In an earlier blog I spoke about payment over the therapy cap would be either a pre-payment or post-payment review following a MAC-directed ‘additional development request’ and the pre-post payment decision would depend on what state your practice was in. Because the provision of therapy submitted to CMS is generally provided with every intent to meet medical necessity/reasonable and necessary care requirements,…
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The Novel Corona Virus akin to SARS now has a name: “Middle East Respiratory Syndrome Coronavirus or (MERS-CoV)”, an NBCNEWS.com article reports. MERS, like its cousin SARS causes cold-like symptoms that quickly escalate to severe and even fatal respiratory infections. Though the search for effective treatment continues with great urgency, The World Health Organization remains disconcerted: ‘“We know that when…
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If you are an institutional provider you shouldn’t see this alert at all – so be ready for G-Codes WITHOUT ALERTS and take this blog as your reminder! The April 18 release of the CMS Medicare FFS Provider e-News contained discussions with references to two MedLearn Matter releases pertinent to implementation of claims-based data collection. In that release, Medlearn Matter 8166 provides…
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Quiet, peaceful, serene; just the way a hospital unit ought to be so that patients can get the rest they need to recover and get well. Except, there are no patients. The unit has been abandoned. Like a ghost town it sits empty, still, eerie. According to Wikipedia: “A ghost town is an abandoned village, town or city, usually one…
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Late last fall, CMS posted this comment on their website, “Please be advised that CMS anticipates delays for all of the FY 2013 PC Pricer releases (IPPS, IRF, IPF, LTCH, SNF, ESRD and HH). CMS is in the process of transitioning to new software products to support the back-end development of all of the PC Pricers. This transition is expected…
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Procrastination seems like a worthwhile event if you are one of those persons that performs best under stress and against all odds meets the necessary deadline. However, if you are talking about the now infamous therapy G-Codes and impairment modifiers, you may have missed a ‘soft’ deadline without even noticing. As an optimist you believe that if you meet the ‘hard’…
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“Alive! It’s alive! IT’S ALIVE!!!” (Dr. Frankenstein, pronounced FRONK-en-steen, in Young Frankenstein.) A while ago, the FDA gave life to the Son of Advair, otherwise known as Breo Ellipta, the new face of COPD pharmaceuticals. The GSK website makes the following celebratory announcement: “GlaxoSmithKline plc (LSE: GSK) and Theravance, Inc. (NASDAQ: THRX) today announced that the Pulmonary-Allergy Drugs Advisory Committee…
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For some time now, several of my colleagues and I have been discussing the transformation of healthcare and how transparency, pay for performance, quality initiatives and the like will impact the way we provide healthcare for ever more. Just this week, CMS made headway toward pushing operational information into the hands of anyone wishing to find it! The CMS News Release…
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With exactly 60 days to comment before July 1, 2013, CMS released the proposed IRF PPS Rule for fiscal year 2014, which would cover discharges on or after Oct. 1, 2013 – Sept. 30, 2014. The rule is referenced as CMS-1448-P and was filed 05/02/2013 with a to be published date of 05/08/2013. CMS is proposing robust updates and changes to next years IRF…
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Blebs; the telltale signs of diseased and damaged lungs, have long indicated the point of irreparable parenchymal destruction producing the stereotypical signs and symptoms of late stage COPD. But the bleb’s days may be numbered. According to snippet in the RC Currents section of the May issue of the AARC Times, John’s Hopkins researchers noted, “using hepatocyte growth factor (HGF)……
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