Medicare Compliance & Reimbursement
CMS Grants Some Assessment Flexibility
HHAs don't have to wait until days 55-60 to perform comprehensive assessments on non-Medicare, non-Medicaid patients unless they want to, CMS spells out in S&C-04-26. "The assessment may be performed any time up to and including the 60th day," CMS says.
"For example, if a non-Medicare/non-Medicaid patient's payer source requires a revised plan of care on day 50 of the episode, the clinician could conduct the follow-up assessment earlier than day 50 without conducting a second assessment on day 55-60," CMS explains.
The timetable for the next 60-day period would start whenever the last assessment is conducted, the memo specifies.
This is good news, since generally "non-Medicare/Medicaid clients are not reimbursed in episodes but by visit," notes Linda Rutman, consultant with Charlotte, NC-based LarsonAllen Health Group. Those patients "often do not have to be seen during the final five days of a 60-day period," Rutman points out.
Now private pay patients who require recertification will "no longer be held to the episodic mandate for the recertification comprehensive assessment," Rutman cheers.
Medicare Compliance & Reimbursement
- Dialysis:
For Dialysis Patients, Choose 'Fistula First'
New CMS program sings the praises of a safer, more cost-effective kind of access.
Providers placing [...] - Rehab:
Therapists Getting Caught In Stroke Coding Trap
Choosing the wrong diagnosis can lead to big problems.
If outpatient therapy providers are treating patients [...] - Home Care:
OASIS Suspensions Add More Work For HHAs
Assessment time points added for some.
The suspension of OASIS data collection for private pay patients [...] - Lab Tests:
CMS Clarifies Confusion On Physician Referrals
Find out when physician referrals are and are not acceptable.
If you have been searching for [...] - Hospitals:
Higher Pay On The Way For Reclassified Hospitals
The list of qualifying facilities to be released soon on CMS' Web site.
Good news for [...] - Health Plans:
New Rx Cards Shake Up Managed Medicare Market
Insurers hope to use the cards to drive business for Medicare Advantage products.
Phase I of [...] - Home Care:
CMS Grants Some Assessment Flexibility
The Centers for Medicare & Medicaid Services has thrown home health agencies one bone in [...] - Chronic Care:
CMS Solicits Proposals For Care Coordination Pilot
Ten applicants wanted for 3-year pilot.
The Centers for Medicare & Medicaid Services is seeking proposals [...] - FDA:
FDA Approves Two New Cancer Drugs
Martha Stewart may be going to prison because she bet against ImClone's new cancer drug [...] - Bill Watch
Bill introduced in the House: HR 4195. A bill to amend part D of title [...]
