March 10, 2012

CMS Dropped a Bombshell at the MDS Conference

News

I returned from the CMS conference in St Louis with my head spinning as did most of the other conference attendees that I spoke with there. John Kane dropped the bombshell which took everyone some time to absorb. He focused on the changes occurring April 1st with the announcement of defined policies which he later said had always been in place but were now being emphasized. So what are these changes? Well they relate to combining scheduled and unscheduled assessments, consequences of early and late unscheduled assessments and inactivating assessments. …
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February 17, 2012

Congress Passes Legislation to Prevent Payment Cuts

News

Congress passed legislation to prevent the Medicare payment cuts. The next step will be for the bill to go to the President for signature. This, I’m sure he will do with pleasure as it is attached to the bill renewing the payroll tax cuts and the jobless benefits. The whole bill is expected to cost $143 billion. See our previous post for more details of the Medicare changes.

Congress Making Deal to Forestall Medicare Cuts

News

Late yesterday the Congressional Conference Committee released the details of a deal that would prevent the 27.4% payment cut to Medicare providers scheduled to take place on March 1. The Geographic Practice Cost Index (GPCI) will be maintained at the current level along with an extension of the therapy cap exceptions process till the end of the year. However there are a few provisions included with this extension. a) Continues consistent use of the KX modifier when the cap ($1880 for 2012) is met provided the patient continues to meet …
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February 16, 2012

HHS to Delay Implimentation of ICD-10

News

HHS has now indicated that it is ready to look at postponing the implimentation od the ICD-10 system in October next year. To learn more visit the ICD Monitor through this link

February 15, 2012

CMS Issues Proposed Rule for Reporting and Returning of Overpayments

News

On Tue Feb 14, CMS proposed that providers and suppliers must “report and return self-identified overpayments either within 60 days of the incorrect payment being identified or on the date when a corresponding cost report is due, whichever is later.” The new announcement is one in a series of steps Medicare is taking to protect taxpayer dollars, including efforts to prevent overpayments from occurring. These efforts include letting private auditors working on behalf of Medicare catch wasteful spending before it happens,by expanding the use of Recovery Audit Contractors; testing changes …
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January 20, 2012

Our Seminars For 2012

News

We have changed how we will be presenting our live seminars for 2012 by scheduling both our SNF and Outpatient Part B seminars over the same weekend. This will help in keeping our registration price down for these presentations. We will be presenting Mastering Medicare: A Practical Guide To Succeeding Under RUG IV on a Friday; the Anatomy of Documentation, which was the second day of last year’s Mastering Medicare, will be scheduled on the Saturday with Tests, Measures & Questionnaires following on Sunday. This change in format will allow …
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January 6, 2012

Legislation Passed to Prevent Caps and Cuts Until February 29, 2012

News

It was the night before Christmas and all through the House (and Senate) members of Congress wanted to get home and so they did what Congress has been doing for the last 5 years (other than in 2010) and passed a stop-gap measure to prevent the reduction in the PFS of almost 28% and to extend the exception process until February 20th 2012. (Actually, it was not really the night before Christmas but almost.) Talk about déjà vue all over again. Both houses had already passed legislation to address the …
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September 4, 2011

CMS publishes the updates to the RAI Manual

News

This week CMS published the updates to the Minimum Data Set (MDS) 3.0 Resident Assessment Instrument (RAI) manual for skilled nursing facilities (SNFs). These updates will be effective October 1st, 2012. The manual contains both the updated version files (new for 2012) and earlier version (no change) files. Change-table files are included only for sections of the manual that have changes that will be effective October 1. Sections that have been updated include: Title Page, Table of Contents, Chapter 1, Chapter 2, Chapter 3 (Introduction, Sections: C, H, I, K, …
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July 30, 2011

CMS Issues SNF Final Rule

News

CMS issued its Final Rule yesterday with an 11.1% reduction in overall payments. All of the other proposals of the Interim Rule were kept. We will review the posted rule and provide additional specific information. We will be including training on the new assessments as well as the updates to group, set-up time and the assessment windows in our upcoming Mastering Medicare series. Don’t wait, places are limited.

July 17, 2011

OIG Warns CMS About Changes In SNF Billing In FY2011

What's New SNF

OIG warns CMS about the escalating cost of SNF services occurring with MDS3.0 and RUG IV.
Encourages CMS to impliment changes to group therapy, assessment windows and recalculating payment level when beneficairy needs change.
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