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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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04/30/13

WPS Functional Reporting for Outpatient Therapy Services Recording Now Available

Wisconsin Physician Services (WPS) has added a recording of a Part A teleconference to its Part B website. The web page contains an audio file and handouts. This would be applicable for providers in the states of Indiana, Iowa, Kansas, Michigan, Missouri, and Nebraska. To listen to the recording, visit the

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04/29/13

Aetna Therapy Payment Update

Beginning June 1, 2013, Aetna will no longer reimburse separately for

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04/28/13

MedPAC Issues Annual Report to Congress

On March 15, the Medicare Payment Advisory Commission (MedPAC) issued its annual report to Congress. Chapters of interest include the following: Chapter 4: Physician and other health professionals Chapter 8: Skilled nursing facility services Chapter 9: Home health services Chapter 10: Inpatient rehabilitation facility services At the end of each Chapter, MedPAC provides recommendations how Medicare payments should change in 2014 in each one of the settings listed above.

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04/28/13

Arkansas Limits Therapy Copayments

Senate Bill 277 was signed into law by Gov Mike Beebe on March 14, 2013. As a result, patients now will pay less out of their own pockets when they visit a PT, OT, and/or SLP, resulting in improved access to vital health care. SB 277 specifies that patient copays, coinsurance, and office visit deductibles charged by health benefit plans for services provided by physical therapists, occupational therapists, and speech language pathologists may not be higher than those charged for services provided by primary care physicians. SB 277 will take effect 90 days after the legislature adjourns.

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04/28/13

Priority Health Payment Changes in Michigan

Priority Health, who is a managed care organization in Michigan, has sent new contracts to private practices in Michigan that will change Priority Healths payment for their HMO and PPO products. Contracts are due back to Priority Health by May 1, 2013. The new contract will change reimbursement from a

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