Providers rip huge backlog of therapy claims reviews
By
James M. Berklan
Jan 01, 2014
A provider-sponsored survey recently uncovered huge backlogs of therapy claim reviews for beneficiaries who exceeded the Medicare Part B caps limits.
‘Doc fix’ bill calls attention to need for therapy fix, NASL leader says
By
Tim Mullaney
Jul 29, 2013
Provider groups are urging lawmakers to address outpatient therapy payments in addition to fixes to Medicare’s physician payment system, according to Cynthia Morton, executive vice president of the...
The G-codes are here for payment claims — ready or not
By
Shelly Mesure, MS, OTR/L
May 23, 2013
Effective July 1, the Centers for Medicare & Medicaid Services will begin rejecting claims received for Medicare Part B patients that do not include the new requirement of G-coding. That really means providers...
Medically Complex Medicare Part B
By
Shelly Mesure, MS, OTR/L
May 08, 2013
While CMS tries to figure out how to proceed with the manual medical review process, we continue to track our caps and apply our modifiers. In the meantime, has anyone noticed how our typical Medicare...
Upon further review
By
Kimberly Marselas
Feb 02, 2013
Instead of spending more time doing hands-on patient care, therapists who work with Medicare beneficiaries have been strapped with increased administrative tasks, sometimes leading to delayed services,...
AHCA gears up for annual therapy caps fight, pushes to reform therapy rule
Oct 13, 2010
As the end of the year approaches, long-term care providers will be lobbying to extend the therapy caps exceptions process, which is set to end Dec. 31. Another therapy issue—a proposed rule to reduce...
Healthcare reforms brighten outlook for Medicare trust fund, trustees say
Aug 06, 2010
The financial outlook for the seniors’ healthcare program has been “substantially improved” by the new healthcare reforms, according to a new report from the Medicare Board of Trustees...
Healthcare reform bill to delay implementation of RUG-IV until 2011
Mar 23, 2010
The RUG-IV classification system will not start until Oct. 1, 2011, under the new healthcare reform bill.
Need grows for therapy caps resolution
By
Liza Berger
Feb 05, 2010
My how things change. Just a month ago a healthcare reform bill seemed en route to passage. Now its very existence is in question and, by extension, some key long-term care services are too.
Letter urges Congress to extend therapy caps exceptions process
Jan 28, 2010
A coalition of 32 healthcare-related organizations, including the two major nursing home organizations, is imploring lawmakers to immediately reinstate the exceptions process for Medicare Part B outpatient...