Medicare Compliance & Reimbursement
IN OTHER NEWS
•Your hospice payments could look a lot different if Congress heeds the new advice of an influential advisory body. The Medicare Payment Advisory Commission is considering recommending a payment revamp that would reimburse hospices at higher rates for days at the beginning and ending of hospice stays and at lower rates for days in the middle. MedPAC will likely vote on the measure, as well as other hospice proposals, in its January meeting. If passed, the recommendation would go in the commission's March report to Congress. The National Association for Home Care & Hospice and the National Hospice and Palliative Care Organization are coming up with their own recommendations for reimbursement modifications to present to law- and policymakers, they say. To read MedPAC's most recent report to Congress, go online to http://www.medpac.gov/documents/Jun08_EntireReport.pdf. •The U.S. economy may look bleak, but the same isn't true for home care. That's no surprise, considering that health care in general is considered a recession-resistant industry. "With an aging population and the largest health care spending in the world, the nation's medical sector could fare perhaps best of all" in the recession, the Minneapolis Star Tribune reports."People get sick and need medical care regardless of the state of the economy," Standard and Poor's David Wyss told the newspaper. Gentiva and LHC Group are two examples of home care companies thriving in the current economy. National chain Gentiva Health Services Inc. reported net income of $120.9 million for the quarter ended Sept. 28 compared to $8.2 million for the year-ago quarter. Even netting out the $107.9 million Gentiva received for selling a 69 percent interest in its managed care CareCentrix unit, it's still a gain. The Melville, N.Y.-based company reported net income of $347.6 million for the quarter compared to $309.1 million for the same period last year. LHC Group Inc. reported net income of $8.0 million on revenues of $98.2 million for the quarter ended Sept. 30. That compares to a $6.0 million profit on $77.5 million in revenues for the same period in 2007. •If you were biting your nails awaiting CMS' permanent RAC program to take effect, you can relax. On Nov. 4, CMS announced that it would impose an "automatic stay in the contract work of the four Recovery Audit Contractors RACs)." The decision was made based on protests that two unsuccessful RAC bidders filed with the General Accountability Office (GAO), according to the Nov. 4 CMS statement. Any decisions about the RAC program will be put on hold until the GAO makes a determination in the case, which it has 100 days to do. To read the RAC delay information, visit http://www.cms.hhs.gov/RAC/03_RecentUpdates.asp#TopOfPage.
Medicare Compliance & Reimbursement
- Fee Schedule:
2009 Conversion Factor Lands At $36.066
But expect a 1.1 percent budget neutrality adjustment boost. The 2009 conversion factor has dropped [...] - Reimbursement:
Feds' Fraud Fight Will Reduce Outlier Rate
CMS punts on wage index yet again. The 2009 home health agency rate update notice [...] - Icd-10:
Test Run Reveals ICD-10 Transition Won't Be Rocky
Plus: Physicians shouldn't have to bend over backward to change how they document their records for [...] - Payments:
Florida Payers Pass Up Refunds After A Year
Here's how a new law is changing the state's overpayment rules. Yes, you should take [...] - Coding Coach:
Use Of Sleep Staging Determines Sleep Test
Coding these procedures incorrectly could raise a red flag for auditors. Despite the similarities, there's [...] - Industry Notes:
Medicare Owes Millions In Back Pay To Physicians
Plus: Hospices may get higher pay for beginning and end of patient's. Physicians in three states [...] - Reader Question:
Here's How You Can Combat FluMist Denials
Stop denials before they start, you shouldn't report 90473 and 90471 together, CPT says. Question: We [...] - IN OTHER NEWS
•Your hospice payments could look a lot different if Congress heeds the new advice of [...]
