MedPAC Submits June Report to Congress – Therapy Highlighted [06-22-13]

Filed under: Industry Updates — Editor @ 10:47 am

medpac-dataOn June 14, the Medicare Payment Advisory Commission (“MedPAC”) submitted its annual June report to Congress on Medicare and the Health Care Delivery System. The Commission estimated that Medicare payments to doctors will be cut by 24.4% on January 1, 2014 if Congress does not pass legislation to correct the Sustainable Growth Rate (“SGR”) formula (also known as “doc fix”) before the end of the year.  Other highlights of the report include the Mandated report: Improving Medicare’s payment system for outpatient therapy services. (more…)

CMS Provides Additional Clarification on Reporting Requirements for Functional Limitation Codes [06-21-13]

Filed under: Industry Updates — Editor @ 9:34 am

cmsannouncementThe Centers for Medicare and Medicaid Services (CMS) recently provided  additional clarification on the functional therapy reporting requirements effective for Part B therapy providers with dates of service on or after July 1, 2013. In our update from Tuesday, June 18th, CMS indicated “for beneficiaries whose treatment began prior to July 1, 2013 but for whom Functional Reporting information has not been submitted, the first claim submitted with a DOS on or after July 1, 2013 should be treated as the initial claim and include the required Functional Reporting.” CMS has provided the following additional clarification for these continuing claims of service: the July claim does not need to include an evaluation or re-evaluation code to begin transmitting the functional limitation codes. The first appointment would be considered a 10 day progress note coded with the G-codes and their related modifiers. This visit will then start the count towards their next progress reporting date. (more…)

Functional Code Reporting Update from CMS [06-18-13]

Filed under: Industry Updates — Editor @ 3:18 pm

cmsannouncementCMS has provided the below update based on the June 4th Open Door Forum statement that, “on July 1st functional reporting will start which requests doing initial evals, goals & status. The July 1st treatment has to be treated as the initial eval, even if [provider] have been treating the patient. [CMS] realizes it is ‘a little bit of a burden’ but feel it is necessary.” (more…)

Medicare Trustees Report Released [05-31-13]

Filed under: Industry Updates — Editor @ 2:56 pm

Treasury-sealOn May 31, the U.S. Treasury Department released the annual Medicare and Social Security Trustees report. The report projected that Medicare’s hospital trust fund will be solvent until 2026, which is two years longer than the 2012 projection.  The improvement reflects the lower-than-expected growth of Medicare spending in 2012 and an expectation that the federal health care law will reduce growth in Medicare advantage spending more than originally anticipated. (more…)

CMS Releases FY 2014 Payment and Policy Changes for SNFs [05-10-13]

Filed under: Industry Updates — Editor @ 10:31 am

cmsannouncementClick here for the pre-publication copy of the CMS proposed rule entitled “Proposed Fiscal Year 2014 Payment and Policy Changes for Medicare Skilled Nursing Facilities”. The proposed regulation contains provisions which will increase aggregate payments to SNFs in FY 2014 by $500 million or 1.4 percent above payments made in FY 2013. Note particularly the provisions concerning the reporting of distinct therapy days. Among other things affecting reporting of therapy days, the rule proposes to add an item to the Minimum Data Set to record the number of distinct calendar days of therapy provided by all rehabilitation disciplines to a beneficiary over the seven-day look-back period. Comments on the proposed rule will be accepted by CMS through the close of business on July 1st.

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