Money moves
Florida Medicaid Managed Care Plans Ordered to Clear SNF Backlog
Florida's AHCA directed Medicaid managed care plans to resolve $215M in outstanding SNF claims within 60 days or face liquidated damages of 1.5% per month.
Quality
CMS Updates Five-Star Methodology With New Staffing Weekend Adjustment
Starting April 2026, CMS will factor weekend staffing levels into the Five-Star staffing domain, penalizing facilities where Saturday-Sunday HPRD drops below 85% of weekday levels.
Compliance
Three-State OIG Sweep Finds $67M in Improper SNF Billing
OIG audits in Georgia, Alabama, and Mississippi identified $67M in improper Medicare claims, primarily from upcoded therapy minutes and unbundled ancillary services.
Technology
Wearable Fall Detection Devices Gain CMS Endorsement for SNFs
CMS issued guidance encouraging SNFs to adopt FDA-cleared wearable fall detection devices, noting they may qualify as allowable costs under the Medicare cost report.
The bottom line
Florida is cracking down on Medicaid MCO payment delays, Five-Star is getting a weekend staffing dimension, and OIG found $67M in billing errors across the South.