Medicine & Health articles from December 2008

Medicine & Health archives from December 2008

Providers prepare for changes as new administration takes office: Obama begins announcing appointments affecting Medicare.(People)
December 5, 2008... Come January, Medicare will have a whole new set of leaders influencing how providers are paid by the program. Obama and Daschle haven't yet announced a candidate for CMS Administrator, although Emory University professor Kenneth Thorpe,...

Baucus plan grabs healthcare industry's attention: 3-pronged plan addresses access, quality of care, and financing.(Policy)
December 5, 2008... U.S. Sen. Max Baueus (D-Mont.), chairman of the Senate Finance Committee, unveiled a whopping healthcare reform "blueprint" at a Nov. 12 press conference, which includes several ambitious proposals. In an 89-page document, Baucus outlines...

CMS amps up consumers' dialysis facility compare web site: FDA tells manufacturers to develop a medication guide for patients.(Quality of Care)
December 5, 2008... The Centers for Medicare & Medicaid Services announced on Nov. 20 new additions to the Dialysis Facility Compare consumer Web site found at www.medicare.gov/dialysis. The agency believes the improved Web site will give consumers even better...

CMS selects National Insurance Corporation as 10th MAC: New England states to transition by May 2009.(Claims Processing)
December 5, 2008... In its mission to convert its carriers and fiscal intermediaries to Part A/Part B Medicare Administrative Contractors, the Centers for Medicare & Medicaid Services has just named its 10th MAC contract. National Heritage Insurance Corporation...

CMS issues new OASIS-C form for HHAs: process measures, M0 item changes will mean big changes for agencies.(Home Health)
December 5, 2008... Home health providers are one step closer to seeing the majorly revamped assessment tool they'll start using in 2010. The Centers for Medicare & Medicaid Services has issued its latest version of the OASIS-C tool, and it contains the changes...

Visit reporting burden to get heavier for hospices: CMS wants to broaden data collection.(Hospice)
December 5, 2008... Hospice providers should brace for a lot more work to submit their claims. Although it will be a hassle, the data could provide the feds with a clearer picture of hospice care. At least in part in response to industry complaints, the...

HHS launches initiative to help seniors and veterans: department doles out $36 million in new grant programs.(Grants)
December 5, 2008... As the population of older Americans grows, so do the challenges posed by long-term care. The Department of Health and Human Services announced on Sept. 29 $36 million in new grant programs to 28 states to try and make a difference. Some $19...

Medicare CERTS run fine-toothed comb through 2008 payment errors: MA, Medicaid, SCHIP reviewed for the first time.(Payment)
December 5, 2008... Medicare continues to pay providers more accurately, according to a new comprehensive error rate testing report. The improper payment rate for Medicare fee-for-service providers dropped from 3.9 percent last year to 3.6 percent in 2008, the...

Medicare deductible no longer applies to 'Welcome to Medicare' exam.
December 5, 2008... As of Jan. 1, the Medicare deductible does not apply to the Welcome to Medicare exam, announced Amy Bassano, MA, with CMS in the presentation "'Medicare Physician Payment Schedule 2009 Changes and Beyond" at the CPT and RBRVS 2009 Annual...

CMS adds RVUs to immunization administration codes that reflect work preparing the vaccine.(In other news ...)
December 5, 2008... CMS had originally said that it would not pay for clinical staff time spent for vaccine administration quality assurance, noted Amy Bassano, MA, director of CMS hospital and ambulatory policy group in the presentation, "Medicare Physician...

CMS gears up for new rehab payment study.(In other news ...)
December 5, 2008... Just a few months back the Centers for Medicare & Medicaid Services launched a contract with Research Triangle Institute to carry out the "DOTPA" project (Developing Outpatient Therapy Payment Alternatives). But that's not the only therapy...

OIG nursing home guidance outlines hospice risks.(In other news ...)
December 5, 2008... Hospices shouldn't have to do all the heavy lifting when it comes to compliance for patients in nursing homes, according to recent guidance. The HHS Office of Inspector General has issued its new voluntary supplemental compliance program...

CMS releases new SNP guidelines.(In other news ...)
December 5, 2008... The number of a facility's patients covered by Medicare Advantage Special Need Plans may go down due to new SNP guidelines from CMS. "Special needs plans are a type of Medicare Advantage plan that serve only beneficiaries living in...

Part B credentialing says goodbye to 2+ year credentialing period: CMS will institute 30-day billing window as of Jan. 1.(Reimbursement)
December 19, 2008... Part B providers are about to lose 26 months of billing privileges, effective Jan. 1. According to the 2009 Medicare Physician Fee Schedule Final Rule, providers will be able to retroactively bill Medicare for services their physician renders...

New York County ensures equal access to persons with physical disabilities: HHS helps create local plan.(ADA)
December 19, 2008... Persons with physical disabilities will have better access to existing social service buildings in Schenectady, N.Y., according to a voluntary agreement between the Department of Health and Human Services and the Schenectady County Department...

Medicare proposes revised policy for bariatric surgery: plan would approve procedure as treatment for some diabetic patients.(Policy)
December 19, 2008... The Centers for Medicare & Medicaid Services proposes to clarify its policies for Medicare coverage of bariatric surgery as a treatment for beneficiaries with type 2 (or non-insulin-dependent) diabetes, a CMS press release stated. ...

CMS issues final rule for redesigning Medicaid: states will have more flexibility in tailoring benefits.(Medicaid)
December 19, 2008... The Centers for Medicare & Medicaid Services will be giving states unprecedented flexibility in designing their own Medicaid programs, including adjusting their benefit package to more closely align with beneficiary needs. The announcement came...

Medicare expands Internet-based enrollment: option now available in 24 states and D.C.(PECOS)
December 19, 2008... Physicians and non-physician practitioners have an easier way to update their Medicare enrollment information, thanks to a new Internet-based system, a CMS statement says. The Provider Enrollment, Chain and Ownership System allows providers to...

Obama taps Daschle to fix U.S. healthcare: the former senator advocates mandatory insurance and a federal health board.(People)
December 19, 2008... Former Sen. Tom Daschle is poised to join President-elect Barack Obama's cabinet as secretary of Health and Human Services--and appears to be the point man for Obama's effort to overhaul U.S. health care. Obama announced Daschle's nomination...

Medicare looks to extend 'never event' payment withholding to physicians: the federal insurer inches toward a pay-for-performance model.(Incentives)
December 19, 2008... Surgical errors can cost patients their lives and well-being--and deprive hospitals of thousands of Medicare dollars. But in many cases, Medicare will still pay physicians when they perform the wrong procedure or operate on the wrong body part...

CMS halts pay for IDET, other thermal intradiscal procedures: new NCD confirms that no Medicare carrier will reimburse for these procedures.(Coverage Policy)
December 19, 2008... Providers who were counting on 2009 to be the year when CMS brought good news to cure their thermal intradiscal procedure payment woes will be let down. They should pin their hopes on 2010--or later. Earlier this year, CMS initiated a...

New York payer blames technical difficulties for denials.
December 19, 2008... For New York providers that have received a few inexplicable denials from their payers, the problem might be due to their carrier's computer software and not coding errors. On Dec. 10, National Government Services, a Medicare Part B payer...

More professionals exempt from DME accreditation.(In other news ...)(durable medical equipment)(Brief article)
December 19, 2008... CMS has added more people to the list of professionals who are exempt from the durable medical equipment accreditation requirements that take place Sept. 30, 2009. Orthotists, prosthetists, opticians, and audiologists are now on the exempt...

Suppliers in high-risk states get lump of OIG coal.(In other news ...)
December 19, 2008... Suppliers shouldn't expect fraud and abuse scrutiny to let up after the HHS Office of Inspector General's latest report to Congress. In its December semiannual report to Congress, the OIG includes a laundry list of durable medical equipment...