Expedited Determinations for Provider Service Terminations

On July 1, 2013, the Centers for Medicare and Medicaid Services (CMS) issued a revised MLN Matters publication on expedited determinations for provider service terminations. This MLN Matters® Article is intended for Home Health Agencies (HHAs), Comprehensive Outpatient Rehabilitation Facilities (CORFs), Hospices, and Skilled Nursing Facilities (SNFs) providing services to Medicare beneficiaries. This has implications…

Congresswoman Speier Unveils “Promoting Integrity in Medicare Act of 2013″

On August 1, 2013, Congresswoman Jackie Speier (D-San Francisco/San Mateo), along with Rep. Jim McDermott (D-WA), Ways and Means Health Subcommittee Ranking Member, and Dina Titus (D-NV), introduced HR 2914, the “Promoting Integrity in Medicare Act of 2013” (PIMA) in the House of Representatives. The bill would cut unnecessary Medicare spending by hundreds of millions…

CMS Releases Special Edition MLN Matters on Medicare G Codes & Functional Limitation Reporting

The Centers for Medicare & Medicaid Services has released a special edition MLN Matters that focuses solely on Medicare G Codes and Patient Functional Limitation Reporting. The article discusses functional reporting requirements, discharge reporting, claims requirements, provides a functional reporting example, and discusses unique functional reporting scenarios, just to name a few. To access the…

Opting out of Medicare and/or Electing to Order and Refer Services

The Centers for Medicare & Medicaid Services has issued a new MLN Matters publication that discusses physicians and non-physician practitioners (NPP’s) who decide to opt out of Medicare and still order/refer services for Medicare beneficiaries. This MLN Matters has implications for outpatient rehabilitation therapy services since physicians and NPP’s order as well as certify for…

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…