Home Health & Hospice Week
REPORT MAE CLAIMS TROUBLE TO CMS
The Centers for Medicare & Medicaid Services has thrown out the old bed- or chair-confined standard for wheelchairs - and the agency wants to know if contractors try to bring it back.
The national coverage determination for mobility assistive equipment became final the moment it was posted to the agency's Web site, which means the functional ambulation standard is now the law of the land, a CMS spokesperson tells Eli.
As a result, durable medical equipment suppliers should not have their claims denied simply because beneficiaries are not completely restricted to beds or chairs. If that does happen, the agency wants suppliers to blow the whistle, it recently made clear.
"If someone is having trouble getting their DMERC to pay the claim, the first remedy is to contact the CMS regional office," the CMS spokesperson says.
The supervising regional office for HealthNow is New York, for CIGNA Government Services and Palmetto GBA is Atlanta, and for AdminaStar Federal is Chicago.
Some suppliers report that the DMERCs have said they will apply the bed- or chair-confined standard until they get further instruction from CMS.
Editor's Note: For CMS regional office contact information, visit www.cms.hhs.gov/about/regions/professionals.asp.
Home Health & Hospice Week
- Therapy:
THERAPY MEDICAL REVIEW MAY INCREASE IN WAKE OF OIG REPORT
OIG audit denied nearly half of HHA's high-therapy claims.
If your therapy documentation isn't ironclad, you [...] - Medical Review:
PROTECT THERAPY REIMBURSEMENT WITH THESE 5 STEPS
Medical reviewers have strong incentives to deny your therapy visits.
Expect medical reviewers to scour your [...] - Coverage:
EXERCISE PATIENCE TO WEATHER MAE MAYHEM
Now that the NCD is final, keep your eyes peeled for DMERCs' local coverage policies.
The [...] - Reimbursement:
REPORT MAE CLAIMS TROUBLE TO CMS
Suppliers should direct NCD-related payment woes to regional offices.
The Centers for Medicare & Medicaid Services [...] - Hospice:
HOSPICE COPs PROPOSE MAJOR DIFFERENCES IN ASSESSMENTS, QI
Host of changes will require hospices to make significant operational shifts.
The long-awaited hospice COPs are [...] - Regulations:
EXPECT JULY 1 IMPLEMENTATION FOR TERMINATION NOTICES
No compliance leeway despite short notice on new forms.
You'd better be prepared to hit the [...] - Industry Notes:
NEW JCAHO SAFETY GOALS FOCUS ON COMMUNICATION
Caregivers, patients and families targeted by new goals for 2006.
Home care providers accredited by JCAHO [...]
