In June, CMS published a Request for Information soliciting public comments on ideas for regulatory, policy, practice, and procedural changes to reduce unnecessary administrative burdens for clinicians, providers, and patients pursuant to CMS’ Patients over Paperwork initiative. SHG worked with one of the nation’s largest long-term care providers to submit extensive comments addressing many administrative burdens placed on facilities on a daily basis with the goal of streamlining processes and reducing the time spent by facility administrators, executive directors, business office managers, and other staff on tasks that do not directly benefit patients. In particular, we focused on delays and inefficiencies in the Medicaid process that lead to a loss of vital public benefits for applicants and result in substantial AR for providers. With providers in many states already stretched thin, in part, as a result of stagnant Medicaid reimbursement rates, streamlining the Medicaid process to ensure that needy and qualified applicants are able to secure benefits in a timely manner is of paramount importance. With this in mind, we identified several areas for improved efficiency, including:
- Asset Verification Systems and ensuring that Medicaid agencies share the results and reports with applicants, and broadening the types of information that can be obtained through such systems;
- Improvements to online patient portals to promote increased accessibility, efficiency, and communication between all parties in the Medicaid application process;
- Reducing delays in payment to providers caused by poorly coordinated payment systems;
- Ensuring that all states allow RFMS accounts to be utilized for Miller Trusts;
- Simplifying procedures to certify patients’ need for skilled nursing level of care services covered by Medicaid;
- Ensuring adequate timeframes are afforded to applicants to produce requested verifications;
- Reducing excessive scrutiny of bank transactions involving a low dollar threshold; and
- Ensuring undue hardship waivers may be requested and approved without the costly requirement to proceed to litigation as a prerequisite.
SHG is honored to have collaborated on this project with one of the industry’s leaders to support the Patients Over Paperwork Initiative and help make the health care industry better for patients and providers everywhere.
To learn more, please feel free to contact Katie Van Lake at [email protected] or Stacy Schaub at [email protected].