Medicare Compliance & Reimbursement
PROGRAM MEMO ROUNDUP
The Centers for Medicare & Medicaid Services Feb. 14 updated payment rules for certain services provided by outpatient physical therapy providers under the Medicare physician fee schedule. In addition to listing outpatient rehabilitation HCPCS codes, program memo A-03-011 (http://cms.hhs.gov/manuals/pm_trans/A03011.pdf) also lays out new payment requirements for fiscal intermediaries — including a mandate that FIs shouldn’t pay for drugs and biologicals in an OPT setting and that OPTs shouldn’t bill separately for supplies they furnish.
In other recent program memoranda, CMS:
• sets out policies relating to additional documentation requests issued to providers that order laboratory services (AB-03-021; http://cms.hhs.gov/manuals/pm_trans/AB03021.pdf);
• outlines refinements to the 3-day payment window as it applies to short-term hospitals (A-03-013; http://cms.hhs.gov/manuals/pm_trans/A03 013.pdf);
• lays out coverage policies for deep brain stimulation for essential tremor disorders and Parkinson’sdisease (AB-03-023; http://cms.hhs.gov/manuals/pm_trans/AB03023.pdf);
• issues instructions to FIs on automating the manual medical review indicator for the comprehensiveerror rate testing program (A-03-010; http://cms.hhs.gov/manuals/pm_trans/A03010.pdf);
• outlines fiscal year 2003 changes to the conversion factors used to determine Medicare Part A workload savings (A-03-012; http://cms.hhs.gov/manuals/pm_trans/A03012.pdf); and
• instructs contractors on when and how they may use the American Medical Association’s current procedural terminology codes on their Web sites (AB-03-022; http://cms.hhs.gov/manuals/pm_trans/AB03022.pdf).
Medicare Compliance & Reimbursement
- Medicare:
FY 2003 FUNDING FINAL AT LAST
Congress tweaked some administration recommendations in the fiscal year 2003 omnibus appropriations bill. But President [...] - Hospitals:
SCHEDULE SLIPS FOR OUTLIER RULE
A new rule limiting outlier payments to hospitals will come out soon, but as a [...] - Home Health:
HHS LAUNCHES HOME HEALTH QUALITY INITIATIVE
As promised, the Bush administration has taken its health care quality improvement efforts into the [...] - Home Health:
HHAs WANT CMS TO KEEP HANDS OFF ALJs
The Centers for Medicare & Medicaid Services’ campaign to reform the appeals process isn’t convincing [...] - Pharmaceuticals:
EMPIRE STATE JOINS AWP CRUSADE
New York Attorney General Eliot Spitzer joined a half dozen other states in suing drugmakers [...] - Antitrust:
DOJ, FTC REEXAMINE HEALTH CARE ANTITRUST
A series of government hearings starting this month could set the framework for how the [...] - ASCs:
MULTI-SPECIALTY PRACTICE FOUNDERS WITH ASC PROPOSAL
While recent advisory opinions suggest that there’s at least a little bit of wiggle room [...] - Hospitals:
JOHNS HOPKINS CAPS OFF PATH PROBE
Johns Hopkins University emerged from a long-running physicians-at-teaching-hospitals audit relatively unscathed February 14, capping off [...] - Medicare:
OIG CONTINUES TO FRET OVER MULTIPLE PROCEDURE CLAIMS
As part of an extensive series of reviews on how well Medicare contractors handle Medicare [...] - Credentialing:
SHRINK STINKS, PLAN THINKS, DEAL INKED
The misdeeds of a phony psychiatrist, the forthrightness of a health maintenance organization and a [...] - Reimbursement:
GAO TARGETS NEW AWP PAYMENT HEMORRHAGE
As with most covered drugs and biologicals,Medicare pays way too much for blood clotting factor, [...] - Medicaid:
HHAs PREPARE TO DEFEND MEDICAID WAIVER PROGRAMS
For many disabled people depending on home care services through Medicaid, this could be the [...] - BILL WATCH
The following Senate bills were introduced: • S. 416. A bill to amend title XVIII [...] - PROGRAM MEMO ROUNDUP
The Centers for Medicare & Medicaid Services Feb. 14 updated payment rules for certain services [...] - REGISTER WATCH
Responsibilities are shifting at the Centers for Medicare & Medicaid Services. A Feb. 20 Federal [...]
