CMS publishes corrections to RUG-IV federal per diem rates & MDS item in SNF PPS final rule

By The Bottom Line.
The Centers for Medicare & Medicaid Services published the following summary of errors published in the FY2019 SNF PPS final rule:

In Tables 6 and 7 on pages 39170 through 39172, we made errors in copying values into the “total rate” column of the tables used in the final rule preamble, so the numbers in this column did not accurately reflect the total case-mix adjusted federal per diem rates.
On page 39222, we made …

CGS to hold webinar about RAPs

By Home Health Line.
Medicare Administrative Contractor (MAC) CGS is holding a webinar 1 p.m. to 2 p.m. EST Nov. 15 to discuss a transmittal that provides instructions to MACs about monitoring home health agencies’ misuse of requests for anticipated payment (RAPs).
“We will discuss the implications to you as a home health provider,” CGS’ calendar of events states. “Please plan to join us and alleviate some of your concerns about this new process as we approach …

Tip: Audits and the False Claims Act’s far reach

If the results of an internal audit determine that Medicare was billed inappropriately, the provider is in potential violation of the False Claims Act, which describes a violator as any entity or person that causes the federal government to make payments for goods or services that are a) not provided, b) provided contrary to federal standards or law, or c) provided at a level or quality different than what the claim was submitted for.
In other …

CMS releases updates to billing for flu vaccine

by The Bottom Line
Flu season is August to April. Make sure you’re prepared to start billing for the influenza virus vaccine by staying up to date on the latest code and payment allowance updates. So far, CMS has released the following two notices:
1. Payment allowances for the influenza virus vaccine are updated on August 1 each year. This year’s annual update has been released, according to a CMS MLN Matters article. Click here for 2018-2019 …