Current News

News

07/19/13

CMS Issues 2014 Proposed Rule

On July 19, 2013, The Centers for Medicare & Medicaid Services (CMS) released “Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule & Other Revisions to Part B for CY 2014; Proposed Rule”. This is the yearly proposed rule that sets payment and regulatory policies for services reimbursed under the Medicare Physician Fee Schedule that does include outpatient physical, occupational, and speech therapy services. Highlights of the proposed rule include: physician fee schedule update, significant changes to the PQRS program, incident to physician therapy services, off-campus hospital-based therapy departments, and implementing the therapy cap

Read More
07/02/13

Mandated Health Insurance Requirement Delayed

The White House announced on July 2, 2013, they were delaying the Accountable Care Organizations mandate of employers with more than 51 full-time workers to offer qualifying health insurance coverage to their employees or face a penalty was being delayed until 2015. The delay does not change the individual mandate, which requires most Americans to purchase insurance. Some consumers may receive subsidies to help them pay for the insurance depending o their incomes.

Read More
06/22/13

MedPAC Issues June Report to Congress

The Medicare Payment Advisory Commission (MedPAC) issued their June 2013 report to Congress. The report is 303 pages in length and consists of 9 chapters. Chapter 9 is titled “Mandated report: Improving Medicare’s payment system for outpatient therapy services” and consists of Medicare payment policy for outpatient therapy services, Medicare spending on outpatient therapy services, and significant recommendations to reform Medicare policy and payment for outpatient therapy services. Recommendations include changing the certification period, a drastic reduction in the therapy cap dollar amount for all 3 disciplines, and changes to the use of V codes for outpatient therapy services, just

Read More
06/20/13

CMS Releases Functional Limitation Reporting FAQs

On June 20, 2013, the Centers for Medicare & Medicaid Services released the long awaited FAQs on the new Medicare G Codes and mandated reporting of patient functional limitation that becomes mandated to report on July 1, 2013. The document contains 22 FAQs on topics including how to report functional limitations, use of assessment tools, and claim requirements. To access this member only benefit, click

Read More
06/18/13

CMS Changes July 1st FLR Requirements

From APTA In response to concerns raised by APTA, providers, and other stakeholders, CMS has changed its functional limitation reporting instructions for claims submitted for each patient’s first visit on or after July 1, 2013. As a result of the change, therapy providers who have submitted functional limitation data (G-codes) on Medicare Part B patients prior to July 1

Read More
06/07/13

Medicare G Codes – New Information

On each beneficiary’s first treatment date on or after July 1, physical therapists, occupational therapists, and speech-language pathologists must

Read More
06/01/13

Clarification of Part A to Part B Rebilling of Inpatient Claims

Effective March 13, 2013 CMS Ruling 1455-R established an interim process allowing all hospitals to bill Medicare for Part B services after receiving a denial for a Part A inpatient admission claim as not reasonable and necessary. This process applies to Part A hospital inpatient claims that were denied by a Medicare review contractor because the inpatient admission was determined not reasonable and necessary, as long as the denial was made: (1) while this Ruling is in effect; (2) prior to the effective date of this Ruling, but for which the timeframe to file an appeal has not expired; or

Read More
06/01/13

CMS Approves Rubber Stamp Signature for Providers with Disabilities

Effective June 18, 2013, the Centers for Medicare & Medicaid Services (CMS) will allow providers with a physical disability to use a rubber stamp as signature when ordering or referring medical services for Medicare beneficiaries. To claim the signature exemption, providers with a physical disability must provide proof to a CMS contractor of their inability to sign their signature. With few exceptions, stamped signatures are not acceptable as described in Chapter/Section 3.3.2.4 of the Medicare Program Integrity Manual. To access the MLN Matters article, click HERE.

Read More