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05/17/13

Novitas Updates SNF FAQs

Novitas Solutions, J12/JH Medicare Administrative contractor, has posted updated FAQs on SNF rehabilitation as of April 30, 2013. To view the FAQs, click HERE.

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05/17/13

Novitas Posts PT FAQs

Novitas Solutions, the J12/JH Medicare Administrative Contractor, has updated PT FAQs on their website as of April 30, 2013. To access the FAQs, click HERE.

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05/16/13

Cigna to Host FLR Teleconference

Cigna Government Services invites you to participate in an Ask-the-Contractor Teleconference (ACT) specifically focused on the new claims-based data collection reporting requirement and changes to the manual medical review process for outpatient therapy services. The teleconference is scheduled for Thursday, May 23, 2013, from 9-10:30 a.m. CT/10-11:30 a.m. ET. No pre-registration is necessary. To join the teleconference, please click HERE.

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05/10/13

MPPR Not Applied Correctly

Beginning in 2013, outpatient therapy services provided in CAH settings should be included in the beneficiary’s therapy cap and threshold total, using the amount that would be payable if the services were paid under the Medicare Physician Fee Schedule. Payments for outpatient hospital therapy services include a multiple procedure payment reduction when more than one unit or procedure is provided to the same patient on the same day by the same provider. Inadvertently, Medicare’s initial implementation of this provision updated the therapy cap and threshold total by the full fee schedule amount, without applying the multiple procedure payment reduction. The

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05/10/13

Oregon PT’s Achieve Unrestricted Direct Access

Oregon Gov John Kitzhaber signed House Bill 2684 into law on May 9, 2013 that eliminates the 60-day time restriction tied to treatment for services provided by a physical therapist without a physician referral, granting unrestricted patient access to the services of a physical therapist. The legislation will take effect on January 1, 2014.

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05/03/13

Noridian to Replace Palmetto as MAC

Noridian will become the Medicare Administrative Contractor for Jurisdiction E that includes California, Hawaii, Nevada, American Samoa, Guam, and Northern Mariana Islands. For non-private practices, the transition will occur on August 26, 2013 and for private practices, the transition will occur on September 16, 2013. To access the implementation page, click HERE.

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05/03/13

Indiana Enacts Direct Access

On May 2, 2013, Indiana Governor Mike Pence signed HB 1034 into law. HB 1034 provides Indiana residents direct access to evaluation and treatment by a physical therapist (PT) without a physician referral. The law, which will take effect on July 1, allows for evaluation and up to 24 days of treatment without a referral but continues to require a referral for spinal manipulation and sharp debridement. For additional information, visit the APTA website.

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05/03/13

CMS Releases FAQ on ABN for Therapy Services

On May 1, 2013, the Centers for Medicare and Medicaid Services released a new Frequently Asked Questions (FAQ) document on Advance Beneficiary Notice of Noncoverage for outpatient therapy services for both below and above the therapy cap dollar threshold. To access the document, click

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