Noridian, Medicare Administrative Contractor for the states of Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming as well as California, Hawaii, and Nevada, is providing clarification of coverage and documentation requirements for common rehabilitation delivery methods based on review findings. If Noridian is your Medicare Administrative Contractor, to read the clarification,

Wisconsin Physician Services (WPS), Medicare Administrative Contractor for the states of Iowa, Kansas, Missouri, and Nebraska, will be hosting 2 seminars on outpatient therapy guidelines. The first is on October 31, 2013 in Lawrence, KS and the second is on November 14, 2013 in Springfield, MO. To learn more about the 2 seminars and to register, click HERE.

The Centers for Medicare and Medicaid (CMS) has issued an article that provides instructions for home health agency (HHA) use of the ABN as the replacement notice for the outgoing Home Health Advance Beneficiary Notice (HHABN), Form CMS-R-296, Option Box 1. In addition, this transmittal includes ABN issuance guidelines for therapy services and therapy specific examples. Examples for therapy includes when to issue an ABN when the patient is below the therapy, above the therapy cap, and when an ABN is not to be issued when the patient is above the therapy cap. Minor editorial changes were made to clarify

Skilled nursing facilities initiating compliance programs are encouraged to review Program for Evaluating Payment Patterns Electronic Report (PEPPER) reports recently sent to each facility by the Centers for Medicare & Medicaid Services (CMS). These free provider-specific comparative data reports help identify billing practices which may be at risk for administrative review. CMS began mailing PEPPER to skilled nursing facilities in August 2013. PEPPER, or program for evaluating payment patterns electronic report, provides facility-specific data statistics for services provided to Medicare beneficiaries. PEPPERs compare a SNF’s claims data statistics with aggregate statistics from similar facilities in the state, Medicare administrative jurisdiction,