To IPA or NOT IPA—A Very Important Question
May 28, 2020
This webinar presentation will review the reasons why an IPA should be considered during Medicare coverage to increase reimbursement. Very few IPAs have been completed since the onset of PDPM on 10/1/19. The complexity of the PDPM system causes the Medicare team to be unsure of which changes would result in increased payment. This webinar will assist the Medicare A teams to understand which PDPM components present the highest opportunity for improved reimbursement. Discussion will include which high ticket items should cause the MDS team to immediately consider completing an IPA. Because the nursing payment items seldom impacted payment in the RUGs IV system, the Medicare team often has not been aware of the payment items and their effect on reimbursement. This webinar will focus on the nursing and NPA components of PDPM, because they provide the best opportunity for increased reimbursement.
1. Participants can state 2 nursing services that have the greatest impact on the nursing component of PDPM.
2. Participants can pinpoint which 2 of the PDPM components have the biggest opportunities to increase reimbursement.
3. Participants can state when the IPA begins affecting the Medicare payment and how long the IPA will continue to pay during Medicare coverage.
Carol Maher, RN-BC, RAC-MTA, RAC-MT, RAC-CTA, RAC-CT, CPC
Carol Maher is a Board Certified Gerontological Registered Nurse with over 30 years of long term care experience and has worked in long term care in many roles. She worked as the MDS Coordinator in a 300 bed SNF in Pennsylvania for 8 years before moving to CA to become the MDS Coordinator/Director for a 1200 bed SNF in San Francisco. She has also worked as the MDS Coordinator in a SNF that typically had 60-75 residents on Medicare in addition to 160 long-term care residents. Most recently she was the Senior VP of Utilization Services and Director of Reimbursement for large multi-facility organizations.
Carol has worked as one of the Gold Standard nurses for MDS 3.0, serving on the RAP workgroup to prepare the way for the CAAs for MDS 3.0, and participating on a number of Technical Expert Panels related to MDS, Quality Measures and care planning. A sought-after speaker, she has given presentations at AANAC, AHCA and Leading Age national conferences as well as many state organization presentations. She is also a frequent author of articles related to the RAI process and PPS. Carol served as a member of the AANAC Board of Directors for 9 years. She is presently serving as the chair of the AANAC Expert Advisory Panel and as an AANAC Master Teacher of the RAC-CT and RAC-CTA certification courses. Ms. Maher is the Director of Education for Hansen Hunter & Co. P.C., providing MDS and Medicare classes across the country, presenting monthly educational webinars and completing compliance audits. She is the author of Long-Term Care MDS Coordinator’s Field Guide (HCPRO 2016).
- 1.25 credit hours for RNs
- 1.25 credit hours for NABs
This pre-recorded webinar expires on May 29, 2022.