Cigna Government Services & Speech Therapy Services

On February 26, 2016, Cigna Government Services (CGS) published an article discussing required documentation for speech therapy services in the skilled nursing facility. When billing for speech therapy in the Skilled Nursing Facility (SNF) setting, the patient’s medical record must contain documentation proving medical necessity for the service. Patients who have been transferred to a…

Mandatory 2% Reduction Continues Under Medicare Program

Medicare Fee-For-Service (FFS) claims with dates-of-service or dates-of-discharge on or after April 1, 2013, will continue to incur a 2 percent reduction in Medicare payment until further notice. Claims for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS), including claims under the DMEPOS Competitive Bidding Program, will continue to be reduced by 2 percent based…

CMS Proposes Prior Authorization Demonstration Project for Home Health

The Centers for Medicare and Medicaid Services is proposing to implement a Medicare demonstration project, which they believe will help assist in developing improved procedures for the identification, investigation, and prosecution of Medicare fraud occurring among Home Health Agencies (HHAs) providing services to Medicare beneficiaries. This demonstration would help assure that payments for home health…