Article Archive
Summary of the CMS Released 2013 Final Rule
Market Basket and Payment Rate Update On November 2, 2012, CMS released the Medicare Home Health Final Rule for the Home Health Prospective Payment System 2013. The proposal includes the 2013 Market Basket Index (MBI) update of 2.3%, the required 1 point reduction under the Obama Affordable Care Act, and the reduction in rates of [...]
Read more...Long Term Care in Home Health Possibility Due to Class-Action Suit
A nationwide class-action lawsuit brought by Medicare beneficiaries would eliminate the present CMS policy requiring Medicare beneficiaries to show a likelihood of medical and/or functional improvement before Medicare will pay for skilled nursing, physical therapy, speech therapy, occupational therapy, medical social services or home health aide. The proposed settlement of the suit would require Medicare [...]
Read more...The Affordable Care Act: At Risk Physician and SNF Reimbursement and Home Health Care
In several prior ezines, we have discussed the Affordable Care Act (ACA) and its far reaching provisions, including the fact that it is transforming hospital provider incentives to a system based on value rather than volume of beds filled. We have discussed the ACA mandated Accountable Care Organizations and the impact of the ACA face [...]
Read more...System Issues with Occurrence Code 55 and Referring Physician Information
CGS has identified two issues affecting claims processing. These issues are impacting all Medicare contractors. The Centers for Medicare & Medicaid Services (CMS) is aware of these issues, and is working to resolve them as quickly as possible. Issue #1: Occurrence code 55, which was implemented with Change Request 7792, is required to be reported [...]
Read more...A Validated falls Risk Assessment from the Missouri Alliance
Finally, a validated falls risk tool that is multi- focal and that no longer requires an accompanying single focused tool such as a TUG or Tinetti, NAHC stated recently that home health agencies have struggled with inadequate falls risk assessment tools since the beginning of OASIS- The Missouri Alliance for Home Care (MACHO) has recently [...]
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