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Penalty for Delayed Request for Anticipated Payment (RAP) Submission – Implementation

In Home Health, News by Mary MadisonLeave a Comment

CMS has issued a new MLN Matters Article MM11855: Penalty for Delayed Request for Anticipated Payment (RAP) Submission – Implementation (PDF).   This MLN Matters Article is for Home Health Agencies (HHAs) who wish to bill Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries.  The article informs you about the implementation of the Calendar Year (CY) 2021 Home Health (HH) …

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Hospice FY2021 Final Rule Issued

In Hospice, News by Mary MadisonLeave a Comment

On July 31, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a final rule CMS-1733-F that updates fiscal year (FY) 2021 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries. CMS is publishing this final rule consistent with the legal requirements to update Medicare payment policies for hospices on an annual basis. In recognition of the …

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Breaking News: Fiscal Year 2021 Payment and Policy Changes for Medicare SNFs Final Rule Issued

In Long Term Care, News by Mary MadisonLeave a Comment

“On July 31, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a final rule [CMS-1737-F] for Fiscal Year (FY) 2021 that updates the Medicare payment rates and the value-based purchasing program for skilled nursing facilities (SNFs). CMS is publishing this final rule consistent with the legal requirements to update Medicare payment policies for SNFs on an annual basis. …

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Administration Proposes to Expand Telehealth Benefits Permanently for Medicare Beneficiaries Beyond the COVID-19 PHE

In COVID-19, News by Mary MadisonLeave a Comment

This Press Release announced CMS changes as well as an Executive Order signed on Monday, August 3, 2020. “The Centers for Medicare & Medicaid Services (CMS) is proposing changes to expand telehealth permanently, consistent with the Executive Order on Improving Rural and Telehealth Access that President Trump signed today. The Executive Order and proposed rule advance our efforts to improve …

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COVID-19 FAQs on Medicare Fee-for-Service Billing Updated Again

In COVID-19, News by Mary MadisonLeave a Comment

This 140-page COVID-19 FAQ document was updated on July 28, 2020. This is what’s new in this version during July: Page 10 – Diagnostic Laboratory Services … Question: If a physician/non-physician practitioner (NPP) reports CPT code 99211 “Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician”, …

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News Alert: Provider Reimbursement Available for Counseling Patients to Self-Isolate at Time of COVID-19 Testing

In COVID-19, News by Mary MadisonLeave a Comment

The following News Alert was issued mid-day on Thursday, June 30, 2020: CMS and CDC announce provider reimbursement available for counseling patients to self-isolate at time of COVID-19 testing Today, the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) are announcing that payment is available to physicians and health care providers to …

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Hospice PEPPER Now Available

In Hospice, News by Mary MadisonLeave a Comment

The Q4FY19 release of the Hospice Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2019 is now available for download through the PEPPER Resources Portal. To obtain your Hospice PEPPER, the Chief Executive Officer, President, Administrator, Compliance Officer, or Quality Assurance/Performance Improvement Officer of your organization should: Review the Secure PEPPER Access Guide. Review the instructions and obtain …

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OIG Report: Medicare Overpaid HHAs $191.8 Million

In Home Health, News by Mary MadisonLeave a Comment

The Office of Inspector General released a report this last week of July that revealed overpayment of home health agencies. The OIG audit covered approximately $1.25 billion in Medicare payments to HHAs for 549,768 claims. These claims were for home health services provided in CY 2017. Because of the large increase in payment starting with the fifth visit, OIG focused …

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[Free webinar, Jul 29] Prepping for PBJ quarterly success: Critical answers to your top questions

In Long Term Care, Webinars by Mary MadisonLeave a Comment

After a bumpy three-month ride, PBJ reporting is back on track for the quarter. In late March, CMS issued a staffing data submission waiver due to the COVID-19 public health emergency.  On June 25, that waiver ended – which means PBJ reporting requirements for the quarter are back in effect. In this free webinar, find out the latest PBJ news and get …