WASHINGTON, D.C. (June 23, 2016)—CMS released a final rule implementing Section 216(a) of the Protecting Access to Medicare Act of 2014 (PAMA), requiring laboratories performing clinical diagnostic laboratory tests to report the amounts paid by private insurers for laboratory tests. Medicare will use these private insurer rates to calculate Medicare payment rates for laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS) beginning January 1, 2018.
reimbursement
WASHINGTON, D.C. (May 4, 2016)—U.S. Senators Johnny Isakson, R-Ga., Lamar Alexander, R-Tenn., Mark Warner, D-Va., and Sherrod Brown, D-Ohio, introduced bipartisan, budget-neutral legislation last week to ensure hospitals are fairly reimbursed for their services by the federal government so they are able to remain open and functioning, especially in underserved and economically struggling regions.
WASHINGTON, D.C. (April 28, 2016)—On April 21, CMS issued a proposed rule [CMS-1645-P] outlining proposed Fiscal Year (FY) 2017 Medicare payment rates and quality programs for skilled nursing facilities (SNFs). The FY 2017 proposals and other issues discussed in the proposed rule are summarized below.
LENEXA, Kan. (April 26, 2016)—Mediware Information Systems, Inc. is hosting a free webinar for attendees on Tuesday, May 24, 2016, at 1:00 Central, 2:00 EST, to outline how HME providers can grow their collections despite the tightened margins of the industry. The webinar is entitled “Five Steps to Surviving HME Reimbursement Challenges in 2016.”
WASHINGTON, D.C. (April 7, 2016)—Recently, the American Association of Respiratory Care, the American College of Chest Physicians and the National Association for Medical Direction of Respiratory Care submitted a reconsideration of the current Medicare National Coverage Determination for home ventilators, including bi-level devices to CMS.
AMSTERDAM (March 4, 2016)—Philips Respironics, a business of Royal Philips, announced it received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for Care Orchestrator, its cloud-based clinical management software application.
CMS Tightens Screws on Home Health Fraud
The Centers for Medicare & Medicaid Services (CMS) is making strides to crack down on home health fraud through data use and more site visits, the agency announced Monday. (Kourtney Liepelt/Home Health Care News)
WASHINGTON, D.C. (January 4, 2016)—CMS Tuesday issued a final rule, “Medicare Program: Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies,” that would establish a prior authorization process for certain DMEPOS items that they cite as frequently subject to unnecessary utilization.
WASHINGTON, D.C. (December 23, 2015)—The initial HME Audit Key test survey from earlier this year tracked audits received from October 2014 through June 2015. One of the preliminary findings was suppliers appealed 80 percent of MAC prepayment denials for respiratory products, and 92 percent were overturned. While based on a small test pool of participants, other findings from the survey indicate that:
RJ Industries, makers of Freedom Ramp Modular Aluminum ADA Access Systems, announced the introduction of their SureSight low light marker system option available on all their 36-inch, 43-inch and 60-inch ramp systems and railings.