Direction on Demand from Encompass Consulting & Education, LLC</= title>  <link rel=3DthemeData href=3D"Jan_Feb_09_files/themedata.thmx"> <link rel=3DcolorSchemeMapping href=3D"Jan_Feb_09_files/colorschememapping.= xml">  <style>  </style>  </head> <body bgcolor=3Dwhite lang=3DEN-US link=3Dblue vlink=3Dpurple style=3D'tab-= interval:.5in'> <div class=3DSection1> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D595 style= =3D'width:446.25pt; mso-cellspacing:1.5pt;background:white;mso-yfti-tbllook:1184;mso-padding-a= lt: 0in 5.4pt 0in 5.4pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td width=3D"99%" style=3D'width:99.32%;padding:.75pt .75pt .75pt .75pt'> <div> You are receiving = this email from Encompass Consulting & Education, LLC because you subscrib= ed on our website or have recently attended one of our seminars and indicated that you wished to subscribe. To ensure that you continue to receive emai= ls from us, add <a href=3D"mailto:pmfranko@encompassmedicare.com">pmfranko@e= ncompassmedicare.com</a> to your address book today. If you haven't done so already, click to <a href=3D"http://visitor.constantcontact.com/c.jsp?t=3D1102456639311.1.6211= 4275.2&m=3D1101399613904&wl=3DF" target=3D"_blank">confirm</a> your interest in receiving email campaigns = from us. <o:p></o:p> <div> <o:p></o:p><= /span> </div> <div> You may <a href=3D"http://visitor.constantcontact.com/d.jsp?p=3Dun&v=3D001dLsZf5= Cw4pNfqOqfZLL0WIuxCdqsguxNb_b3q0ul-Ye8gDcldSATbX690YNldhDF2d-lWFKCO4M%3D" target=3D"_blank">unsubscribe</a> if you no longer wish to receive our em= ails.<o:p></o:p> </div> </div> </td> </tr> </table> </div> <img border=3D0 width=3D1 height=3D1 id=3D"_x0000_i1032" src=3D"http://rs6.net/on.jsp?t=3D1102456639311.0.1101399613904.1&ts=3DS= 0391&o=3Dhttp://ui.constantcontact.com/images/p1x1.gif" alt=3D" ">= <o:p></o:p> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D610 style= =3D'width:457.5pt; mso-cellspacing:1.5pt;background:#CC3366;mso-yfti-tbllook:1184;mso-padding= -alt: 0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td style=3D'background:white;padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 = width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook:1184;mso-padd= ing-alt: 0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'padding:0in 0in 0in 0in'> <i= mg border=3D0 width=3D600 height=3D129 id=3D"_x0000_i1031" src=3D"http://ih.constantcontact.com/fs035/1101399613904/img/1.jpg?a=3D= 1102456639311" alt=3D"Direction on Demand"><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;height:45.0pt'> <td colspan=3D2 style=3D'background:white;padding:0in 0in 0in 0in;heigh= t:45.0pt'> Encompass Consulting & Education, = LLC E-Zine= <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2;mso-yfti-lastrow:yes'> <td style=3D'padding:0in 0in 0in 3.75pt'> Vol. 4, No. 1<= /span><o:p></o:p><= /p> </td> <td style=3D'padding:0in 3.75pt 0in 0in'> January/February 2009<o:p></o:p><= /p> </td> </tr> </table> <o:p> </o:p> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 = width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:#CCCCCC;mso-yfti-tb= llook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:1.5pt 1.5pt 1.5pt 1.5pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'background:#CCCCCC;padding:1.5pt 1.5pt 1.5p= t 1.5pt'> <o:p> </o:p> <a href=3D"#column" color=3D"#003366" shape=3Drect>Encom= pass Seminars 2009</a><o:p></o:p> <a href=3D"#article1.= bg1" color=3D"#003366" shape=3Drect>Q&A:= Can a 701 in a skilled nursing setting replace the weekly note? </a><o:p= ></o:p> <a href=3D"#article1.= bg2" color=3D"#003366" shape=3Drect>Q&A:= Mandated to have a percentage of Part B patients on caseload in SNF</a>= <o:p></o:p> <a href=3D"#article2.= bg1" color=3D"#003366" shape=3Drect>News From Medicare: </a><o:p></o:p> <a href=3D"#article2.= bg2" color=3D"#003366" shape=3Drect>Medicare Contracting Reform:</a><o:p></o:p> <a href=3D"#article3.= bg1" color=3D"#003366" shape=3Drect>Joining = with Summit Professional Education</a><o:p></o:p> <a href=3D"#article5.= bg1" color=3D"#003366" shape=3Drect>Our Comp= any</a><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td valign=3Dtop style=3D'background:#CC3366;padding:1.5pt 1.5pt 1.5p= t 1.5pt'> <div> <o:p></o:p> </div> </td> </tr> </table> <o:p> </o:p> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:#C= CCCCC; mso-yfti-tbllook:1184;mso-padding-alt:0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:ye= s'> <td style=3D'padding:0in 0in 0in 0in'> <div> <a na= me=3Dcolumn shape=3Drect> </a>Encompass Seminars 2009<o:p></o:p> </div> <img border=3D0 width=3D91 height=3D110 id=3D"_x0000_i1030" src=3D"http://ih.constantcontact.com/fs035/1101399613904/img/2.jpg?a= =3D1102456639311" alt=3D"Pauline M. Franko, PT, MCSP"><o:p></o:p> Here are the 2009 dates and locations for Medicare Made Easy for SNF. We a= re doing something a little different and presenting the seminars during= the week instead of on the weekend.<o:p></o:p> We are also opening day 2 for none SNF therapists as this day covers Par= t B regulations and how to document skilled therapy. Places will be as available. We will list availability on our website under the Part B webpage.<o:p></o:p> Here is our schedule. <o:p></o:p> Dallas, TX: March 2 - 3<o:p></o:p> San Antonio, TX: March 5 - 6<o:p></o:p> San Diego, CA: March 30 - 31<o:p></o:p> San Jose, CA: April 2 - 3<o:p></o:p> Chicago, IL: April 30 - May 1<o:p></o:p> Columbus, OH: May 4 - 5<o:p></o:p> Nashville, TN: August 20 - 21<o:p></o:p> Macon, GA August 24 - 25<o:p></o:p> St Louis, MO: September 21 - 22<o:p></o:p> Omaha, NE: September 24 - 25<o:p></o:p> Worcester, MA: October 19 - 20<o:p></o:p> Cherry Hill, NJ: October 22 - 23<o:p></o:p> West Palm Beach, FL: Nov 9 - 10<o:p></o:p> Orlando, FL: November 12 - 13<o:p></o:p> Please note the changes in the Chicago and Columbus locations. We have switc= hed them around due to scheduling conflicts. <o:p></o:p> Our class size is limited so make sure you register early. Visit our webs= ite for more information <o:p></o:p></b= > </td> </tr> </table> <o:p></o:p> </td> <td width=3D420 rowspan=3D2 valign=3Dtop style=3D'width:315.0pt;backgro= und:white; padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:1.5pt 1.5pt 1.5pt 1.5pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'background:white;padding:1.5pt 1.5pt 1.5pt = 7.5pt'></td> <td valign=3Dtop style=3D'background:white;padding:1.5pt 1.5pt 1.5pt = 1.5pt'> Dear Pauline,<= /span> <o:p></o:p> Here we are, already half way through February.The new President has already been at work on healthcare with the establishme= nt of a moratorium on any new regulations and a review of any regulation= s passed during the last 6 months.<o:p></o:p> What that will mean for us is not sure. All we can prese= ntly do is to ensure we are following the guidelines in place and provide skilled therapy services to the Medicare beneficiary.<o:p></o:p></spa= n> Thank you for your subscription to "Direction On Demand", a free e-zine from Encompass Consulting & Education, LLC. <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;height:2.25pt'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:1= .5pt 1.5pt 1.5pt 1.5pt; height:2.25pt'></td> </tr> <tr style=3D'mso-yfti-irow:2;height:1.5pt'> <td colspan=3D2 valign=3Dbottom style=3D'padding:1.5pt 1.5pt 1.5pt 1.= 5pt; height:1.5pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes;height:1.5pt'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:1= .5pt 1.5pt 1.5pt 1.5pt; height:1.5pt'></td> </tr> </table> <a name=3Darticle1.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · Q&A= : Can a 701 in a skilled nursing setting replace the weekly note? </= b><o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Question:</spa= n><o:p></o:p></s= pan> Can a 701(rece= rt) in a skilled nursing setting be used to replace a weekly note? For examp= le, if the weekly note is due on the same day of the recert is it necessa= ry to also complete the weekly note? Myth?<o:p></o:p> Thanks so much= . I try to keep up with MEDICARE guidelines/regulations by signing up to their CMS e- NEWS but I end up receiving up to 20 emails a day just o= n a skilled nursing setting, its hard to keep up. <o:p></o:p></spa= n> Answer:= <o:p></o:p></s= pan> First of all t= he 700 and 701 are no longer in use and have never been required for Par= t A patients and I am presuming you are talking about Part A. For progress reports, you need to go with whatever your facility policy is as there are no CMS listed requirements for Part A documentation like there are with Part B.<o:p></o:p> Certification = and recertification for Part A patients is the responsibility of the facility, not the therapist. This certification is for all the servic= es the patient is receiving, including therapy. There never has been a requirement for a 30 day updated plan and recert for therapy, that was taken from the use of the 700/701 forms. CMS is looking at trying to standardize documentation across the board with acknowledgement of the different site regulations.<o:p></o:p> What we do kno= w we have to have for Part A is an evaluation and POT; daily documentation of the skilled services provided, the total time spent on treatment and the identification of the therapist who provid= ed of those services and any other relevant information for that day. <o= :p></o:p> Progress notes identifying the patient's progress towards the established goals, other informati= on such as objective measurement or tests done on the evaluation, and the therapist's assessment of progress made. <o:p></o:p> There are no Medicare instructions as to when these progress notes have to be writ= ten, it has become a standard of practice for weekly notes but your P&P should identify that one. <o:p></o:p> A recert (which was the use of the 701) was never required for Part A as that was a P= art B requirement. If you look at the current Part B requirements, the POT should be written for the length of time the therapist believes it wi= ll take to achieve the LTGs. (This should have been the way POTs were written for Part A patients all along.) So, if you write your POT for= the length of time to reach LTG, there is absolutely no reason to do a "recert" to update your plan of treatment. Justification for medical necessity should be in the progress notes. Also, there is no = need for a monthly progress note, defunct if the weekly is done as appropriate. <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle1.bg2 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Q&A: Mandated to have a percenta= ge of Part B patients on caseload in SNF<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Question:</s= pan><o:p></o:p><= /span> What is your opinion on a company mandate that states 20% of all eligible Part B patients in a long term care facility should be on therapy caseload a= t all times? Obviously I have issues with this. Also, how many times can you pick up the same person over and over again when the reason they have declined is because post therapy instructions have not been followed ( restorative not done, walk to dine/bathroom not done by nursing staff= ). It seems wrong to continue to pick people up for this reason, however they have a real decline so I am unsure of the "right" thin= g to do. Thank you so much for your services, those of us in the field must have some hard facts to back us up sometimes when we are asked to do things we know are not right.<o:p></o:p> Answer:</spa= n><o:p></o:p><= /span> My opinion is that you cannot mandate your residents to require therapy services on= a regulated schedule! Should there be patients on Part B, absolutely. C= an you have a mandated number, Absolutely NOT. In working out budget requirements, there are a number of patients that can be factored in,= but it depends on your patient mix.<o:p></o:p> To keep pick= ing patients up for therapy because the facility is not doing its job is = not what Medicare is for. To keep picking a patient up because of a decli= ne that could have been preventive through the facility doing what they = are getting paid for (maintaining or preventing decline) is Medicare Abuse and something that should certainly be identified during State Survey= .<o:p></o:p> As therapist= s, we know we can help, but the "person" who should be paying = for your services is the administrator. If there are no restorative progr= ams or any follow through by the facility, then the administrator can have the therapy department follow through, pay for those services and cou= nt as Restorative Nursing on the MDS.<o:p></o:p> You have to = be knowledgeable of Medicare compliance and to pick up patients who do n= ot meet their requirements can affect your license. If you pick a patien= t up who has used their cap up and use the KX modifier for billing those services, the facility opens itself up to accusation of abuse or maybe fraud on a Medical Review. <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle2.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · News Fr= om Medicare: <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Clarifying Con= fusion over Certification, Re- certification and POT review in ORFs and CORF= s<o:p></o:p></s= pan> With the implementation of the 90 day certification interval, there has been confusion between the regulations for "Conditions of Participati= on. Several of the MACS have been addressing the regulations for ORF (Reh= ab Agencies) and CORFs. As part of their Medicare certification and surv= ey process, the CORF must have the physician review the plan of treatment and re-certify need at 60 days, not the 90 allowed under the Part B r= egulations. <o:p></o:p> Under the regulations for ORF, "the plan of care and results of treatment = be reviewed by the physician OR by the individual who established the pl= an at least as often as the patient's condition requires, and the indica= ted action taken, which for Medicare patients being treated in rehabilita= tion agencies must be at least every 30 days." Therefore, documentati= on that the therapist has reviewed the plan and has made appropriate changes, according to patient response and the current plan is approp= riate should meet this requirement (progress reports!) and certification of= the plan will still proceed under the max 90 days guidelines for physician review and recert.<o:p></o:p> And how will Medicare know? You tell them right there on your bill. Did you know t= hat? On the UB-04, occurrence codes 29, 17 and 30 identify when the associ= ated plan (PT, OT or Speech) was last reviewed, and for CORF, occurrence c= ode 28 identifies the same thing. So, if for CORF, the date exceeds 60 da= ys from the initial treatment date, that's your red flag, for everyone e= lse, including ORF, that period should not exceed 90 days. <o:p></o:p></sp= an> President Obama issued an executive order to place a moratorium on any new regulations for Medicare as well as reviewing those that have passed in the last = six months. What actual effect that will have on Rehab is not sure at this time. <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle2.bg2 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Medicare Contracting Reform:<= /b><o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Finally CMS = has announced their final selections for the remaining A/B Macs. Interestingly enough there is only one NEW name added to this group. <o:p></o:p> Noridian Administrative Services, LLC (NAS) has been awarded a contract for the combined administration of Part A/Part B Medicare cl= aims payment in Jurisdiction 6 comprised of Illinois, Minnesota and Wiscon= sin. NAS is headquartered in Fargo, ND They also handle Jurisdiction 3, comprising of Arizona, Montana, North Dakota, South Dakota, Utah, and Wyoming<o:p></o:p> National Government Services (NGS) has been awarded a contract for the combined administration of Part A/Part B Medicare claims payment in Jurisdicti= on 8 comprised of Indiana and Michigan. NGS is headquartered in Indianapol= is, IN. NGS is also the MAC for Jurisdiction 13, consisting of Connecticut and New York.<o:p></o:p> Cahaba Government Benefit Administrators, LLC (Cahaba GBA) <= /span>has been awarded a contract for the combined administration of Part A/Part B Medicare cl= aims payment in Jurisdiction 10 comprised of Alabama, Georgia and Tennesse= e. Cahaba GBS is headquartered in Birmingham, AL. <o:p></o:p></sp= an> Palmetto Government Benefits Administrators, LLC (Palmetto GBA) </= b>has been awarded a contract for the combined administration of Part A/Part B Medicare cl= aims payment in Jurisdiction 11 comprised of North Carolina, South Carolin= a, Virginia and West Virginia. Palmetto GBA has its operational headquar= ters in Columbia, SC, with some operations performed in Columbus, OH. Palm= etto also has Jurisdiction 1 which consists of American Samoa, California, Guam, Hawaii, Nevada and Northern Mariana Islands.<o:p></o:p><= /span> Highmark Medicare Services (HMS) .has been awarded a contract for the combined administration of Part A/Part B Medicare claims payment in Jurisdicti= on 15 comprised of Kentucky and Ohio. HMS is headquartered in Camp Hill,= PA. HMS also was awarded Jurisdiction 12, Delaware, District of Columbia, Maryland, New Jersey and Pennsylvania.<o:p></o:p> With the finalization of the MAC awards, we will be dealing with a total of 10 MACS servicing the 15 jurisdictions. This should make life a little easier as now, we will only have 10 sets of LCDs to contend with.</sp= an> <o:p></o:p></= span> On the 6th of February, CMS announced the satisfaction of the contest of RAC awards= and therefore have lifted the moratorium on the RACS. The resolution has resulted in the original awards being maintained, but the two compani= es that challenged the awards obtained positions as subcontractors to the main RACs. <o:p></o:p> PRG-Schultz, Inc. will work with: <o:p></o:p> Region A: Diversified Collection Services, Inc (DCS) <o:p></o:p></sp= an> Region B: CGI Technologies and Solutions, Inc. (CGI) <o:p></o:p><= /p> Region D: HealthDataInsights, Inc. (HDI) <o:p></o:p> Viant Payment Systems, Inc. will work with: <o:p></o:p> Region C: Connolly Consulting Associates, Inc. <o:p></o:p><= /span> Each subcontractor has negotiated different responsibilities in each regio= n, including some claim review. <o:p></o:p> CMS is also = in the process of changing the Program Safeguard Contractors (PSC) to Zo= ne Program Integrity Contractors (ZPIC). What the difference in their ro= le will be, we are not sure as yet. Just be aware - BIG BROTHER will be watching. The latest figure for the $$ amount recouped by the demonstration RACs has inched up to almost 1 billion. These programs = have been extremely successful in identifying "errors" in billing and recouping Medicare Trust Fund dollars. <o:p></o:p></= span> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle3.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · Joining= with Summit Professional Education<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> We are excited= to announced that we have finalized a relationship with Summit Pro= fessional Education to do a series of one day seminars on Medicare. This seminar provides a good overview of the Medicare program and will be = of interest for therapists in all provider sites. <o:p></o:p></sp= an> The course is called "Optimizing Reimbursement for Physical, Occupational and Speech Therapy Services". The first seminars will ro= le out in Pennsylvania and New Jersey. Summit schedules locations about = 6 to 8 weeks in advance, so I don't yet know if I will be coming to a place near you. I will post the locations on our website as I have them so = you can keep up to date. This will be a great Medicare 101 for new to Medicare therapists as well as a "bringing up to date"= ; for those who have been in the field for some time. CMS has changed, = make sure you do as well! <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle5.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Our Company<o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Direction on Demand is brought to you by Encompass Consulting & Education, LLC= . A therapist owned company specializing in Consulting and Educational services for therapists and other professionals providing Medicare se= rvices in SNF, Rehab Agencies, Private Practice, and Hospital Outpatient Facilities.<o:p></o:p> Pauline M. Franko, PT, MCSP is owner and president of the company and is also kn= own as the "Medicare Advisor" for the "Advance for" family of News Magazines.She acts as a resource for the respected Eli Reports and is on the editorial board of the "MDS Alert" and "Outpatient Physical Therapy Coding Alert".<s= pan style=3D'mso-bookmark:"article5\.bg1"'> <o:p></o:p></= span> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td valign=3Dbottom style=3D'padding:0in 0in 0in 0in'> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td style=3D'background:#CC3366;padding:0in 0in 0in 0in'> <img border=3D0 width=3D1 height=3D1 id=3D"_x0000_i= 1029" src=3D"http://img.constantcontact.com/letters/images/spacer.gif" alt=3D"http://img.constantcontact.com/letters/images/spacer.gif"></sp= an><o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td style=3D'padding:7.5pt 0in 7.5pt 0in'> <div> :: <a href=3D"mailto:pmfranko@encompassmedicare.com" color=3D"#003366" shap= e=3Drect>pmfranko@encompassmedicare.com</a> <o:= p></o:p> </div> <div> :: <a href=3D"http://rs6.net/tn.jsp?et=3D1102456639311&e=3D001-6DCBKKVK= qW_s5DCM6zVSQz-KPTzAGPGIGL-jgbhm20_ARkmA-4l9sfPIx5Fc5kcQmBE_P-3yLWuYfoCXagr= yaibD_dLhgLnxoR2jxyBzFVKqoattRDGZQ=3D=3D" color=3D"#003366" shape=3Drect>http://w= ww.encompassmedicare.com</a> <o:p></o:p> </div> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td style=3D'background:#CC3366;padding:0in 0in 0in 0in'> <img border=3D0 width=3D1 height=3D1 id=3D"_x0000_i= 1028" src=3D"http://img.constantcontact.com/letters/images/spacer.gif" alt=3D"http://img.constantcontact.com/letters/images/spacer.gif"></sp= an><o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:3'> <td style=3D'padding:7.5pt 0in 7.5pt 0in'></td> </tr> <tr style=3D'mso-yfti-irow:4;mso-yfti-lastrow:yes'> <td style=3D'background:#CC3366;padding:0in 0in 0in 0in'> <img border=3D0 width=3D1 height=3D1 id=3D"_x0000_i= 1027" src=3D"http://img.constantcontact.com/letters/images/spacer.gif" alt=3D"http://img.constantcontact.com/letters/images/spacer.gif"></sp= an><o:p></o:p></span= > </td> </tr> </table> </div> </td> </tr> </table> <o:p></o:p> </td> </tr> </table> </div> <o:p> </o:p> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:1.5pt;background:white;mso-yfti-tbll= ook: 1184;mso-padding-alt:0in 5.4pt 0in 5.4pt' padding=3D0> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td style=3D'padding:.75pt .75pt .75pt .75pt'> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D595 style=3D'width:446.25pt;mso-cellspacing:1.5pt;background:white;mso-yfti-= tbllook: 1184;mso-padding-alt:0in 5.4pt 0in 5.4pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 style=3D'padding:.75pt .75pt .75pt .75pt'> <a href=3D"http://ui.constantcontact.com/sa/fwtf.jsp?m=3D1101399613904&= ;ea=3Dpmfranko%40encompassmedicare.com&a=3D1102456639311" target=3D"_blank">Forward email</a><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td style=3D'padding:.75pt .75pt .75pt .75pt'> <a href=3D"http://visitor.constantcontact.com/d.jsp?p=3Dun&v=3D001dLsZ= f5Cw4pNfqOqfZLL0WIuxCdqsguxNb_b3q0ul-Ye8gDcldSATbX690YNldhDF2d-lWFKCO4M%3D" target=3D"_blank"><img border=3D0 width=3D32 height=3D32 id=3D"= _x0000_i1026" src=3D"http://img.constantcontact.com/letters/images/safe_unsubscribe_l= ogo.gif" alt=3D"Safe Unsubscribe"></a><o:p>= </o:p> <div> This email was sent to <a href=3D"mailto:pmfranko@encompassmedicare.com">pmfranko@encompassmedica= re.com</a> by <a href=3D"mailto:pmfranko@encompassmedicare.com">pmfranko@encompass= medicare.com</a>.<o:p></o:p> </div> <div> <a href=3D"http://visitor.constantcontact.com/d.jsp?p=3Doo&v=3D001dLsZ= f5Cw4pNfqOqfZLL0WIuxCdqsguxNb_b3q0ul-Ye8gDcldSATbX690YNldhDF2d-lWFKCO4M%3D" target=3D"_blank">Update Profile/Email Address</a> | Instant removal wi= th <a href=3D"http://visitor.constantcontact.com/d.jsp?p=3Dun&v=3D001dLsZ= f5Cw4pNfqOqfZLL0WIuxCdqsguxNb_b3q0ul-Ye8gDcldSATbX690YNldhDF2d-lWFKCO4M%3D" target=3D"_blank">SafeUnsubscribe</a>™ | <a href=3D"http://ui.constantcontact.com/roving/CCPrivacyPolicy.jsp" target=3D"_blank">Privacy Policy</a>.<o:p></o:p> </div> </td> <td style=3D'padding:.75pt .75pt .75pt .75pt'></FooterContent><FooterLo= go > <div style=3D'word-wrap:normal'> <a href=3D"http://www.constantcontact.com/index.jsp?cc=3Dnews05" target=3D= "_blank">Email Marketing</a> by<o:p></o:p> </div> <a href=3D"http://www.constantcontact.com/index.jsp?cc=3Dnews05"><img border=3D0 width=3D32 height=3D32 id=3D"_x0000_i1025" src=3D"http://img.constantcontact.com/letters/images/cc-logo-color-sm.g= if" alt=3D"http://img.constantcontact.com/letters/images/cc-logo-color-sm.g= if"></a><o:p></o:p><= /p> </td> </tr> <tr style=3D'mso-yfti-irow:2;mso-yfti-lastrow:yes'> <td colspan=3D2 style=3D'padding:.75pt .75pt .75pt .75pt'> Encompass Consulting & Education, LLC | 8114 NW 100th Terrace | Tam= arac | FL | 33321-1259 <o:p></o:p> </td> </tr> </table> </div> </td> </tr> </table> <o:p> </o:p> </div> </body> </html> ------=_NextPart_01C991E2.A8D55740 Content-Location: file:///C:/52828239/Jan_Feb_09_files/themedata.thmx Content-Transfer-Encoding: base64 Content-Type: application/vnd.ms-officetheme UEsDBBQABgAIAAAAIQCCirwT+gAAABwCAAATAAAAW0NvbnRlbnRfVHlwZXNdLnhtbKyRy2rDMBBF 94X+g9C22HK6KKXYzqJJd30s0g8Y5LEtao+ENAnJ33fsuFC6CC10IxBizpl7Va6P46AOGJPzVOlV XmiFZH3jqKv0++4pu9cqMVADgyes9AmTXtfXV+XuFDApmaZU6Z45PBiTbI8jpNwHJHlpfRyB5Ro7 E8B+QIfmtijujPXESJzxxNB1+SoLRNegeoPILzCKx7Cg8Pv5DCSAmAtYq8czYVqi0hDC4CywRDAH an7oM9+2zmLj7X4UaT6DF9jNBDO/XGD1P+ov5wZb2A+stkfp4lx/xCH9LdtSay6Tc/7Uu5AuGC6X t7Rh5r+tPwEAAP//AwBQSwMEFAAGAAgAAAAhAKXWp+fAAAAANgEAAAsAAABfcmVscy8ucmVsc4SP z2rDMAyH74W9g9F9UdLDGCV2L6WQQy+jfQDhKH9oIhvbG+vbT8cGCrsIhKTv96k9/q6L+eGU5yAW mqoGw+JDP8to4XY9v3+CyYWkpyUIW3hwhqN727VfvFDRozzNMRulSLYwlRIPiNlPvFKuQmTRyRDS SkXbNGIkf6eRcV/XH5ieGeA2TNP1FlLXN2Cuj6jJ/7PDMMyeT8F/ryzlRQRuN5RMaeRioagv41O9 kKhlqtQe0LW4+db9AQAA//8DAFBLAwQUAAYACAAAACEAa3mWFoMAAACKAAAAHAAAAHRoZW1lL3Ro ZW1lL3RoZW1lTWFuYWdlci54bWwMzE0KwyAQQOF9oXeQ2TdjuyhFYrLLrrv2AEOcGkHHoNKf29fl 44M3zt8U1ZtLDVksnAcNimXNLoi38Hwspxuo2kgcxSxs4ccV5ul4GMm0jRPfSchzUX0j1ZCFrbXd INa1K9Uh7yzdXrkkaj2LR1fo0/cp4kXrKyYKAjj9AQAA//8DAFBLAwQUAAYACAAAACEAlrWt4pYG AABQGwAAFgAAAHRoZW1lL3RoZW1lL3RoZW1lMS54bWzsWU9v2zYUvw/YdyB0b2MndhoHdYrYsZst TRvEboceaYmW2FCiQNJJfRva44ABw7phhxXYbYdhW4EW2KX7NNk6bB3Qr7BHUpLFWF6SNtiKrT4k Evnj+/8eH6mr1+7HDB0SISlP2l79cs1DJPF5QJOw7d0e9i+teUgqnASY8YS0vSmR3rWN99+7itdV RGKCYH0i13Hbi5RK15eWpA/DWF7mKUlgbsxFjBW8inApEPgI6MZsablWW12KMU08lOAYyN4aj6lP 0FCT9DZy4j0Gr4mSesBnYqBJE2eFwQYHdY2QU9llAh1i1vaAT8CPhuS+8hDDUsFE26uZn7e0cXUJ r2eLmFqwtrSub37ZumxBcLBseIpwVDCt9xutK1sFfQNgah7X6/W6vXpBzwCw74OmVpYyzUZ/rd7J aZZA9nGedrfWrDVcfIn+ypzMrU6n02xlsliiBmQfG3P4tdpqY3PZwRuQxTfn8I3OZre76uANyOJX 5/D9K63Vhos3oIjR5GAOrR3a72fUC8iYs+1K+BrA12oZfIaCaCiiS7MY80QtirUY3+OiDwANZFjR BKlpSsbYhyju4ngkKNYM8DrBpRk75Mu5Ic0LSV/QVLW9D1MMGTGj9+r596+eP0XHD54dP/jp+OHD 4wc/WkLOqm2chOVVL7/97M/HH6M/nn7z8tEX1XhZxv/6wye//Px5NRDSZybOiy+f/PbsyYuvPv39 u0cV8E2BR2X4kMZEopvkCO3zGBQzVnElJyNxvhXDCNPyis0klDjBmksF/Z6KHPTNKWaZdxw5OsS1 4B0B5aMKeH1yzxF4EImJohWcd6LYAe5yzjpcVFphR/MqmXk4ScJq5mJSxu1jfFjFu4sTx7+9SQp1 Mw9LR/FuRBwx9xhOFA5JQhTSc/yAkArt7lLq2HWX+oJLPlboLkUdTCtNMqQjJ5pmi7ZpDH6ZVukM /nZss3sHdTir0nqLHLpIyArMKoQfEuaY8TqeKBxXkRzimJUNfgOrqErIwVT4ZVxPKvB0SBhHvYBI WbXmlgB9S07fwVCxKt2+y6axixSKHlTRvIE5LyO3+EE3wnFahR3QJCpjP5AHEKIY7XFVBd/lbobo d/ADTha6+w4ljrtPrwa3aeiINAsQPTMR2pdQqp0KHNPk78oxo1CPbQxcXDmGAvji68cVkfW2FuJN 2JOqMmH7RPldhDtZdLtcBPTtr7lbeJLsEQjz+Y3nXcl9V3K9/3zJXZTPZy20s9oKZVf3DbYpNi1y vLBDHlPGBmrKyA1pmmQJ+0TQh0G9zpwOSXFiSiN4zOq6gwsFNmuQ4OojqqJBhFNosOueJhLKjHQo UcolHOzMcCVtjYcmXdljYVMfGGw9kFjt8sAOr+jh/FxQkDG7TWgOnzmjFU3grMxWrmREQe3XYVbX Qp2ZW92IZkqdw61QGXw4rxoMFtaEBgRB2wJWXoXzuWYNBxPMSKDtbvfe3C3GCxfpIhnhgGQ+0nrP +6hunJTHirkJgNip8JE+5J1itRK3lib7BtzO4qQyu8YCdrn33sRLeQTPvKTz9kQ6sqScnCxBR22v 1VxuesjHadsbw5kWHuMUvC51z4dZCBdDvhI27E9NZpPlM2+2csXcJKjDNYW1+5zCTh1IhVRbWEY2 NMxUFgIs0Zys/MtNMOtFKWAj/TWkWFmDYPjXpAA7uq4l4zHxVdnZpRFtO/ualVI+UUQMouAIjdhE 7GNwvw5V0CegEq4mTEXQL3CPpq1tptzinCVd+fbK4Ow4ZmmEs3KrUzTPZAs3eVzIYN5K4oFulbIb 5c6vikn5C1KlHMb/M1X0fgI3BSuB9oAP17gCI52vbY8LFXGoQmlE/b6AxsHUDogWuIuFaQgquEw2 /wU51P9tzlkaJq3hwKf2aYgEhf1IRYKQPShLJvpOIVbP9i5LkmWETESVxJWpFXtEDgkb6hq4qvd2 D0UQ6qaaZGXA4E7Gn/ueZdAo1E1OOd+cGlLsvTYH/unOxyYzKOXWYdPQ5PYvRKzYVe16szzfe8uK 6IlZm9XIswKYlbaCVpb2rynCObdaW7HmNF5u5sKBF+c1hsGiIUrhvgfpP7D/UeEz+2VCb6hDvg+1 FcGHBk0Mwgai+pJtPJAukHZwBI2THbTBpElZ02atk7ZavllfcKdb8D1hbC3ZWfx9TmMXzZnLzsnF izR2ZmHH1nZsoanBsydTFIbG+UHGOMZ80ip/deKje+DoLbjfnzAlTTDBNyWBofUcmDyA5LcczdKN vwAAAP//AwBQSwMEFAAGAAgAAAAhAA3RkJ+2AAAAGwEAACcAAAB0aGVtZS90aGVtZS9fcmVscy90 aGVtZU1hbmFnZXIueG1sLnJlbHOEj00KwjAUhPeCdwhvb9O6EJEm3YjQrdQDhOQ1DTY/JFHs7Q2u LAguh2G+mWm7l53JE2My3jFoqhoIOumVcZrBbbjsjkBSFk6J2TtksGCCjm837RVnkUsoTSYkUigu MZhyDidKk5zQilT5gK44o49W5CKjpkHIu9BI93V9oPGbAXzFJL1iEHvVABmWUJr/s/04GolnLx8W Xf5RQXPZhQUoosbM4CObqkwEylu6usTfAAAA//8DAFBLAQItABQABgAIAAAAIQCCirwT+gAAABwC AAATAAAAAAAAAAAAAAAAAAAAAABbQ29udGVudF9UeXBlc10ueG1sUEsBAi0AFAAGAAgAAAAhAKXW p+fAAAAANgEAAAsAAAAAAAAAAAAAAAAAKwEAAF9yZWxzLy5yZWxzUEsBAi0AFAAGAAgAAAAhAGt5 lhaDAAAAigAAABwAAAAAAAAAAAAAAAAAFAIAAHRoZW1lL3RoZW1lL3RoZW1lTWFuYWdlci54bWxQ SwECLQAUAAYACAAAACEAlrWt4pYGAABQGwAAFgAAAAAAAAAAAAAAAADRAgAAdGhlbWUvdGhlbWUv dGhlbWUxLnhtbFBLAQItABQABgAIAAAAIQAN0ZCftgAAABsBAAAnAAAAAAAAAAAAAAAAAJsJAAB0 aGVtZS90aGVtZS9fcmVscy90aGVtZU1hbmFnZXIueG1sLnJlbHNQSwUGAAAAAAUABQBdAQAAlgoA AAAA ------=_NextPart_01C991E2.A8D55740 Content-Location: file:///C:/52828239/Jan_Feb_09_files/colorschememapping.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml <?xml version=3D"1.0" encoding=3D"UTF-8" standalone=3D"yes"?> <a:clrMap xmlns:a=3D"http://schemas.openxmlformats.org/drawingml/2006/main"= bg1=3D"lt1" tx1=3D"dk1" bg2=3D"lt2" tx2=3D"dk2" accent1=3D"accent1" accent= 2=3D"accent2" accent3=3D"accent3" accent4=3D"accent4" accent5=3D"accent5" a= ccent6=3D"accent6" hlink=3D"hlink" folHlink=3D"folHlink"/> ------=_NextPart_01C991E2.A8D55740 Content-Location: file:///C:/52828239/Jan_Feb_09_files/filelist.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" <xml xmlns:o=3D"urn:schemas-microsoft-com:office:office"> <o:MainFile HRef=3D"../Jan_Feb_09.htm"/> <o:File HRef=3D"themedata.thmx"/> <o:File HRef=3D"colorschememapping.xml"/> <o:File HRef=3D"filelist.xml"/> </xml> ------=_NextPart

MIME-Version: 1.0 Content-Type: multipart/related; boundary="----=_NextPart_01C991E2.A8D55740" This document is a Single File Web Page, also known as a Web Archive file. If you are seeing this message, your browser or editor doesn't support Web Archive files. Please download a browser that supports Web Archive, such as Windows® Internet Explorer®. ------=_NextPart_01C991E2.A8D55740 Content-Location: file:///C:/52828239/Jan_Feb_09.htm Content-Transfer-Encoding: quoted-printable Content-Type: text/html; charset="us-ascii" Direction on Demand from Encompass Consulting & Education, LLC</= title>  <link rel=3DthemeData href=3D"Jan_Feb_09_files/themedata.thmx"> <link rel=3DcolorSchemeMapping href=3D"Jan_Feb_09_files/colorschememapping.= xml">  <style>  </style>  </head> <body bgcolor=3Dwhite lang=3DEN-US link=3Dblue vlink=3Dpurple style=3D'tab-= interval:.5in'> <div class=3DSection1> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D595 style= =3D'width:446.25pt; mso-cellspacing:1.5pt;background:white;mso-yfti-tbllook:1184;mso-padding-a= lt: 0in 5.4pt 0in 5.4pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td width=3D"99%" style=3D'width:99.32%;padding:.75pt .75pt .75pt .75pt'> <div> You are receiving = this email from Encompass Consulting & Education, LLC because you subscrib= ed on our website or have recently attended one of our seminars and indicated that you wished to subscribe. To ensure that you continue to receive emai= ls from us, add <a href=3D"mailto:pmfranko@encompassmedicare.com">pmfranko@e= ncompassmedicare.com</a> to your address book today. If you haven't done so already, click to <a href=3D"http://visitor.constantcontact.com/c.jsp?t=3D1102456639311.1.6211= 4275.2&m=3D1101399613904&wl=3DF" target=3D"_blank">confirm</a> your interest in receiving email campaigns = from us. <o:p></o:p> <div> <o:p></o:p><= /span> </div> <div> You may <a href=3D"http://visitor.constantcontact.com/d.jsp?p=3Dun&v=3D001dLsZf5= Cw4pNfqOqfZLL0WIuxCdqsguxNb_b3q0ul-Ye8gDcldSATbX690YNldhDF2d-lWFKCO4M%3D" target=3D"_blank">unsubscribe</a> if you no longer wish to receive our em= ails.<o:p></o:p> </div> </div> </td> </tr> </table> </div> <img border=3D0 width=3D1 height=3D1 id=3D"_x0000_i1032" src=3D"http://rs6.net/on.jsp?t=3D1102456639311.0.1101399613904.1&ts=3DS= 0391&o=3Dhttp://ui.constantcontact.com/images/p1x1.gif" alt=3D" ">= <o:p></o:p> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D610 style= =3D'width:457.5pt; mso-cellspacing:1.5pt;background:#CC3366;mso-yfti-tbllook:1184;mso-padding= -alt: 0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td style=3D'background:white;padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 = width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbllook:1184;mso-padd= ing-alt: 0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'padding:0in 0in 0in 0in'> <i= mg border=3D0 width=3D600 height=3D129 id=3D"_x0000_i1031" src=3D"http://ih.constantcontact.com/fs035/1101399613904/img/1.jpg?a=3D= 1102456639311" alt=3D"Direction on Demand"><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;height:45.0pt'> <td colspan=3D2 style=3D'background:white;padding:0in 0in 0in 0in;heigh= t:45.0pt'> Encompass Consulting & Education, = LLC E-Zine= <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2;mso-yfti-lastrow:yes'> <td style=3D'padding:0in 0in 0in 3.75pt'> Vol. 4, No. 1<= /span><o:p></o:p><= /p> </td> <td style=3D'padding:0in 3.75pt 0in 0in'> January/February 2009<o:p></o:p><= /p> </td> </tr> </table> <o:p> </o:p> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 = width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:#CCCCCC;mso-yfti-tb= llook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:1.5pt 1.5pt 1.5pt 1.5pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'background:#CCCCCC;padding:1.5pt 1.5pt 1.5p= t 1.5pt'> <o:p> </o:p> <a href=3D"#column" color=3D"#003366" shape=3Drect>Encom= pass Seminars 2009</a><o:p></o:p> <a href=3D"#article1.= bg1" color=3D"#003366" shape=3Drect>Q&A:= Can a 701 in a skilled nursing setting replace the weekly note? </a><o:p= ></o:p> <a href=3D"#article1.= bg2" color=3D"#003366" shape=3Drect>Q&A:= Mandated to have a percentage of Part B patients on caseload in SNF</a>= <o:p></o:p> <a href=3D"#article2.= bg1" color=3D"#003366" shape=3Drect>News From Medicare: </a><o:p></o:p> <a href=3D"#article2.= bg2" color=3D"#003366" shape=3Drect>Medicare Contracting Reform:</a><o:p></o:p> <a href=3D"#article3.= bg1" color=3D"#003366" shape=3Drect>Joining = with Summit Professional Education</a><o:p></o:p> <a href=3D"#article5.= bg1" color=3D"#003366" shape=3Drect>Our Comp= any</a><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td valign=3Dtop style=3D'background:#CC3366;padding:1.5pt 1.5pt 1.5p= t 1.5pt'> <div> <o:p></o:p> </div> </td> </tr> </table> <o:p> </o:p> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:#C= CCCCC; mso-yfti-tbllook:1184;mso-padding-alt:0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:ye= s'> <td style=3D'padding:0in 0in 0in 0in'> <div> <a na= me=3Dcolumn shape=3Drect> </a>Encompass Seminars 2009<o:p></o:p> </div> <img border=3D0 width=3D91 height=3D110 id=3D"_x0000_i1030" src=3D"http://ih.constantcontact.com/fs035/1101399613904/img/2.jpg?a= =3D1102456639311" alt=3D"Pauline M. Franko, PT, MCSP"><o:p></o:p> Here are the 2009 dates and locations for Medicare Made Easy for SNF. We a= re doing something a little different and presenting the seminars during= the week instead of on the weekend.<o:p></o:p> We are also opening day 2 for none SNF therapists as this day covers Par= t B regulations and how to document skilled therapy. Places will be as available. We will list availability on our website under the Part B webpage.<o:p></o:p> Here is our schedule. <o:p></o:p> Dallas, TX: March 2 - 3<o:p></o:p> San Antonio, TX: March 5 - 6<o:p></o:p> San Diego, CA: March 30 - 31<o:p></o:p> San Jose, CA: April 2 - 3<o:p></o:p> Chicago, IL: April 30 - May 1<o:p></o:p> Columbus, OH: May 4 - 5<o:p></o:p> Nashville, TN: August 20 - 21<o:p></o:p> Macon, GA August 24 - 25<o:p></o:p> St Louis, MO: September 21 - 22<o:p></o:p> Omaha, NE: September 24 - 25<o:p></o:p> Worcester, MA: October 19 - 20<o:p></o:p> Cherry Hill, NJ: October 22 - 23<o:p></o:p> West Palm Beach, FL: Nov 9 - 10<o:p></o:p> Orlando, FL: November 12 - 13<o:p></o:p> Please note the changes in the Chicago and Columbus locations. We have switc= hed them around due to scheduling conflicts. <o:p></o:p> Our class size is limited so make sure you register early. Visit our webs= ite for more information <o:p></o:p></b= > </td> </tr> </table> <o:p></o:p> </td> <td width=3D420 rowspan=3D2 valign=3Dtop style=3D'width:315.0pt;backgro= und:white; padding:0in 0in 0in 0in'> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:1.5pt 1.5pt 1.5pt 1.5pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td valign=3Dtop style=3D'background:white;padding:1.5pt 1.5pt 1.5pt = 7.5pt'></td> <td valign=3Dtop style=3D'background:white;padding:1.5pt 1.5pt 1.5pt = 1.5pt'> Dear Pauline,<= /span> <o:p></o:p> Here we are, already half way through February.The new President has already been at work on healthcare with the establishme= nt of a moratorium on any new regulations and a review of any regulation= s passed during the last 6 months.<o:p></o:p> What that will mean for us is not sure. All we can prese= ntly do is to ensure we are following the guidelines in place and provide skilled therapy services to the Medicare beneficiary.<o:p></o:p></spa= n> Thank you for your subscription to "Direction On Demand", a free e-zine from Encompass Consulting & Education, LLC. <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;height:2.25pt'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:1= .5pt 1.5pt 1.5pt 1.5pt; height:2.25pt'></td> </tr> <tr style=3D'mso-yfti-irow:2;height:1.5pt'> <td colspan=3D2 valign=3Dbottom style=3D'padding:1.5pt 1.5pt 1.5pt 1.= 5pt; height:1.5pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes;height:1.5pt'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:1= .5pt 1.5pt 1.5pt 1.5pt; height:1.5pt'></td> </tr> </table> <a name=3Darticle1.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · Q&A= : Can a 701 in a skilled nursing setting replace the weekly note? </= b><o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Question:</spa= n><o:p></o:p></s= pan> Can a 701(rece= rt) in a skilled nursing setting be used to replace a weekly note? For examp= le, if the weekly note is due on the same day of the recert is it necessa= ry to also complete the weekly note? Myth?<o:p></o:p> Thanks so much= . I try to keep up with MEDICARE guidelines/regulations by signing up to their CMS e- NEWS but I end up receiving up to 20 emails a day just o= n a skilled nursing setting, its hard to keep up. <o:p></o:p></spa= n> Answer:= <o:p></o:p></s= pan> First of all t= he 700 and 701 are no longer in use and have never been required for Par= t A patients and I am presuming you are talking about Part A. For progress reports, you need to go with whatever your facility policy is as there are no CMS listed requirements for Part A documentation like there are with Part B.<o:p></o:p> Certification = and recertification for Part A patients is the responsibility of the facility, not the therapist. This certification is for all the servic= es the patient is receiving, including therapy. There never has been a requirement for a 30 day updated plan and recert for therapy, that was taken from the use of the 700/701 forms. CMS is looking at trying to standardize documentation across the board with acknowledgement of the different site regulations.<o:p></o:p> What we do kno= w we have to have for Part A is an evaluation and POT; daily documentation of the skilled services provided, the total time spent on treatment and the identification of the therapist who provid= ed of those services and any other relevant information for that day. <o= :p></o:p> Progress notes identifying the patient's progress towards the established goals, other informati= on such as objective measurement or tests done on the evaluation, and the therapist's assessment of progress made. <o:p></o:p> There are no Medicare instructions as to when these progress notes have to be writ= ten, it has become a standard of practice for weekly notes but your P&P should identify that one. <o:p></o:p> A recert (which was the use of the 701) was never required for Part A as that was a P= art B requirement. If you look at the current Part B requirements, the POT should be written for the length of time the therapist believes it wi= ll take to achieve the LTGs. (This should have been the way POTs were written for Part A patients all along.) So, if you write your POT for= the length of time to reach LTG, there is absolutely no reason to do a "recert" to update your plan of treatment. Justification for medical necessity should be in the progress notes. Also, there is no = need for a monthly progress note, defunct if the weekly is done as appropriate. <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle1.bg2 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Q&A: Mandated to have a percenta= ge of Part B patients on caseload in SNF<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Question:</s= pan><o:p></o:p><= /span> What is your opinion on a company mandate that states 20% of all eligible Part B patients in a long term care facility should be on therapy caseload a= t all times? Obviously I have issues with this. Also, how many times can you pick up the same person over and over again when the reason they have declined is because post therapy instructions have not been followed ( restorative not done, walk to dine/bathroom not done by nursing staff= ). It seems wrong to continue to pick people up for this reason, however they have a real decline so I am unsure of the "right" thin= g to do. Thank you so much for your services, those of us in the field must have some hard facts to back us up sometimes when we are asked to do things we know are not right.<o:p></o:p> Answer:</spa= n><o:p></o:p><= /span> My opinion is that you cannot mandate your residents to require therapy services on= a regulated schedule! Should there be patients on Part B, absolutely. C= an you have a mandated number, Absolutely NOT. In working out budget requirements, there are a number of patients that can be factored in,= but it depends on your patient mix.<o:p></o:p> To keep pick= ing patients up for therapy because the facility is not doing its job is = not what Medicare is for. To keep picking a patient up because of a decli= ne that could have been preventive through the facility doing what they = are getting paid for (maintaining or preventing decline) is Medicare Abuse and something that should certainly be identified during State Survey= .<o:p></o:p> As therapist= s, we know we can help, but the "person" who should be paying = for your services is the administrator. If there are no restorative progr= ams or any follow through by the facility, then the administrator can have the therapy department follow through, pay for those services and cou= nt as Restorative Nursing on the MDS.<o:p></o:p> You have to = be knowledgeable of Medicare compliance and to pick up patients who do n= ot meet their requirements can affect your license. If you pick a patien= t up who has used their cap up and use the KX modifier for billing those services, the facility opens itself up to accusation of abuse or maybe fraud on a Medical Review. <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle2.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · News Fr= om Medicare: <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Clarifying Con= fusion over Certification, Re- certification and POT review in ORFs and CORF= s<o:p></o:p></s= pan> With the implementation of the 90 day certification interval, there has been confusion between the regulations for "Conditions of Participati= on. Several of the MACS have been addressing the regulations for ORF (Reh= ab Agencies) and CORFs. As part of their Medicare certification and surv= ey process, the CORF must have the physician review the plan of treatment and re-certify need at 60 days, not the 90 allowed under the Part B r= egulations. <o:p></o:p> Under the regulations for ORF, "the plan of care and results of treatment = be reviewed by the physician OR by the individual who established the pl= an at least as often as the patient's condition requires, and the indica= ted action taken, which for Medicare patients being treated in rehabilita= tion agencies must be at least every 30 days." Therefore, documentati= on that the therapist has reviewed the plan and has made appropriate changes, according to patient response and the current plan is approp= riate should meet this requirement (progress reports!) and certification of= the plan will still proceed under the max 90 days guidelines for physician review and recert.<o:p></o:p> And how will Medicare know? You tell them right there on your bill. Did you know t= hat? On the UB-04, occurrence codes 29, 17 and 30 identify when the associ= ated plan (PT, OT or Speech) was last reviewed, and for CORF, occurrence c= ode 28 identifies the same thing. So, if for CORF, the date exceeds 60 da= ys from the initial treatment date, that's your red flag, for everyone e= lse, including ORF, that period should not exceed 90 days. <o:p></o:p></sp= an> President Obama issued an executive order to place a moratorium on any new regulations for Medicare as well as reviewing those that have passed in the last = six months. What actual effect that will have on Rehab is not sure at this time. <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle2.bg2 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Medicare Contracting Reform:<= /b><o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Finally CMS = has announced their final selections for the remaining A/B Macs. Interestingly enough there is only one NEW name added to this group. <o:p></o:p> Noridian Administrative Services, LLC (NAS) has been awarded a contract for the combined administration of Part A/Part B Medicare cl= aims payment in Jurisdiction 6 comprised of Illinois, Minnesota and Wiscon= sin. NAS is headquartered in Fargo, ND They also handle Jurisdiction 3, comprising of Arizona, Montana, North Dakota, South Dakota, Utah, and Wyoming<o:p></o:p> National Government Services (NGS) has been awarded a contract for the combined administration of Part A/Part B Medicare claims payment in Jurisdicti= on 8 comprised of Indiana and Michigan. NGS is headquartered in Indianapol= is, IN. NGS is also the MAC for Jurisdiction 13, consisting of Connecticut and New York.<o:p></o:p> Cahaba Government Benefit Administrators, LLC (Cahaba GBA) <= /span>has been awarded a contract for the combined administration of Part A/Part B Medicare cl= aims payment in Jurisdiction 10 comprised of Alabama, Georgia and Tennesse= e. Cahaba GBS is headquartered in Birmingham, AL. <o:p></o:p></sp= an> Palmetto Government Benefits Administrators, LLC (Palmetto GBA) </= b>has been awarded a contract for the combined administration of Part A/Part B Medicare cl= aims payment in Jurisdiction 11 comprised of North Carolina, South Carolin= a, Virginia and West Virginia. Palmetto GBA has its operational headquar= ters in Columbia, SC, with some operations performed in Columbus, OH. Palm= etto also has Jurisdiction 1 which consists of American Samoa, California, Guam, Hawaii, Nevada and Northern Mariana Islands.<o:p></o:p><= /span> Highmark Medicare Services (HMS) .has been awarded a contract for the combined administration of Part A/Part B Medicare claims payment in Jurisdicti= on 15 comprised of Kentucky and Ohio. HMS is headquartered in Camp Hill,= PA. HMS also was awarded Jurisdiction 12, Delaware, District of Columbia, Maryland, New Jersey and Pennsylvania.<o:p></o:p> With the finalization of the MAC awards, we will be dealing with a total of 10 MACS servicing the 15 jurisdictions. This should make life a little easier as now, we will only have 10 sets of LCDs to contend with.</sp= an> <o:p></o:p></= span> On the 6th of February, CMS announced the satisfaction of the contest of RAC awards= and therefore have lifted the moratorium on the RACS. The resolution has resulted in the original awards being maintained, but the two compani= es that challenged the awards obtained positions as subcontractors to the main RACs. <o:p></o:p> PRG-Schultz, Inc. will work with: <o:p></o:p> Region A: Diversified Collection Services, Inc (DCS) <o:p></o:p></sp= an> Region B: CGI Technologies and Solutions, Inc. (CGI) <o:p></o:p><= /p> Region D: HealthDataInsights, Inc. (HDI) <o:p></o:p> Viant Payment Systems, Inc. will work with: <o:p></o:p> Region C: Connolly Consulting Associates, Inc. <o:p></o:p><= /span> Each subcontractor has negotiated different responsibilities in each regio= n, including some claim review. <o:p></o:p> CMS is also = in the process of changing the Program Safeguard Contractors (PSC) to Zo= ne Program Integrity Contractors (ZPIC). What the difference in their ro= le will be, we are not sure as yet. Just be aware - BIG BROTHER will be watching. The latest figure for the $$ amount recouped by the demonstration RACs has inched up to almost 1 billion. These programs = have been extremely successful in identifying "errors" in billing and recouping Medicare Trust Fund dollars. <o:p></o:p></= span> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle3.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · Joining= with Summit Professional Education<o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> We are excited= to announced that we have finalized a relationship with Summit Pro= fessional Education to do a series of one day seminars on Medicare. This seminar provides a good overview of the Medicare program and will be = of interest for therapists in all provider sites. <o:p></o:p></sp= an> The course is called "Optimizing Reimbursement for Physical, Occupational and Speech Therapy Services". The first seminars will ro= le out in Pennsylvania and New Jersey. Summit schedules locations about = 6 to 8 weeks in advance, so I don't yet know if I will be coming to a place near you. I will post the locations on our website as I have them so = you can keep up to date. This will be a great Medicare 101 for new to Medicare therapists as well as a "bringing up to date"= ; for those who have been in the field for some time. CMS has changed, = make sure you do as well! <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <a name=3Darticle5.bg1 shape=3Drect><o:p> </o:p></= a> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;background:wh= ite; mso-yfti-tbllook:1184;mso-padding-alt:3.0pt 3.0pt 3.0pt 3.0pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt= '> · = Our Company<o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 3.0pt'> Direction on Demand is brought to you by Encompass Consulting & Education, LLC= . A therapist owned company specializing in Consulting and Educational services for therapists and other professionals providing Medicare se= rvices in SNF, Rehab Agencies, Private Practice, and Hospital Outpatient Facilities.<o:p></o:p> Pauline M. Franko, PT, MCSP is owner and president of the company and is also kn= own as the "Medicare Advisor" for the "Advance for" family of News Magazines.She acts as a resource for the respected Eli Reports and is on the editorial board of the "MDS Alert" and "Outpatient Physical Therapy Coding Alert".<s= pan style=3D'mso-bookmark:"article5\.bg1"'> <o:p></o:p></= span> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td valign=3Dtop style=3D'padding:3.0pt 3.0pt 3.0pt 7.5pt'></td> <td style=3D'padding:3.0pt 3.0pt 7.5pt 3.0pt'></td> </tr> <tr style=3D'mso-yfti-irow:3;mso-yfti-lastrow:yes'> <td colspan=3D2 valign=3Dbottom style=3D'background:#CC3366;padding:3= .0pt 3.0pt 3.0pt 3.0pt'></td> </tr> </table> <o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1;mso-yfti-lastrow:yes'> <td valign=3Dbottom style=3D'padding:0in 0in 0in 0in'> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellspacing=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:0in;mso-yfti-tbll= ook: 1184;mso-padding-alt:0in 0in 0in 0in'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td style=3D'background:#CC3366;padding:0in 0in 0in 0in'> <img border=3D0 width=3D1 height=3D1 id=3D"_x0000_i= 1029" src=3D"http://img.constantcontact.com/letters/images/spacer.gif" alt=3D"http://img.constantcontact.com/letters/images/spacer.gif"></sp= an><o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td style=3D'padding:7.5pt 0in 7.5pt 0in'> <div> :: <a href=3D"mailto:pmfranko@encompassmedicare.com" color=3D"#003366" shap= e=3Drect>pmfranko@encompassmedicare.com</a> <o:= p></o:p> </div> <div> :: <a href=3D"http://rs6.net/tn.jsp?et=3D1102456639311&e=3D001-6DCBKKVK= qW_s5DCM6zVSQz-KPTzAGPGIGL-jgbhm20_ARkmA-4l9sfPIx5Fc5kcQmBE_P-3yLWuYfoCXagr= yaibD_dLhgLnxoR2jxyBzFVKqoattRDGZQ=3D=3D" color=3D"#003366" shape=3Drect>http://w= ww.encompassmedicare.com</a> <o:p></o:p> </div> </td> </tr> <tr style=3D'mso-yfti-irow:2'> <td style=3D'background:#CC3366;padding:0in 0in 0in 0in'> <img border=3D0 width=3D1 height=3D1 id=3D"_x0000_i= 1028" src=3D"http://img.constantcontact.com/letters/images/spacer.gif" alt=3D"http://img.constantcontact.com/letters/images/spacer.gif"></sp= an><o:p></o:p></span= > </td> </tr> <tr style=3D'mso-yfti-irow:3'> <td style=3D'padding:7.5pt 0in 7.5pt 0in'></td> </tr> <tr style=3D'mso-yfti-irow:4;mso-yfti-lastrow:yes'> <td style=3D'background:#CC3366;padding:0in 0in 0in 0in'> <img border=3D0 width=3D1 height=3D1 id=3D"_x0000_i= 1027" src=3D"http://img.constantcontact.com/letters/images/spacer.gif" alt=3D"http://img.constantcontact.com/letters/images/spacer.gif"></sp= an><o:p></o:p></span= > </td> </tr> </table> </div> </td> </tr> </table> <o:p></o:p> </td> </tr> </table> </div> <o:p> </o:p> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D"100%" style=3D'width:100.0%;mso-cellspacing:1.5pt;background:white;mso-yfti-tbll= ook: 1184;mso-padding-alt:0in 5.4pt 0in 5.4pt' padding=3D0> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes;mso-yfti-lastrow:yes'> <td style=3D'padding:.75pt .75pt .75pt .75pt'> <div align=3Dcenter> <table class=3DMsoNormalTable border=3D0 cellpadding=3D0 width=3D595 style=3D'width:446.25pt;mso-cellspacing:1.5pt;background:white;mso-yfti-= tbllook: 1184;mso-padding-alt:0in 5.4pt 0in 5.4pt'> <tr style=3D'mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td colspan=3D2 style=3D'padding:.75pt .75pt .75pt .75pt'> <a href=3D"http://ui.constantcontact.com/sa/fwtf.jsp?m=3D1101399613904&= ;ea=3Dpmfranko%40encompassmedicare.com&a=3D1102456639311" target=3D"_blank">Forward email</a><o:p></o:p> </td> </tr> <tr style=3D'mso-yfti-irow:1'> <td style=3D'padding:.75pt .75pt .75pt .75pt'> <a href=3D"http://visitor.constantcontact.com/d.jsp?p=3Dun&v=3D001dLsZ= f5Cw4pNfqOqfZLL0WIuxCdqsguxNb_b3q0ul-Ye8gDcldSATbX690YNldhDF2d-lWFKCO4M%3D" target=3D"_blank"><img border=3D0 width=3D32 height=3D32 id=3D"= _x0000_i1026" src=3D"http://img.constantcontact.com/letters/images/safe_unsubscribe_l= ogo.gif" alt=3D"Safe Unsubscribe"></a><o:p>= </o:p> <div> This email was sent to <a href=3D"mailto:pmfranko@encompassmedicare.com">pmfranko@encompassmedica= re.com</a> by <a href=3D"mailto:pmfranko@encompassmedicare.com">pmfranko@encompass= medicare.com</a>.<o:p></o:p> </div> <div> <a href=3D"http://visitor.constantcontact.com/d.jsp?p=3Doo&v=3D001dLsZ= f5Cw4pNfqOqfZLL0WIuxCdqsguxNb_b3q0ul-Ye8gDcldSATbX690YNldhDF2d-lWFKCO4M%3D" target=3D"_blank">Update Profile/Email Address</a> | Instant removal wi= th <a href=3D"http://visitor.constantcontact.com/d.jsp?p=3Dun&v=3D001dLsZ= f5Cw4pNfqOqfZLL0WIuxCdqsguxNb_b3q0ul-Ye8gDcldSATbX690YNldhDF2d-lWFKCO4M%3D" target=3D"_blank">SafeUnsubscribe</a>™ | <a href=3D"http://ui.constantcontact.com/roving/CCPrivacyPolicy.jsp" target=3D"_blank">Privacy Policy</a>.<o:p></o:p> </div> </td> <td style=3D'padding:.75pt .75pt .75pt .75pt'></FooterContent><FooterLo= go > <div style=3D'word-wrap:normal'> <a href=3D"http://www.constantcontact.com/index.jsp?cc=3Dnews05" target=3D= "_blank">Email Marketing</a> by<o:p></o:p> </div> <a href=3D"http://www.constantcontact.com/index.jsp?cc=3Dnews05"><img border=3D0 width=3D32 height=3D32 id=3D"_x0000_i1025" src=3D"http://img.constantcontact.com/letters/images/cc-logo-color-sm.g= if" alt=3D"http://img.constantcontact.com/letters/images/cc-logo-color-sm.g= if"></a><o:p></o:p><= /p> </td> </tr> <tr style=3D'mso-yfti-irow:2;mso-yfti-lastrow:yes'> <td colspan=3D2 style=3D'padding:.75pt .75pt .75pt .75pt'> Encompass Consulting & Education, LLC | 8114 NW 100th Terrace | Tam= arac | FL | 33321-1259 <o:p></o:p> </td> </tr> </table> </div> </td> </tr> </table> <o:p> </o:p> </div> </body> </html> ------=_NextPart_01C991E2.A8D55740 Content-Location: file:///C:/52828239/Jan_Feb_09_files/themedata.thmx Content-Transfer-Encoding: base64 Content-Type: application/vnd.ms-officetheme UEsDBBQABgAIAAAAIQCCirwT+gAAABwCAAATAAAAW0NvbnRlbnRfVHlwZXNdLnhtbKyRy2rDMBBF 94X+g9C22HK6KKXYzqJJd30s0g8Y5LEtao+ENAnJ33fsuFC6CC10IxBizpl7Va6P46AOGJPzVOlV XmiFZH3jqKv0++4pu9cqMVADgyes9AmTXtfXV+XuFDApmaZU6Z45PBiTbI8jpNwHJHlpfRyB5Ro7 E8B+QIfmtijujPXESJzxxNB1+SoLRNegeoPILzCKx7Cg8Pv5DCSAmAtYq8czYVqi0hDC4CywRDAH an7oM9+2zmLj7X4UaT6DF9jNBDO/XGD1P+ov5wZb2A+stkfp4lx/xCH9LdtSay6Tc/7Uu5AuGC6X t7Rh5r+tPwEAAP//AwBQSwMEFAAGAAgAAAAhAKXWp+fAAAAANgEAAAsAAABfcmVscy8ucmVsc4SP z2rDMAyH74W9g9F9UdLDGCV2L6WQQy+jfQDhKH9oIhvbG+vbT8cGCrsIhKTv96k9/q6L+eGU5yAW mqoGw+JDP8to4XY9v3+CyYWkpyUIW3hwhqN727VfvFDRozzNMRulSLYwlRIPiNlPvFKuQmTRyRDS SkXbNGIkf6eRcV/XH5ieGeA2TNP1FlLXN2Cuj6jJ/7PDMMyeT8F/ryzlRQRuN5RMaeRioagv41O9 kKhlqtQe0LW4+db9AQAA//8DAFBLAwQUAAYACAAAACEAa3mWFoMAAACKAAAAHAAAAHRoZW1lL3Ro ZW1lL3RoZW1lTWFuYWdlci54bWwMzE0KwyAQQOF9oXeQ2TdjuyhFYrLLrrv2AEOcGkHHoNKf29fl 44M3zt8U1ZtLDVksnAcNimXNLoi38Hwspxuo2kgcxSxs4ccV5ul4GMm0jRPfSchzUX0j1ZCFrbXd INa1K9Uh7yzdXrkkaj2LR1fo0/cp4kXrKyYKAjj9AQAA//8DAFBLAwQUAAYACAAAACEAlrWt4pYG AABQGwAAFgAAAHRoZW1lL3RoZW1lL3RoZW1lMS54bWzsWU9v2zYUvw/YdyB0b2MndhoHdYrYsZst TRvEboceaYmW2FCiQNJJfRva44ABw7phhxXYbYdhW4EW2KX7NNk6bB3Qr7BHUpLFWF6SNtiKrT4k Evnj+/8eH6mr1+7HDB0SISlP2l79cs1DJPF5QJOw7d0e9i+teUgqnASY8YS0vSmR3rWN99+7itdV RGKCYH0i13Hbi5RK15eWpA/DWF7mKUlgbsxFjBW8inApEPgI6MZsablWW12KMU08lOAYyN4aj6lP 0FCT9DZy4j0Gr4mSesBnYqBJE2eFwQYHdY2QU9llAh1i1vaAT8CPhuS+8hDDUsFE26uZn7e0cXUJ r2eLmFqwtrSub37ZumxBcLBseIpwVDCt9xutK1sFfQNgah7X6/W6vXpBzwCw74OmVpYyzUZ/rd7J aZZA9nGedrfWrDVcfIn+ypzMrU6n02xlsliiBmQfG3P4tdpqY3PZwRuQxTfn8I3OZre76uANyOJX 5/D9K63Vhos3oIjR5GAOrR3a72fUC8iYs+1K+BrA12oZfIaCaCiiS7MY80QtirUY3+OiDwANZFjR BKlpSsbYhyju4ngkKNYM8DrBpRk75Mu5Ic0LSV/QVLW9D1MMGTGj9+r596+eP0XHD54dP/jp+OHD 4wc/WkLOqm2chOVVL7/97M/HH6M/nn7z8tEX1XhZxv/6wye//Px5NRDSZybOiy+f/PbsyYuvPv39 u0cV8E2BR2X4kMZEopvkCO3zGBQzVnElJyNxvhXDCNPyis0klDjBmksF/Z6KHPTNKWaZdxw5OsS1 4B0B5aMKeH1yzxF4EImJohWcd6LYAe5yzjpcVFphR/MqmXk4ScJq5mJSxu1jfFjFu4sTx7+9SQp1 Mw9LR/FuRBwx9xhOFA5JQhTSc/yAkArt7lLq2HWX+oJLPlboLkUdTCtNMqQjJ5pmi7ZpDH6ZVukM /nZss3sHdTir0nqLHLpIyArMKoQfEuaY8TqeKBxXkRzimJUNfgOrqErIwVT4ZVxPKvB0SBhHvYBI WbXmlgB9S07fwVCxKt2+y6axixSKHlTRvIE5LyO3+EE3wnFahR3QJCpjP5AHEKIY7XFVBd/lbobo d/ADTha6+w4ljrtPrwa3aeiINAsQPTMR2pdQqp0KHNPk78oxo1CPbQxcXDmGAvji68cVkfW2FuJN 2JOqMmH7RPldhDtZdLtcBPTtr7lbeJLsEQjz+Y3nXcl9V3K9/3zJXZTPZy20s9oKZVf3DbYpNi1y vLBDHlPGBmrKyA1pmmQJ+0TQh0G9zpwOSXFiSiN4zOq6gwsFNmuQ4OojqqJBhFNosOueJhLKjHQo UcolHOzMcCVtjYcmXdljYVMfGGw9kFjt8sAOr+jh/FxQkDG7TWgOnzmjFU3grMxWrmREQe3XYVbX Qp2ZW92IZkqdw61QGXw4rxoMFtaEBgRB2wJWXoXzuWYNBxPMSKDtbvfe3C3GCxfpIhnhgGQ+0nrP +6hunJTHirkJgNip8JE+5J1itRK3lib7BtzO4qQyu8YCdrn33sRLeQTPvKTz9kQ6sqScnCxBR22v 1VxuesjHadsbw5kWHuMUvC51z4dZCBdDvhI27E9NZpPlM2+2csXcJKjDNYW1+5zCTh1IhVRbWEY2 NMxUFgIs0Zys/MtNMOtFKWAj/TWkWFmDYPjXpAA7uq4l4zHxVdnZpRFtO/ualVI+UUQMouAIjdhE 7GNwvw5V0CegEq4mTEXQL3CPpq1tptzinCVd+fbK4Ow4ZmmEs3KrUzTPZAs3eVzIYN5K4oFulbIb 5c6vikn5C1KlHMb/M1X0fgI3BSuB9oAP17gCI52vbY8LFXGoQmlE/b6AxsHUDogWuIuFaQgquEw2 /wU51P9tzlkaJq3hwKf2aYgEhf1IRYKQPShLJvpOIVbP9i5LkmWETESVxJWpFXtEDgkb6hq4qvd2 D0UQ6qaaZGXA4E7Gn/ueZdAo1E1OOd+cGlLsvTYH/unOxyYzKOXWYdPQ5PYvRKzYVe16szzfe8uK 6IlZm9XIswKYlbaCVpb2rynCObdaW7HmNF5u5sKBF+c1hsGiIUrhvgfpP7D/UeEz+2VCb6hDvg+1 FcGHBk0Mwgai+pJtPJAukHZwBI2THbTBpElZ02atk7ZavllfcKdb8D1hbC3ZWfx9TmMXzZnLzsnF izR2ZmHH1nZsoanBsydTFIbG+UHGOMZ80ip/deKje+DoLbjfnzAlTTDBNyWBofUcmDyA5LcczdKN vwAAAP//AwBQSwMEFAAGAAgAAAAhAA3RkJ+2AAAAGwEAACcAAAB0aGVtZS90aGVtZS9fcmVscy90 aGVtZU1hbmFnZXIueG1sLnJlbHOEj00KwjAUhPeCdwhvb9O6EJEm3YjQrdQDhOQ1DTY/JFHs7Q2u LAguh2G+mWm7l53JE2My3jFoqhoIOumVcZrBbbjsjkBSFk6J2TtksGCCjm837RVnkUsoTSYkUigu MZhyDidKk5zQilT5gK44o49W5CKjpkHIu9BI93V9oPGbAXzFJL1iEHvVABmWUJr/s/04GolnLx8W Xf5RQXPZhQUoosbM4CObqkwEylu6usTfAAAA//8DAFBLAQItABQABgAIAAAAIQCCirwT+gAAABwC AAATAAAAAAAAAAAAAAAAAAAAAABbQ29udGVudF9UeXBlc10ueG1sUEsBAi0AFAAGAAgAAAAhAKXW p+fAAAAANgEAAAsAAAAAAAAAAAAAAAAAKwEAAF9yZWxzLy5yZWxzUEsBAi0AFAAGAAgAAAAhAGt5 lhaDAAAAigAAABwAAAAAAAAAAAAAAAAAFAIAAHRoZW1lL3RoZW1lL3RoZW1lTWFuYWdlci54bWxQ SwECLQAUAAYACAAAACEAlrWt4pYGAABQGwAAFgAAAAAAAAAAAAAAAADRAgAAdGhlbWUvdGhlbWUv dGhlbWUxLnhtbFBLAQItABQABgAIAAAAIQAN0ZCftgAAABsBAAAnAAAAAAAAAAAAAAAAAJsJAAB0 aGVtZS90aGVtZS9fcmVscy90aGVtZU1hbmFnZXIueG1sLnJlbHNQSwUGAAAAAAUABQBdAQAAlgoA AAAA ------=_NextPart_01C991E2.A8D55740 Content-Location: file:///C:/52828239/Jan_Feb_09_files/colorschememapping.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml <?xml version=3D"1.0" encoding=3D"UTF-8" standalone=3D"yes"?> <a:clrMap xmlns:a=3D"http://schemas.openxmlformats.org/drawingml/2006/main"= bg1=3D"lt1" tx1=3D"dk1" bg2=3D"lt2" tx2=3D"dk2" accent1=3D"accent1" accent= 2=3D"accent2" accent3=3D"accent3" accent4=3D"accent4" accent5=3D"accent5" a= ccent6=3D"accent6" hlink=3D"hlink" folHlink=3D"folHlink"/> ------=_NextPart_01C991E2.A8D55740 Content-Location: file:///C:/52828239/Jan_Feb_09_files/filelist.xml Content-Transfer-Encoding: quoted-printable Content-Type: text/xml; charset="utf-8" <xml xmlns:o=3D"urn:schemas-microsoft-com:office:office"> <o:MainFile HRef=3D"../Jan_Feb_09.htm"/> <o:File HRef=3D"themedata.thmx"/> <o:File HRef=3D"colorschememapping.xml"/> <o:File HRef=3D"filelist.xml"/> </xml> ------=_NextPart_01C991E2.A8D55740--