determine if the collateral supports the loan balance on any historical month. HCC will then make term sheet recommendations leading to improved cost savings, and/or the ability to obtain additional funds from untapped collateral.

Inventory Analysis: Healthcare Collateral Consulting, LLC reviews the inventory posting processes, statistics, inventory comparative trends, physical test counts and sampling, gross profit tests, inventory costing, inventory concentration, and slow moving inventory. Hard-asset Verifications: Healthcare Collateral Consulting, LLC will verify the existence and quality of a lender's collateral, with equipment, real estate and other property.

Special Assets Divestitures: Healthcare Collateral Consulting, LLC offers assistance to banks, asset-based lenders, private equity and institutional investors in divesting non-performing or high risk accounts or portfolios. HCC will work with a borrower by recommending process and debt structure changes, creating a comprehensive financing memorandum, and soliciting new creditors; all while taking into account the interests of the existing lender. Through its healthcare industry contacts, Healthcare Collateral Consulting, LLC is likely to find a new home for even the most challenged credits.

About HCC's Management:
Managing Director and President - David J. Lacasse has more than 11 years of experience in asset based lending, healthcare finance, and medical device manufacturing, most recently managing the loan portfolio for a prior healthcare finance business since 2004.

How do you get started?
If you are interested in learning more, or would like to get in touch with Mr. David Lacasse; He can be reached at the following email address: djlacasse@gmail.com . Please included your name, title, company name and phone number where Mr. Lacasse can reach you.

We look forward to hearing from you,

Healthcare Collateral Consulting, LLC
Fairfield County, Connecticut

2007 MedPAC Releases Updated Medicare Basics Documents

On October 5, 2007, the Medicare Payment Advisory Commission (MedPAC) released updated documents for its Medicare Basics and Medicare Payment Basics series. The documents include a document entitled Medicare Benefit Design and the following documents which provide an overview of individual Medicare payment systems:

Oxygen and Oxygen Equipment
Skilled Nursing Facilities
Physician Services
Psychiatric Hospital Services
Rehabilitation Facilities
Medicare Part D
Outpatient Therapy Services
Medicare Advantage Program
Outpatient Dialysis Services
Outpatient Hospital Services
Home Health Care Services
Hospice Services
Hospital Acute Inpatient Services
Long-Term Care Hospitals
Clinical Laboratory Services
Critical Access Hospitals
Durable Medical Equipment
Ambulatory Surgical Centers

MedPAC is an independent federal body established by the Balanced Budget Act of 1997 to advise Congress on issues affecting the Medicare program.

http://medicareupdate.typepad.com/medicare_update/2007/10/on-october-5-20.html

Cost Reports: General Information

Medicare-certified institutional providers are required to submit an annual cost report to a Fiscal Intermediary (FI). The cost report contains provider information such as facility characteristics, utilization data, cost and charges by cost center (in total and for Medicare), Medicare settlement data, and financial statement data. CMS maintains the cost report data in the Healthcare Provider Cost Reporting Information System (HCRIS). HCRIS includes subsystems for the Hospital Cost Report (CMS-2552-96), Skilled Nursing Facility Cost Report (CMS-2540-96), Home Health Agency Cost Report (CMS-1728-94), Renal Facility Cost Report (CMS-265-94) and Hospice Cost Report (CMS-1984-99). The data is available in a relational database and consists of every data element included in the HCRIS extract created for CMS by the provider's FI. The data files contain the highest level of Medicare Cost report status; for example, if HCRIS has both an as submitted report and a final settled report for a specific fiscal year the data files will only contain the final settled report.

for more information go to: http://www.cms.hhs.gov/CostReports/