Medicare & Insurance

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Physical therapy is one of several health care professions that stands to lose clients to physician-owned businesses because of loopholes in the Stark laws. A recent Journal of the American Medical Association evaluates the few options for closing these loopholes, including blunt legislative action.
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The Senate recently approved the IMPACT Act; legislation intended to improve post-acute care for Medicare beneficiaries while paving the way for more accountable, quality-driven benefits to patients.
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Legislators sent a bipartisan, bicameral letter to the Centers for Medicare and Medicaid Services (CMS) requesting that it provide an explanation regarding recent policy changes impacting many Americans living with neurological and degenerative disabilities.
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According to a Medicare risk compliance web-based survey launched by Clinicient, 64% of its respondents are at significant risk for Medicare regulatory noncompliance and consequential cash flow issues, denied claims, Medicare fines, and higher overhead costs for audit preparation and response.
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The Centers for Medicare and Medicaid Services (CMS) recently issued final 2015 rules for prospective payment systems for long-term care and acute care hospitals.
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SI-BONE Inc, a medical device company that offers the iFuse Implant System designed for fusion of the sacrolliac (SI) joint, reports that it has been provided positive coverage for its MIS SI joint fusion procedure, thanks to a policy update published by Priority Health (Michigan).
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An APTA news release reports that recent rules proposed by the Centers for Medicare and Services (CMS) include a 2.1% increase in payment rates for 2015 under the outpatient prospective payment system (OPPS) and changes to hospital admissions requirements.
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Newly introduced legislation aims to expand telehealth services under Medicare, including telehealth coverage for healthcare professionals such as speech language therapists, occupational therapists, physical therapists, and audiologists.
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In a recent congressional report, the Senate Special Committee on Aging assesses the Centers for Medicare and Medicaid Service's (CMS) attempts to curb improper payments.
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Comments submitted by AMRPA to CMS voice concern regarding changes in its proposed FY 2015 rule for the inpatient rehabilitation facility prospective payment system (IRF PPS), which it says could potentially limit patient access to key rehabilitation services provided in an inpatient rehabilitation hospital and unit.
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The National Transitions of Care Coalition (NTOCC) recently announced its support for Medicare Transitional Care Act of 2014, legislation designed to improve transitions of care for the Medicare beneficiaries at the highest risk for readmission during their transition from a hospital setting to their home, skilled nursing facility, or next point of care.
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A statement released by American Medical Rehabilitation Providers Association (AMRPA) chairman Bruce M. Gans, MD, responds to the MedPAC June Report to Congress, and its recommendation to implement a site-neutral Medicare payment policy for certain conditions treated in inpatient rehabilitation hospitals, units, and skilled nursing facilities.
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The APTA reports that CMS has implemented a variety of fixes intended to decrease the number of rejects in the processing of functional limitation reporting (FLR) claims.
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Kathleen Sebelius, Health and Human Services (HHS) secretary, recently announced the release of new, privacy-protected data regarding services and procedures provided to Medicare beneficiaries by physicians and other healthcare professionals in 2012; included in the dataset were service locations such as military treatment facilities, comprehensive inpatient rehabilitation, and skilled nursing facilities.
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The Coalition for ICD-10, an alliance of hospitals, health plans, professional associations, coding experts, and vendors, recently requested the US Department of Health and Human Services (HHS) to establish October 1, 2015 as the new ICD-10 date.
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The AAC Institute is asking for support to urge the White House, Congress, and Centers for Medicare and Medicaid Services (CMS) to exempt Speech Generating Devices (SGDs) from all rental requirements and remove SGDs from the capped rental rule that takes effect April 1.
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According to the American Physical Therapy Association (APTA), new rules proposed under the Affordable Care Act (ACA) on March 14 include changes to provider network requirements that may help increase the number and variety of facilities, as well as specialists provided by policies in the federally managed exchanges.
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Legislation designed to reinforce the repeal of Medicare’s sustainable growth rate (SGR) and other enhancements in healthcare delivery has reportedly gained backing from the American Medical Association (AMA).