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Don't Miss ASHA Article Co-Authored by NASL Board member; NASL Meets with Therapy Organizations
 ASHA’s publication, Leader, this month featured an article co-written by NASL Board Member, Margaret Hemm, Ed. D. CCC-SLP and Janet Brown, ASHA staff. See article here. Garry Pezzano, NASL President, is quoted in the article that details several meetings NASL leaders have had with ASHA regarding issues arising from speech language pathologists. Read more.
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Latest Version of 21st Century Cures Legislation Passed in Subcommittee
On May 14, 2015, the House Energy & Commerce Health Subcommittee passed by voice vote the latest revision of the 21st Century Cures legislation. The full committee is scheduled to take up the legislation next week, and the full House could vote on the proposal before the end of June. Read more.
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Pioneer ACO Report Released by CMS
Last week, CMS released a report on the Pioneer Accountable Care Organization Model that shows Pioneer ACOs saved $384 million in the first two years. CMS plans to use its authority under the Affordable Care Act to expand the Pioneer ACO program by adding it to the regular ACO program called the Medicare Shared Savings Program. Read more.
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Congressional Budget Resolution Approved
Congress this week approved the Budget Resolution for Fiscal Year 2016, which sets a path towards a balanced budget in 10 years. It sets forth budgetary levels for fiscal years 2017 through 2025, and a recommendation that Congress address the problem of “government overspending and rising debt.†Read more.
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CMS' Proposed Rules for SNFs, IRFs & LTCHs Underscore Importance of IMPACT Act
In April, CMS released its annual series of Medicare payment-related proposed rules for LTPAC settings, including SNFs, IRFs and LTCHs. In addition to updating Medicare payment rates for FY2016, each of these proposed rules include measures to satisfy the cross-setting requirements of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). NASL is reviewing these proposed rules and will comment in early June. Read NASL’s initial summary of the SNF, IRF and LTCH proposed rules. NASL member login required.
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OMHA is Committed to Making Medicare Appeals Process Work and Addressing the 5 Percent Responsible for the Majority of Appeals
On April 28th the Senate Finance Committee held a hearing on “Creating a More Efficient and Level Playing Field: Audit and Appeals Issues in Medicare.†Senate Finance Committee Chairman Orrin Hatch (R-UT) shared that the Committee is concerned about the increase in audits which has led to seemingly insurmountable Medicare appeals, with a current backlog of over 500,000 cases. Read more.
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Legislation Reintroduced to Put an End to RACs Being Paid on Contingency Fee Structure
Bipartisan legislation, the Medicare Audit Improvement Act of 2015 (H.R. 2156), was recently reintroduced to address the Medicare Recovery Auditors (RAs), with an effort of ensuring that Medicare recovery is efficient, transparent and fair. Read more.
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NASL Supports Legislation that Allows Observation Stays to be Counted for Medicare Coverage
Over the last several years, hospitals are increasingly classifying Medicare beneficiaries as “outpatients†receiving observation services, rather than admitting them as inpatients. Beneficiaries are called outpatients despite the fact that they may stay for many days and nights in hospital beds and receive medical and nursing care, diagnostic tests, treatments, and medications - just as they would if they were inpatients. Read more.
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In Case You Missed It . . .
Replay of the May 14, 2015 NASL Medical Services Committee call is available here. NASL member login required.
Off Premise Activities Guidelines Added to SOM
CMS added guidelines to the State Operations Manual (SOM) to clarify certification requirements for off premise activities for providers of Outpatient Physical Therapy (OPT), including addressing the issue of whether a rehab agency can render services in assisted living facilities and under what circumstances. You can access the April 3, 2015 CMS Letter (15-33-OPT) and clarification of requirements here. Read more.
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