Question: How do you spell “rural regulatory relief?" Answer: By providing a permanent extension of the enforcement instruction on unreasonable supervision requirements for outpatient therapeutic services in critical access and small rural hospitals. In what some are seeing as a wrong being addressed – if not finally righted – and at perhaps one of the most vulnerable times for healthcare in rural America in history, with nearly 30 percent of the country's …Read more
In a recent article, I quoted Dave Mason to illustrate the point that it can be reasonable to question authority. At times, however, people make unreasonable challenges. An irrational employee is not only a huge frustration; they also present a major compliance risk. Many qui tam lawsuits being with an employee who mistakenly believe you are breaking the law but won’t listen to reason. While it is true that in most cases …Read more
Some loyal RACmonitor readers may recall that way back in November of 2014, I wrote a RACmonitor article entitled It’s All About the Money – When is a Doctor Not a Doctor?, about Medicare Advantage (MA) plans contracting with firms to send physicians and non-physician practitioners out to the homes of their enrollees to take a history and perform a physical examination in order to get documentation of medical conditions. …Read more
The OPPS (Outpatient Prospective Payment System) update Federal Register appeared in examination form on July 7, 2016. Section X.A., Implementation of Section 603 of the Bipartisan Budget Act of 2015 Relating to Payment for Certain Items and Services furnished by Certain Off-Campus Departments of a Prover, addresses what The Centers for Medicare & Medicaid Services (CMS) believes Congress intended. Note...Read more
I was giving a presentation recently on the Comprehensive Error Rate Testing Program, or CERT. This is a study conducted annually by the Centers for Medicare & Medicaid Services (CMS) that, in effect, measures the error rate found for claims that have been previously approved and paid by Medicare. For 2015, the CERT study reported on the findings of reviews for...Read more
EDITOR’S NOTE: Last Wednesday, CMS Acting Administrator Andy Slavitt told members of the U.S. Senate Finance Committee that his agency might delay the implementation of MACRA scheduled to rollout January 1, 2017. It is wheat harvest time in Rural America—a time when the amber waves of grain come full circle, when one hopes that the last several months of careful planting and...Read more
Andrew Wachler, Esq. Steven Greenspan, JD, LLM With hopes that the Centers for Medicare & Medicaid Services (CMS) might reopen the 68-percent settlement solution it once offered providers to expedite the appeal process, RACmonitor is producing a special-edition broadcast on the topic scheduled to air live at noon ET on Tuesday, Aug. 9. The 60-minute, live “town hall” broadcast is being sponsored by...Read more
The data collection requirements for inpatient rehabilitation facilities (IRFs) continue to grow and there is NO relief in sight. This webcast will demonstrate and how potential opportunities could reduce the burden of this data collection.
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