Online resource packed with regulatory news and expert guidance, tips & tools pertinent to professionals across the post-acute care continuum.
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 […]
There is now a second game available on the Medicare arcade through Medicare Administrative Contractor (MAC) National Government Services. The game is called the MBI quiz jumper. It allows the player to control a character as he jumps from platform to platform. Landing on certain boxes will prompt a question about new Medicare Beneficiary Identifiers […]
Agencies will soon be required to submit all claims using new Medicare beneficiary identifiers (MBIs), but agencies should be prepared for times when those MBIs change. Medicare beneficiaries or their authorized representative can request to change the MBI if needed, as can CMS, according to a release from Medicare Administrative Contractor (MAC) CGS. This could happen if the […]
SNF admissions from hospitals dropped in all 50 states last year, according to the 2019 Industry Trend Report from Trella Health. The report examined Medicare Part A and Part B claims submitted across the postacute care continuum, and found that 23.3% of patients were discharged to home health, while only 21.1% were discharged to a […]
There are less than fifty days until the Medicare Beneficiary Identifiers (MBIs) transition period is over. Providers will be required to use MBIs on claims beginning Jan. 1, 2020. As of that date, there only will be a few exceptions for when providers will be allowed to use Social Security-based Health Insurance Claim Numbers (HICNs) […]
CMS has released a fact sheet for 2020 Medicare Part A premiums and deductibles. The 2020 coinsurance amounts are as follows: Part A Deductible and Coinsurance Amounts for Calendar Years 2019 and 2020 by Type of Cost Sharing 2019 2020 Inpatient hospital deductible $1,364 $1,408 Daily coinsurance for 61st-90th Day $341 $352 Daily coinsurance for lifetime […]
The 2020 PPS final rule, which was posted to the Federal Register October 31, reinforces the plan to implement the Patient-Driven Groupings Model (PDGM) on Jan. 1, 2020. But CMS has eased off of plans to implement an 8.01% decrease in agencies’ payments due to changes it anticipates agencies will make in response to the […]
Starting in January 2020, Medicare-enrolled nurse practitioners in Maryland will be allowed to certify home health services as part of the Medicare Total Cost of Care (TCOC) Model. The change will be effective for services provided on or after Jan. 1, according to change request 11330. Currently Medicare only pays for home health if a […]
CMS issued a proposed notice that they received an application from the Joint Commission (TJC) for continued recognition as a national accrediting organization for HHAs that wish to participate in the Medicare or Medicaid programs. Within 60 days of receiving an organization’s complete application, the state required CMS to publish a notice that: 1) identifies […]
A State Health Insurance Program (SHIP) is an insurance counseling service that is provided free of charge by the Administration on Community Living in partnership with the Centers for Medicare & Medicaid Services as well as state aging agencies to help assist Medicare beneficiaries and their caregivers. By discussing coverage, cost and convenience, the goal […]