Articles and Blogs

reimbursement

Important Information Regarding Medicare Claims and Payments for Part A Indiana and Michigan Providers

[07/10/12]

Posted on July 10, 2012 in Health Law News

Published by: Hall Render

National Government Services, Inc. (NGS) recently announced important information regarding Medicare claims and payments for Part A Indiana and Michigan providers.  With the impending transition of these providers to Wisconsin Physician Services (WPS), NGS posted the following transition timeline: National Government Services Transition Timeline Date Activity July 19, 2012 {5:00 p.m. ET} National Government... READ MORE

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OIG Report Finds Extensive Misuse of Antipsychotics in Nursing Facilities

[07/09/12]

Posted on July 9, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Office of Inspector General (OIG) released a report this morning detailing issues found in the use of antipsychotics in nursing facilities.  Utilizing a sample of records from January through June of 2007, the OIG found over 99% of records reviewed failed to meet one or more Federal requirements.   READ MORE

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CMS Proposes Changes to GME Rules in 2013 IPPS Proposed Rule

[05/29/12]

Posted on May 29, 2012 in Health Law News

Published by: Hall Render

On May 11, 2012, the Centers for Medicare and Medicaid Services (“CMS”) issued the 2013 Inpatient Prospective Payment System (“IPPS”) Proposed Rule.  In the IPPS Proposed Rule, CMS proposed to change the rules for: Calculating new teaching hospital full-time equivalent cap (“FTE cap”) by moving from a 3-year window to a 5-year window; What... READ MORE

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Nursing Facility Antipsychotic Legislation Fails to Clear Senate

[05/29/12]

Posted on May 29, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

Last Thursday, a proposed regulation aimed at curbing the high levels of “off-label” uses for antipsychotic medications failed to pass the Senate.  This proposed legislation relates back to a report last November by Daniel R. Levinson, the U.S. Inspector General, that exposed the high levels of antipsychotic medications administered to nursing facility residents.  That report stated a... READ MORE

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WPS Message for Indiana and Michigan Providers

[05/11/12]

Posted on May 11, 2012 in Health Law News

Published by: Hall Render

Wisconsin Physicians Service (WPS) will soon begin to serve as the Medicare Administrative Contractor (MAC) for Jurisdiction 8, which includes the states of Indiana and Michigan.  According to listserve communications, Indiana Part A providers and Michigan Part A providers will transition to WPS effective July 23, 2012.  Indiana Part B suppliers will transition to... READ MORE

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CMS Implements “Community First Choice” Medicaid State Plan Option

[05/10/12]

Posted on May 10, 2012 in Health Law News

Published by: Hall Render

This installment of Hall Render’s Health Law Broadcast series on health care reform is designed to provide you with the insight, analysis and practical suggestions with respect to the various reform initiatives that will affect your organization. On May 7, 2012, the Centers for Medicare and Medicaid Services (“CMS”) published a final rule (“Final... READ MORE

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DSH Data Now Available – CMS Webinar May 8 on Data Use Agreement Requirements

[05/07/12]

Posted on May 7, 2012 in Health Law News

Published by: Hall Render

Disproportionate Share Hospital (DSH) Routine Use Data is now available through CMS.  In our Update indicating new SSI Ratios for Medicare DSH were published on March 16, 2012 for Fiscal Years (FYs) 2006 – 2009, we recommended that Hospitals obtain their DSH Routine Use Data in order to have the underlying data used by... READ MORE

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RAC Error Impacting Illinois, Indiana, Michigan, and Wisconsin Part A Providers

[04/27/12]

Posted on April 27, 2012 in Health Law News

Published by: Hall Render

On April 26, 2012, Corporate Communications at National Government Services, Inc. issued the following statement: “Recently, the Region B Medicare Recovery Audit Contractor (RAC), CGI Federal, announced that ‘Based on a technical error discovered, CGI finds the Rituximab edit, an automated take back, was disallowed in error. Therefore, CGI reverses the original decision on... READ MORE

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First in Series on Medicare DSH and Top Cost Report Appeal Issues

[04/10/12]

Posted on April 10, 2012 in Health Law News

Published by: Hall Render

On March 16, 2012, CMS published the long-awaited Supplemental Security Income (SSI) ratios used in computing Medicare Disproportionate Share Hospital (DSH) payments for Federal Fiscal Years (FFYs) 2006, 2007, 2008 and 2009. This should finally end the cost report settlement moratorium implemented by CMS in July 2008 and lead to a flood of Notices... READ MORE

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MedPAC Recommends Significant SNF Reimbursement Changes

[01/13/12]

Posted on January 13, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Medicare Payment Advisory Commission (MedPAC) voted on Wednesday of this week to recommend to Congress a significant change in the way skilled nursing facilities (SNFs) are reimbursed under the Medicare program within the next two years.  READ MORE

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