Billing, News, Payment/economy, Skilled Nursing Facility

MedPAC publishes resource for SNFs: Payment basics

By The Bottom Line.
MedPAC released their Payment Basics for SNFs 2018 report, which provides an overview of Medicare coverage and reimbursement. You can download this resource from The Billers’ Association resource library. The report includes a map explaining how reimbursement is calculated under the current prospective payment system, Medicare daily base rates for FY19, and the RUG-IV classification system.
The initial payment rates were set in 1998 to reflect the projected amount that SNFs received in …

Billing, News, Skilled Nursing Facility

SNFs: Two jurisdictions announce new Targeted Probe and Educate topic

From The Bottom Line
The MACs for the J5 (Iowa, Kansas, Missouri, and Nebraska) and J8 (Indiana and Michigan) jurisdictions (WPS Government Health Administrators) announced that CMS has authorized them to conduct a Targeted Probe and Educate (TPE) review of outpatient therapy (CPT code 97110). The announcement was made on October 15 on the WPS website.
The webpage states that “This is a required process for providers identified by Medical Review. The TPE review process incudes three …

Hospice, News, QAPI, Quality of care

CMS adds future hospice quality measure development to Provider Engagement Opportunities webpage

By Home Health Line.
CMS on its website has added a portion about future quality measure development for hospices.
“This addition to the webpage will keep stakeholders informed of hospice measures that CMS has submitted to the National Quality Forum (NQF) Measure Application Process (MAP),” according to a post on CMS’ website. “At this time, CMS is developing a claims-based Transitions from Hospice Care, Followed by Death or Acute Care, measure, which is posted on the Measures …

Home Health, News

CMS to require states self-report progress toward electronic visit verification

By Home Health Line.
CMS is seeking public comment on a proposal to implement a survey requiring states report progress toward implementing electronic visit verification (EVV) as required by the 21st Century Cures Act.
The survey will be a live form, which means states will be able to update their status as they progress. Comments must be submitted by Dec. 4.
The EVV requirement primarily impacts Medicaid for now, but will be coming later for Medicare and likely …