Payment Matters Newsletter
Current
11/12/08 | Payment Matters: CMS Postpones Deadline for Submission of Quality Data; Battle of Bounty Hunters; CMS Issues Final Outpatient PPS Regulations; Changes in Medicare Payment, Billing and Enrollment Policies in the Final 2009 Medicare Physician Fee Schedule
10/29/08 | Payment Matters: Medically Unlikely Edits Now Available; Failure to Respond to Information Request May Result in Revocation of Billing Privileges; OIG Rolls Out its 2009 Work Plan – What Should Hospitals Be Aware Of?
10/24/08 | Payment Matters: FTC Delays Enforcement of "Red Flag" Rules Until May 1, 2009
10/15/08 | Payment Matters: PRRB - Oct. 20 Deadline to Add Issues and Recent Alerts; CMS Releases Final Rule Limiting Duration of Non-Random Prepayment Complex Medical Review; CMS Announces New RACs and Revisions to RAC Program; CMS Publishes FY 2009 Final Wage Indices and IPPS Rates
10/02/08 | Payment Matters: Relief from DMEPOS Accreditation Requirements; Providers May Need to Act on Identify Theft "Red Flags"; New CMS Rules Limiting Recoupment Pending Claims Appeals; Delinquent Tax Payments - IRS Sharpens Collection Tools
09/17/08 | Payment Matters: Don't Miss Deadline for Adding Issues to Pending PRRB Appeals (Generally, October 20, 2008); CMS Issues FY 2010 Hospital Wage Index Development Timetable
09/05/08 | Payment Matters: CMS Issues Final EMTALA Provisions for FY 2009 - Two Significant Changes from Proposed Rule; Final FY 2009 IPPS Rule Addresses Wage Index Issues; Revised Guidance on Signature Stamps Leaves Unanswered Questions
08/21/08 | Payment Matters: PRRB Issues New Rules, Effective August 21, 2008; CMS' Do-Not-Pay List Continues to Grow; CMS Adds Thirteen New Quality Measures for Reporting in the Hospital Quality Data Program; Kyphon, Inc. Settles Fraud Allegations - Hospitals Next in the Government's Sights?
08/06/08 | Payment Matters: Final IPPS Rule Contains Significant Stark Changes; CMS Releases Final IPPS Rule for FY 2009; Act Now or Risk Losing Ability to Bill for Services Prior to Obtaining Medicare Enrollment; Be Careful What You Assume: CMS Issues Latest Clarification of Physician Supervision Rules in Hospital Outpatient Departments; CMS Issues Proposed Outpatient PPS/ASC Payment Update
07/23/08 | Payment Matters: Deadline to Appeal Reduction in Annual Payment Update for FFY 2008 Under RHQDAPU is Fast Approaching; Are You At Risk for Losing Medicare Billing Privileges?; Top Ten Things You Need To Know About Medicare Claims Appeal
07/10/08 | Payment Matters: CMS Proposes Bold Changes for the 2009 Medicare Physician Fee Schedule; Proposed Changes to Anti-markup Prohibition Leave Providers of Diagnostic Services in a Quandry; Proposed Rule Requires Physicians and Non-Physician Practitioners to Enroll as IDTFs; Watch for E-mails from the PRRB
06/26/08 | Payment Matters: D.C. Appeals Court Reverses Favorable Decision on Charity Care Days in Adena Regional Medical Center v. Leavitt; CMS Issues a Rash of LTCH Rules; Bill Introduced to Fund Grants for U.S. Trauma Centers
06/11/08 | Payment Matters: CMS Adopts Final Rule Addressing Part A Appeals Before Intermediaries and PRRB; CMS Adds IDTFs to Payment Manual; DC District Ct Rules on Moratorium Laws and CMS Bad Debt Policy; Beware of Overpayments in a CHOW Situation; "Incident To" Transmittal Rescinded; CMS Note to Providers on FY 2006 DSH/SSI Ratios
05/28/08 | Payment Matters: Final PRRB Rules Issued; CMS "Clarifies" Bad Debt Policy Related to Claiming Bad Debts While Accounts Are at a Collection Agency, Removing Benefit of Moratorium; Federal Court Dismisses Challenge to "Anti-Markup" Rule
05/15/08 | Payment Matters: Pathology Payment Issues;
Disclosure of Financial Relationships Report (DFRR): CMS Proposes Mandatory Reporting of Hospitals' Financial Relationships and Solicits Comments on Proposed Rule; Hospital Emergency Services Under the Emergency Medical Treatment and Labor Act (EMTALA); CMS "Manualizes" Incident to Rules; New Enrollment Forms Required as of June 1, 2008
05/01/08 | Payment Matters: If At First We Don't Succeed... CMS Seeks Comments Regarding Self-Referral Provisions in FY 2009 Hospital IPPS Proposed Rule; Proposed Changes to the Hospital Wage Index
04/18/08 | Payment Matters: D.C. District Court Rules in Favor of Baystate in DSH/SSI Decision; April 21, 2008 Deadline To Protest FY 2009 Wage Index Data; CMS Releases Proposed IPPS Rule for FY 2009
04/02/08 | Payment Matters: No NPI Means No Payment Income; PRRB Has Jurisdiction Over Costs Not Claimed By Provider On Its Cost Report
03/18/08 | Payment Matters: Government Reaches $666 Million Settlement in Medicare Reimbursement Case; New ABN Form Adopted By CMS; Recent Medicare Bad Debt Cases; April 1 Deadline Approaches for Tamper Resistant Medicaid Prescriptions
03/05/08 | Payment Matters: CMS Creates a Process for Prior Medical Necessity Determinations; Suppliers Beware: The OIG Estimates That Over $125 Million in Potential Overpayments Were Made on Behalf of Beneficiaries in Part-A Covered SNF Stays
02/20/08 | Payment Matters: Final Part A Reimbursement Appeal Regulations Expected Soon; Insurers Agree to Pay for Online Visits with Physicians; Interpretive Guidelines for Hospital CoPs Issued
02/06/08 | Payment Matters: Another Step Designed to Reign in Unscrupulous DMEPOS Suppliers; Provisions in the Paper-based Manual Omitted from Internet-only Manuals May Still Be Good Policy
01/23/08 | Payment Matters: Victory for IRFs, Mixed Bag of Relief and Scrutiny for LTCHs; CMS' Reliance On Unpublished Payment Principles Rejected by Federal Court; Private Payers Refusing to Pay for "Never Events"
01/09/08 | Payment Matters: Physicians Convince CMS to Delay Implementation of Anti-markup Rule Pending Further Study; Significant Changes Proposed for DAB; U.S. District Court Enjoins CMS from Implementing Average Manufacturer Price Rule for Medicaid Reimbursement; Outpatient Quality Reporting Deadline: January 31, 2008