February 2010: In November 2009, the Centers for Medicare and Medicaid Services (CMS) announced changes to Medicare’s 2010 home health prospective payment system rates and modifications to the home health outlier policy. The rule became effective January 1, 2010. In recent years, CMS has become more attuned to the growth…
On February 5, 2010 the Centers for Medicare and Medicaid Services (CMS) rescinded Change Request(CR) 6375, Transmittal 1873, dated December 11, 2009. The rescinded CR contained instructions regarding place of service (POS) and date of service (DOS) for the professional component (i.e. interpretation) and technical component of diagnostic tests. The…
On January 28, 2010, the Centers for Medicare and Medicaid Services (CMS) announced modified additional documentation request limits for institutional providers for the RAC program in FY 2010. The limits will be annually set by each RAC in accordance with this CMS guidance to create a per campus cap on…
On January 27, 2010, leaders of the American Dental Association (ADA), American Medical Association (AMA), American Osteopathic Association (AOA), and the American Veterinary Medical Association (AVMA) sent a letter to the Federal Trade Commission (FTC) Chairman Jon Leibovitz requesting that health professionals be excluded from the “Red Flags” Rule, a…
The RAC for Region D, HealthDataInsights (HDI), recently approved “anesthesia care package” and evaluation and management services for RAC review. Specifically, HDI stated: Under NCCI Edit rules, the anesthesia care package consists of preoperative evaluation, standard preparation and monitoring services, administration of anesthesia, and post-anesthesia recovery care. Anesthesia CPT codes…
The U.S. District Court for the Southern District of Florida dismissed a lawsuit filed by the American College of Cardiology (ACC) against the Department of Health and Human Services (DHHS). The suit was based on the DHHS’s cuts to Medicare reimbursements for cardiology services. The ACC requested the court to…
On January 13, the Department of Health and Human Services’ Office of Inspector General (OIG) issued a special fraud alert to remind durable medical equipment (DME) suppliers that unsolicited telephone calls to Medicare beneficiaries are prohibited by federal law. The fraud alert referred specifically to instances in which independent marketing…