The Office of the Inspector General (OIG) has released their 2013 work plan. To no ones surprise, rehab is on their radar. For IRF, the OIG will look at appropriateness of admission and level of therapy. The OIG work plan will also focus on independent physical therapists in private practice and high utilization of outpatient PT services. To read the work plan, click…

The Centers for Medicare and Medicaid Services (CMS) has awarded contracts for Jurisdictions that will impact that states of California, Hawaii, Illinois, Minnesota, Nevada, and Wisconsin.

As of October 1, 2012, Medicare will start fining hospitals that have too many patients readmitted within 30 days of discharge due to complications. The penalties are part of a broader push under President Barack Obama’s health care law to improve quality while also trying to save taxpayers money. To read the full story from USA Today, click…

The Medicare Payment Advisory Commission today discussed draft recommendations for reforming the Medicare benefit for outpatient physical and occupational therapy and speech-language pathology to control spending while improving care and access to services. Proposals include…

The Medicare Payment Advisory Commission (MedPAC), on November 1, 2012, unanimously voted to recommend changes to reform the Medicare benefit for outpatient physical and occupational therapy and speech-language pathology. The final recommendations include…

Please log in to see valuable information per your Medicare contractor for the manual medical review process.

Below you will find the various Medicare contractors and links to their respective Manual Medical Review and Advance Exception Request web page and applicable forms and documents. In addition, many of the sites inform providers of various systems to track the therapy cap.

Over the past several weeks, the Centers for Medicare & Medicare Services has released several transmittals, MedLearn Matters Article, a Fact Sheet and a Q&A document all pertaining to the therapy cap and manual medical review process. I have combined multiple news articles to include all the documents here.