May 23, 2013
Effective July 1, the Centers for Medicare & Medicaid Services will begin rejecting claims received for Medicare Part B patients that do not include the new requirement of G-coding. That really means providers need to be ready by June 1.
May 08, 2013
While CMS tries to figure out how to proceed with the manual medical review process, we continue to track our caps and apply our modifiers. In the meantime, has anyone noticed how our typical Medicare Part B patients have become more medically complex than just a few years ago?
The American Health Care Association and National Center for Assisted Living came out in support of bipartisan legislation to permanently repeal Medicare Part B therapy caps for skilled nursing facilities. The legislation was introduced in both the House of Representatives and the Senate on Feb. 15.
A keynote address by Farzad Mostashari, MD, ScM, the National Coordinator for Health Information Technology, will highlight opening day of the annual winter Legislative and Regulatory Conference of the National Association for the Support of Long-Term Care.
February 06, 2013
Every time we send our patients to the hospital for rehab-related tests, exams or services, these services are billed to Medicare Part B, and, therefore, reduce our cap allowances. Any small oversights could have major impacts on our ability to successfully track therapy cap levels. Here's some help.
February 01, 2013
Instead of spending more time doing hands-on patient care, therapists who work with Medicare beneficiaries have been strapped with increased administrative tasks, sometimes leading to delayed services, or worse.
Providers will have their say about the future of Medicare Administrative Contractors.
October 29, 2012
What a mess — and that's probably an understatement! Medicare Part B decided to roll out its new manual medical review process by dividing providers into three phases. If you are unfortunate to be part of the Phase One group, you have my deepest sympathies.
A proposed rule that would require Medicare providers to return overpayments within 60 days of detection could significantly increase administrative time and costs, an expert says.
Members of a Congressional conference committee need to authorize the longest possible exceptions extension for Medicare Part B therapy services, according to a coalition of therapy advocates.
The federal government spent nearly $48 billion on improper Medicare payments in 2010 according to a new report from the Government Accountability Office. The report was released just prior to a House Oversight Committee hearing on government efficiency.
November 16, 2010
Doctors across the United States are taking a wait-and-see approach while Congress decides whether or not to allow a scheduled 23% cut in Medicare reimbursement rates to take effect on Dec. 1.
It's hard to believe we're in the midst of another conference season. The American Health Care Association's annual meeting already has passed and the American Association of Homes and Services for the Aging's is about a week away.
Consolidating drugs covered by Medicare Part B and Part D under Part D could save Medicare nearly $150 million, according to a new report from the Centers for Medicare & Medicaid Services.
October 13, 2010
As the end of the year approaches, long-term care providers will be lobbying to extend the therapy caps exceptions process, which is set to end Dec. 31. Another therapy issue—a proposed rule to reduce payments when multiple therapy procedures are provided to a Medicare beneficiary in one day—also is on providers' radar screens.
The financial outlook for the seniors' healthcare program has been "substantially improved" by the new healthcare reforms, according to a new report from the Medicare Board of Trustees released Thursday.
Another proposed rehab rule threatens to cut significant revenues from long-term care providers.
March 31, 2010
A recent Washington Post analysis of the use of "ultra-high" reimbursement categories for nursing homes "paints a negative, incomplete picture of the growing role and tangible benefits associated with skilled nursing facility (SNF) patient care," two leading long-term care advocates said.
The RUG-IV classification system will not start until Oct. 1, 2011, under the new healthcare reform bill.
February 12, 2010
Senate Finance Committee leaders Thursday issued a draft of a jobs-creation bill. The legislation would extend the Medicare Part B therapy caps exceptions process and delay through Sept. 30 an impending 21% cut in payments for Medicare physicians.
February 11, 2010
A snowstorm that pummeled the East Coast this week has delayed the Senate's consideration of a jobs bill that would extend the Medicare Part B therapy caps exceptions process and prevent a pay cut for Medicare physicians, according to reports from Washington.
My how things change. Just a month ago a healthcare reform bill seemed en route to passage. Now its very existence is in question and, by extension, some key long-term care services are too.
A coalition of 32 healthcare-related organizations, including the two major nursing home organizations, is imploring lawmakers to immediately reinstate the exceptions process for Medicare Part B outpatient therapy caps.
Medicare's fee schedule for enteral nutrients under Medicare Part B was more than double the prices available to suppliers to nursing homes in 2006, according to a newly released report from the Department of Health and Human Services' Office of the Inspector General.
Whether or not you are a fan of healthcare reform, here's one reason Congress should pass it: It would extend the therapy caps exceptions process.
Unless Congress takes action to extend it, the exceptions process for Medicare Part B therapy caps will expire Dec. 31.
The Medicare Part A deductible will increase by $32 in 2010 to $1,100, according to the Centers for Medicare & Medicaid Services.
A measure that would prevent a cut to Social Security payments failed in the Senate. As a result, rising Medicare Part B premiums are expected to adversely affect 27% of Medicare beneficiaries.
