Online resource packed with regulatory news and expert guidance, tips & tools pertinent to professionals across the post-acute care continuum.
CMS released Frequently Asked Questions (FAQs) on Medicare fee-for-service billing. These FAQs are supplemental to those previously released by CMS in March. To view those, visit https://go.cms.gov/2yIS29R. CMS noted in the release that in many instances, the general statements of the FAQs referenced above have been superseded by COVID-19-specific legislation, emergency rules and waivers granted […]
In order for a patient to receive the Medicare hospice benefit, the patient must be certified as terminally ill, according to a cgsmedicare webpage. The certification/recertification is an important part of required documentation for Medicare payment for the hospice services provided. A common reason for hospice certification errors are related to a missing or invalid […]
CMS announced that Medicare will now cover any medically necessary ambulance ride for individuals with COVID-19 from any origin to any destination equipped to treat the patient’s condition. Acceptable destinations include, but are not limited to: Any location that is an alternative site determined to be part of a hospital, Critical Access Hospital (CAH), or […]
Due to the COVID-19 pandemic and its financial effect, CMS has implemented an accelerated and advance payment request and approval, according to a CMS fact sheet. As part of the accelerated and advance payment request and approval, CMS will provide accelerated payments to Medicare Part A providers and advance payments to Medicare Part B providers […]
With COVID-19 being declared a national emergency, the Centers for Medicare and Medicaid Services (CMS) can waive some requirements in Medicare, Medicaid, and CHIP with Section 1135 authority, according to a CMS news release. Florida was the first state to submit a Section 1135 waiver request due to COVID-19. CMS approved a wide variety of […]
The Centers for Medicare & Medicaid Services (CMS) issued frequently asked questions and answers (FAQs) for healthcare providers regarding Medicare payment for laboratory tests and other services related to the 2019-Novel Coronavirus (COVID-19). The agency is receiving questions from providers and created this document to be transparent and share answers to some of the most […]
CMS announced on February 27 the selection of 205 applicants to participate in Emergency Triage, Treat, and Transport (ET3) Model, a new payment model that gives flexibility to ambulance staff when addressing emergency needs of Medicare fee-for-service beneficiaries. This voluntary, five-year payment model will allow participating EMS to treat SNF residents within the facility following […]
CMS has issued an update to the Medicare Benefit Policy Manual for home health. The update reflects policy changes finalized in the 2019 and 2020 PPS final rules, according to Change Request 11577. These changes include implementation of the Patient-Driven Groupings Model (PDGM), the shift to a 30-day payment period, changes to requests for anticipated payment […]
According to a 2019 study by Bankers Life, 56% of baby boomers mistakenly believe that Medicare covers ongoing long-term care. In an attempt to address gaps in LTC Medicare payments, former CMS technical expert Diane Omdahl recommends to Forbes that residents take out a reverse mortgage to cover gaps in care costs. “Let’s be very […]
An extensive manual change concerning enrollment deactivations suggests that CMS is trying to make it easier for providers to avoid the hassle of accidental removal from Medicare — but you still have to know and follow the rules. Currently, Chapter 15 of the Medicare Program Integrity Manual, which covers enrollment, has simple templates for letters […]