Medicare Compliance & Reimbursement
COVERAGE DECISIONS COULD COME QUICKER
Aggrieved beneficiaries get a fast track in updated Medicare coverage decision process. An overhauled method of issuing national coverage decisions could clear some of the murk from the process of securing Medicare coverage for new products and services. In a final rule published in the Sept. 26 Federal Register, the Centers for Medicare & Medicaid Services updates the process it will use to issue Medicare NCDs. Among the new policies: a separate process for beneficiaries who need an item or service that isn't currently covered. CMS says it will issue NCDs in such cases in 90 days. The rule also clarifies what elements are required to make a formal request for an NCD and outlines what CMS will consider in making its determinations. "Our goal is to make the latest advances in medical care available to Medicare beneficiaries more rapidly, while making evidence-based decisions that safeguard the health and safety of patients," says CMS Administrator Tom Scully. The rule goes into effect Oct. 27, 2003. To see the rule, go to http://www.access.gpo.gov/su_docs/fedreg/a030926c.html. Lesson Learned: Health care organizations that want to ensure that a new item or service gets covered under Medicare should look to CMS' Sept. 26 rule to make sure their coverage requests comply with all of the agency's requirements.
Medicare Compliance & Reimbursement
- Enforcement:
WHAT'S IN STORE FOR 2004
The OIG offers a peek at its priorities for the coming 12 months Exclusion from [...] - Rehab:
5 WAYS THE NEW 65 PERCENT RULE WILL AFFECT REHAB
Experts reveal the hidden fallout from CMS' recently proposed rule.
There's still a lot to hate [...] - Home Health:
HHA RATES INCREASE, BUT THE MATH IS COMPLICATED
Hospice billing trickier for new rates.
Oct. 1 ushered in a new fiscal year for the [...] - Pharmaceuticals:
GENERIC COMPANIES NEXT TARGET IN DRUG PRICING WAR
"Marketing the spread" alleged in sweeping new lawsuit The campaign by state fraud fighters against [...] - Rehab:
THERAPY CAPS GO INTO EFFECT
But therapists still hoping for yet another moratorium next year. Unless and until Congress declares otherwise, [...] - Coverage:
COVERAGE DECISIONS COULD COME QUICKER
Aggrieved beneficiaries get a fast track in updated Medicare coverage decision process. An overhauled method [...] - Home Health:
HHA MARKET STABILIZING, FEDS MAINTAIN
But do publicly traded companies give a clear picture of the industry? If lawmakers are looking [...] - Physicians:
DON'T LET MEDICAL RECORDS COME BACK TO HAUNT YOU
Noted physician sentenced in dialysis billing probe. A 7-year-old entry in a dialysis patient's medical [...] - Pharmaceuticals:
DRUGMAKER PRICE-CHANGE RULES DELAYED TO 2004
New recordkeeping requirements to go into effect Jan. 1. The new three-year time limit for [...] - PROGRAM MEMO ROUNDUP
Hospital-based renal dialysis facilities need to stop using their hospitals' provider numbers when billing for [...]
