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“Failure is not an Option,†Declares Congressman G.T. Thompson (R-PA) to NASL Members at Fly-In
Speaking about his “Plan A†to delay the Round 2 expansion of the Medicare DMEPOS Competitive Bidding program until the end of 2013, Representative G.T. Thompson (R-PA) spoke to attendees of NASL’s June 5 Fly-In about the "Dear Colleague" letter to CMS Administrator Marilyn Tavenner which he plans to deliver to CMS this week. In an effort to further motivate participants before their visits to Members of Congress, he urged them to help attain the goal of 150 signers to the letter; and as of today, that goal was met and surpassed with 206. Read more.
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MedPAC Urges CMS To Eliminate the Proposed Nursing Home Payment Increase
The Medicare Payment Advisory Commission’s (MedPAC) comment letter on the FY 2014 Skilled Nursing Facilities (SNF) Prospective Payment System (PPS) proposed rule, urges CMS to back away from its proposal to increase nursing home payment rates, and commissioners worry that the proposed pay rule does not correct shortcomings in the design of the nursing home pay system. The Commission concludes that SNF payments are more than adequate to accommodate cost growth and in March 2013 reiterated its previous recommendation to eliminate the market basket update, revise the prospective payment system, and rebase payments beginning with a 4 percent reduction. Read more.
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Slower SNF Spending Helped Extend Medicare Trust Fund
The 2013 Medicare Trustees Report projected that the Hospital Insurance (HI) trust fund, otherwise known as Medicare Part A, that helps pay for hospital, home health following hospital stays, skilled nursing facility, and hospice care, will remain solvent until 2026, two years beyond what was projected in last year’s report. A number of factors have contributed to the improved outlook, including lower-than-expected Part A spending in 2012. Lower-than-expected Medicare spending, particularly in nursing homes, was a key factor in the 2013 Medicare Trustees' Report, issued on May 31, 2013.
"The more favorable outlook is primarily due to lower projected spending for most HI service categories -- especially skilled nursing facilities -- to reflect lower than expected spending in 2012 and other recent data," the Medicare Trustees report says. Read more.
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NASL Members Recognized for Extraordinary Advocacy
Two NASL members were among the four individuals to receive the American Health Care Association's 2013 Joe Warner Patient Advocacy Award this week - Doug Burr of Health Care Navigator, LLC (parent company of Halcyon Rehabilitation) and Phil Fogg, Jr., of Marquis Companies (parent company of Consonus Healthcare Services).
Doug Burr is the vice president of finance, reimbursement, and government relations for Health Care Navigator, LLC. Mr. Burr also serves in several leadership committees for health care associations. Phil Fogg, Jr., is continuing his family’s tradition of operating long term care facilities as president and CEO of Marquis Companies - a long term care company with 26 facilities across Oregon and the Northwest.
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In case you missed it…
MM8304 – Detailed Written Orders and Face-to-Face Encounters
Read this article covering Change Request (CR) 8304, which instructs DME MACs to implement requirements that take effect on July 1, 2013 and detail written orders for face-to-face encounters conducted by the physician, PA, NP or CNS for certain DME items as defined in 42 CFR 410.38(g).
ICD-10 Resources for FFS Providers Now Available
CMS has released new and updated MLN products to assist Medicare providers in learning about ICD-10. These products are posted on the ICD-10 Medicare FFS Provider Resources web page and includes an MLN Matters® Special Edition Article on institutional services split claims billing instructions; fact sheets covering basic information about ICD-10, the use of the General Equivalence Mappings (GEMs), and the ICD-10 implementation date; and a booklet of Frequently Asked Questions about the GEMS.
§ MLN Matters® Special Edition Article SE1325, “Institutional Services Split Claims Billing Instructions for Medicare FFS Claims that Span the ICD-10 Implementation Dateâ€
§ “ ICD-10-CM/PCS Myths and Facts†Fact Sheet
§ “ ICD-10-CM/PCS The Next Generation of Coding†Fact Sheet
§ “ ICD-10-CM Classification Enhancements†Fact Sheet
§ “ General Equivalence Mappings Frequently Asked Questions†Booklet
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