Medicare’s plan to cover Alzheimer’s drugs hinges on patient data registries
By
Alicia Lasek
Jun 02, 2023
Medicare Part B will cover Alzheimer’s drugs with traditional FDA approval, CMS announced Thursday. Prescribing clinicians must participate in a patient data registry.
Medicare drug pricing order could have ‘significant ramifications’ on LTC pharmacies in long run:...
By
Danielle Brown
Sep 16, 2020
Long-term care pharmacies could soon be facing “significant ramifications in the long run” following an executive order signed by President Trump on Sunday. That directive states that the Medicare...
What administrators need to know about therapy metrics
By
Stacy Darling, MBA, MPT, AT, RAC-CT
Aug 08, 2014
Administrators have multiple departments to oversee, so it is important that they have a method to determine if their therapy department is running efficiently, meeting its goals and adding to the strategic...
CMS announces Medicare appeals without administrative law judge hearings
By
Tim Mullaney
Jul 07, 2014
Long-term care providers will be able to appeal certain Medicare claims decisions without going through an administrative law judge hearing, the Office of Medicare Hearings and Appeals (OMHA) announced...
Are standardized assessment tools our future?
By
Shelly Mesure, MS, OTR/L
May 20, 2014
With therapy documentation being put under the microscope more than ever, you would be wise to make sure standardized assessment tools are at your fingertips. Unbiased views of data and outcomes information...
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...
Efforts to prevent, care for diabetic foot ulcers cut amputation rate in half, study finds
By
Tim Mullaney
Jul 23, 2013
Better ulcer care contributed to a nearly 50% decrease in diabetes-related leg amputations between 2000-2010, according to a study in the current issue of Foot & Ankle International.
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...