Section 603(c) of the American Taxpayer Relief Act of 2012 (ATRA) changed the payment liability for denials resulting from the outpatient therapy caps from beneficiaries to providers effective January 1, 2013. Medicare systems were not updated in time to accurately represent this change on provider remittance advices (RAs). Medicare contractors may have already processed therapy cap denials for services provided in 2013. These denials incorrectly report on RAs beneficiary liability (Group Code “PR”) when liability legally rests with the provider (Group Code “CO”). Read more

Monday, April 29, 2013

AHCA/NCAL has made the issue of Observation Stays one of its top advocacy and outreach priorities. Our efforts include supporting the Improving Access to Medicare Coverage Act of 2013, which ensures observation stays count toward the Medicare-required three-day hospital stay, and connecting with key members of Congress to support this legislation. To boost our efforts, we need your help in collecting stories and/or names of those beneficiaries who have been impacted financially and emotionally by this observation stays issue. Read more

Nursing home operators can now download a brief clarifying which tasks physicians may delegate to other practitioners caring for Medicare beneficiaries in skilled nursing facilities, the Centers for Medicare & Medicaid Services announced in a document released Wednesday. Read more

The Centers for Medicare & Medicaid Services has proposed changing the way hospital readmission penalties are calculated as part of its 2014 Medicare rate update. Potential readmissions penalties for long-term care providers — such as those recently floated by the White House — would likely be based on the established CMS formula for hospitals. Read more

By Amanda Green, HTS Director of Marketing

1. Rehab Services: Rehabilitation Outcomes

As many of you already know, our hospital discharge planners and physicians are overloaded with senior care communities trying to get through their door.  Stand out from the masses with clear, concise data on your facility’s rehabilitation outcomes by diagnosis.  Through measurable outcomes, the efficiency and worth of your services are shown.  Measurable rehabilitation outcomes allow you to prove your success in clinical areas and can significantly align your community with referring partners.  With increased legislation for reimbursement-based quality outcomes, hospitals need good partners to build a strong “bridge” in the post-acute arena before discharging to home.  In the minds of the medical community and general public, your outcomes are reflective of your level of quality.   How can YOU be a good partner? Read more

The 4th annual Greenwood Rotary Magic Show, which took place on Wed. Feb 13th at Greenwood Community High School, entertained hundreds of area residents and their children and helped feed the hungry. This year was the first in which the club partnered with the local nonprofit organization, Kids Against Hunger. The proceeds from the show by Las Vegas magician Garry Carson will provide more than 30,000 nutritious meals locally and abroad.

The event was conducted with support from Southland Community Church, Wilson St Pierre, Franklin United Methodist Community, Greenwood Orthopedics and Capstone Investment Partners.

CDC’s Injury Center created the STEADI Tool Kit for health care providers who see older adults in their practice who are at risk of falling or who may have fallen in the past. The STEADI Tool Kit gives health care providers the information and tools they need to assess and address their older patients’ fall risk.

http://www.cdc.gov/homeandrecreationalsafety/Falls/steadi/index.html

As many of you are aware, barring a last-minute bridging of the vast partisan gap in our nation’s capital, across the board cuts through sequestration are to go into effect today, March 1st. As we understand it, due to a technicality in the stop-gap continuance that was passed by Congress on January 1, 2013, cuts to Medicare payments will not be implemented until April 1st. Read more

The American Taxpayer Relief Act of 2012 (ATRA) was signed into law by President Obama on January 2, 2013.  This law extends the Medicare Part B Outpatient Therapy Cap Exceptions Process through December 31, 2013.  Section 603 of this Act contains a number of Medicare provisions affecting the outpatient therapy caps and manual medical review (MR) threshold. Read more

Have you received flyers about the Functional G-Codes Claims Based Reporting that is required to implement no later than July 2013? This information was introduced in the 2012 proposed rule of the Physician Fee Schedule for 2013. Read more