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Permanent Policy on MMR for Part B Therapy Above $3,700 Threshold
CMS’ George Mills has signaled that very soon CMS will release permanent policy for handling Medicare Part B Outpatient Therapy claims above $3,700. The verbiage on the CMS website right now is interim guidance. NASL will report on the new guidance as soon as it is known.
Important Billing Update from HHS
The March 7th edition of CMS Medicare FFS Provider e-News is chock-full of news that demonstrates how important HIT is becoming to all of us – especially providers of therapy and other health care and services. In the article, “Problem Impacting Crossover of Medicare Part B Outpatient Therapy Claims,” the agency explains the reason for the recent uptick in the number of HIPAA rejection codes (H51000, H51061 – H51064, H51108), which are listed on provider notification letters. Read more
No April Fools - Sequester To Impact Medicare Payments April 1st
Under the sequester, Medicare payments to doctors, hospitals, and other health care providers, as well as health plans and drug plans are to be reduced by two percent for services provided on or after April 1, 2013. Absent further action by the Congress, these reductions will take effect beginning in April and will result in $11 billion in lost revenues – out of projected total spending of $554.3 billion – to Medicare doctors, hospitals, nursing homes, Part B providers and other providers, who will only be reimbursed at 98 cents on the dollar for their services to Medicare beneficiaries. Read more
SGR Replacement Opportunity Gaining Momentum
The Congressional Budget Office (CBO) has significantly reduced the score to repeal the Sustainable Growth Rate (SGR) physician payment formula by more than $100 billion, and physicians' groups are urging the administration and Congress to take advantage of the lower price. Up to now, Congress has also passed short-term "doc fix" bills, but this year lawmakers hope to permanently fix the payment system. Read more
CMS Highlights Hospital Readmissions Program Rates
During his opening testimony, CMS Medicare Chief Jonathan Blum, emphasized that Medicare has made strides in changing how care is delivered. He said hospital 30-day “all cause” readmissions dropped to 17.8 percent in the second half of 2012, down from an average of 19 percent over the past five years. Blum told the Senate Finance panel February 28 during his testimony on the “Delivery System Reform: Progress Report from CMS.” Read more
That's What They Mean By Potomac Fever?
Despite weather-related challenges, which played havoc on travel plans of several Winter Conference attendees, NASL’s 2013 Legislative & Regulatory Winter Conference was a huge success. NASL was especially pleased to host a special pre-conference session "A Conversation with the National Coordinator for Health Information Technology, Dr. Farzad Mostashari, ScM." As it turns out, Dr. Mostashari also gave NASL members a good preview of some of this week's HIT news (read "HIT Making News" below). Read more
HIT Making News – ONC 2013 Agenda Gets Practical About Implementation
HHS and ONC have issued a Request for Information (RFI), which was published in the Federal Register on March 7, 2013. The RFI seeks public input as to how to improve and both speed and strengthen electronic exchange across the care continuum. The RFI is featured in this week's announcement by CMS Administrator Marilyn Tavenner and National HIT Coordinator, Dr. Mostashari, which outlines HHS’ HIT agenda for 2013. Read more
NASL To Address House Briefing on DMEPOS Competitive Bidding
Congressmen GT Thompson (R-PA) and Bruce Braley (D-IA) will hold an educational briefing for Members of Congress and their staff on "Provider Concerns and Perspectives on CMS’ Medicare Competitive Bidding Program for Durable Medical Equipment Prosthetics, Orthotics & Supplies" (DMEPOS). Read more
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