Documenting Medical Necessity for Hip & Knee Joint Replacements
The Centers for Medicare & Medicaid Services has published a MedLearn Matters article as an educational guide to improve compliance with documentation requirements for major joint replacement surgery (i.e. knee and hip). To read the article and how physical therapy plays a role in the decision the Medicare contractor will make when deciding to pay or not pay for the procedure, click…
Novitas Solutions In & TrailBlazer Health Out
Novitas Solutions transitioned as the Part A MAC for non-private practice settings in the states of Colorado, New Mexico, Oklahoma, and Texas on October 29, 2012. Transition news can be found
OIG Releases 2013 Work Plan
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…
CMS Awards Contracts
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.
Hospitals To Be Fined For Readmissions
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…
MedPAC Recommends Changes to Outpatient Therapy
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…
MedPAC Recommends Changes to Outpatient Therapy Payment
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…
Manual Medical Review Updates
Please log in to see valuable information per your Medicare contractor for the manual medical review process.