AffloVest

WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) has scheduled a National Provider Call for 1:30-3 p.m. (EST) Tuesday with subject matter experts on Medicare’s Shared Savings Program and the Advanced Payment Model for physician-led and rural Accountable Care Organizations. The call is for Medicare fee-for-service providers, and registration closes at noon Tuesday or when available space is filled.

WASHINGTON, July 12, 2012—A 10-page letter from the Government Accountability Office’s (GAO) general counsel to the Department of Health and Human Services said the Centers for Medicare & Medicaid Services (CMS) failed to legally establish an $8 billion Medicare Advantage Quality Bonus Payment Demonstration, and it should be terminated.

WASHINGTON, July 6, 2012—The Centers for Medicare & Medicaid Services (CMS) has proposed cutting payments to home health care companies next year by 0.1 percent, or about $20 million. The proposed cuts are based upon the underlying cost of health care and adjustments required by the Patient Protection and Affordable Care Act of 2010. www.cms.gov

WASHINGTON, July 6, 2012—The federal Department of Health and Human Services (HHS) announced that 89 new Accountable Care Organizations (ACOs) on July 1 began serving 1.2 million people with Medicare in 40 states and Washington.

ACOs are organizations formed by groups of doctors and other health care providers that have agreed to work together to coordinate care for people with Medicare. They share savings generated by the efficient management of patients.

WASHINGTON, July 6, 2012—In a letter to the Senate Finance Committee, the American Association for Homecare recommended that the Centers for Medicare & Medicaid Services (CMS) refocus its strategy for fighting fraud.

WASHINGTON, July 5, 2012—The Centers for Medicare & Medicaid Services (CMS) has published a proposed rule that sets criteria for items that would require a face-to-face encounter as a condition of payment. The section on the face-to-face requirement starts on page 249 of the proposed rule.

WASHINGTON, June 22, 2012—The Centers for Medicare & Medicaid Services (CMS) has scheduled a public meeting for July 23 to discuss adjustments in Medicare payments for non-mail order diabetes supplies through a controversial “inherent reasonableness” process.

WASHINGTON, June 21, 2012—An HME industry working group has asked the Centers for Medicare & Medicaid Services (CMS) to add practical guidelines for making claims on surety bonds. At issue is a recent decision by CMS to start making unannounced claims on surety bonds to collect relatively small overpayments from providers.

WASHINGTON, June 20, 2012—The Centers for Medicare & Medicaid Services (CMS) issued a reminder last week that the enforcement discretionary period for upgrading to Version 5010 ends Sunday, July 1. Originally, all HIPAA-covered entities doing business with CMS were required to upgrade to Version 5010 by Jan. 1, but CMS provided additional time to meet full compliance with transaction standards for ASC X12 Version 5010 and NCPDP Versions D.0 and 3.0. www.cms.gov.

WASHINGTON, June 11, 2012—The Centers for Medicare & Medicaid Services (CMS) has issued a final decision memo stating that it will discontinue most coverage of TENS (transcutaneous electrical nerve stimulation) devices for the treatment of chronic lower back pain.

WASHINGTON, D.C., June 6, 2012—The Centers for Medicare & Medicaid Services (CMS) has scheduled a special open door forum for 2 p.m. ET Thursday, June 28, to allow providers to hear information and ask questions about Medicare’s Prior Authorization for Power Mobility Devices Demonstration. To participate by phone, call 866-501-5502 (toll-free) and enter conference ID: 61960445.

WASHINGTON, D.C., June 1, 2012—The Centers for Medicare & Medicaid Services (CMS) will release a national provider comparative billing report (CBR) on June 26 addressing home oxygen services. CBRs produced by SafeGuard Services, under contract with CMS, compare supplier billing and payment patterns to peers located in individual states and nationwide.

WASHINGTON, D.C., June 4, 2102—The Centers for Medicare & Medicaid Services is offering regional webinars on Version 5010 for health care providers, clearinghouses, vendors and others on June 20.  Health care organizations that submit transactions electronically are required to upgrade from Version 4010/4010A to Version 5010 transaction standards. Organizations were required to use Version 5010 starting Jan.

Jonathan Blum, deputy administrator and director of the Centers for Medicare & Medicaid Services (CMS) visited Potosi, Mo., on May 21 to discuss problems related to providing HME goods and services through competitive bidding in rural Washington County.

The Centers for Medicare & Medicare Services (CMS) last Tuesday published in the Federal Register a request for comments on the power mobility devices prior authorization demonstration project. The 30-day public comment period is open through June 28. The American Association for Homecare noted that the project is likely to start after Aug. 1 since CMS intends to notify providers at least 30 days prior to beginning the demonstration.

The American Association for Homecare last week submitted comments to the Center for Medicare & Medicaid Services recommending a one-year delay in the implementation of the ICD-10 code set.

AAHomecare also recommended that CMS:
• Continue the policy of allowing providers to use information in their records to migrate to a more specific ICD-10 code if the information supports use of that code.

The American Association for Homecare expressed “grave concern” last week to the Center for Medicare & Medicaid Services (CMS) over new product categories devised for the Competitive Bidding Program’s Round 1 Recompete.

A report last week on Medicare Advantage plans criticized the Centers for Medicare & Medicaid Service (CMS) for improperly offsetting some cuts to the plans.

At issue is a provision in health care reform that was supposed to cut excessive Medicare Advantage payments by $68 billion by 2017, but the Government Accountability Office report noted that CMS has used a demonstration project to pay these plans $8.35 billion in bonuses to offset cuts.

Medicare officials last week backed off a proposal that would have required long-term care facilities to hire consultant pharmacists to review medications prescribed to residents.

Community Health Accreditation Program (CHAP) announced March 23 continued approval of its home health accreditation program by the Centers for Medicare & Medicaid Services (CMS) for six years. This recognizes CHAP’s program as a national accreditation program for home health agencies seeking to participate in the Medicare or Medicaid programs. CHAP was originally granted deeming authority by the CMS in 1992 for home health.

The Centers for Medicare & Medicaid Services has scheduled an open door forum from 3-4:30 p.m. ET Wednesday, March 21, on the prior authorization for power mobility devices demonstration.

The demonstration is scheduled for seven states: California, Florida, Illinois, Michigan, New York, North Carolina and Texas. The controversial program was canceled late in 2011, and then rescheduled for 2012 with significant changes.