Medicare Compliance & Reimbursement

Feds want LTCs' Medicare status tied to flu, pneumonia immunizations.

Long-term care providers that don't have stellar immunization programs could soon be booted from the Medicare ranks.

Under a new proposal from the Centers for Medicare and Medicaid Services, nursing homes that want to continue getting federal funds would have to ensure that their residents have been vaccinated against flu and pneumonia.

The plan: Facilities serving Medicare and Medicaid patients would have to provide immunizations against influenza and pneumococcal disease to all residents unless they or their families refuse, according to a proposed rule that appears in the Aug. 15 Federal Register. CMS received input from the American Association of Homes and Services for the Aging and the American Health Care Association in developing the proposed rule.

"[The feds] are sending the right message," says Paul Drinka, MD, a representative of the American Medical Directors Association. But the timing may be tough for nursing homes, which already face a slew of changes related to Medicare participation, which include CMS' expedited review appeals program and Medicare Part D.