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CMS Announces Changes in Criteria for Classifying Inpatient Rehabilitation Facilities
The Centers for Medicare & Medicaid Services (CMS) has announced a final rule revising the criteria for classifying hospitals as inpatient rehabilitation facilities (IRFs) for purposes of Medicare payment. This final rule will make it possible for Medicare to pay appropriately for intensive rehabilitation services in the correct setting, while improving access to inpatient rehabilitation services for beneficiaries who require intensive clinical services. For more information, please check out our May Government Report or please visit: www.cms.org.
CMS Announces Changes in Criteria For Classifying Inpatient Rehabilitation Facilities
A final rule revising the criteria for classifying hospitals as inpatient rehabilitation facilities (IRFs) for purposes of Medicare Payment was announced on Friday, April 30, 2004 from the Center for Medicare and Medicaid Services (CMS). This directive will make it possible for Medicare to pay for intensive rehabilitation services in the appropriate setting, while improving access to inpatient rehabilitation services for beneficiaries who require intensive clinical services. For more information, please visit http://www.cms.hhs.gov/media/press/release.asp?Counter=1029
CMS Addresses Payment Cap Moratorium, Evaluation Period for Therapy Services
CMS has published a one-time notification regarding the renewed moratorium on physical therapy, occupational therapy, and speech-language pathology service payment caps for claims received from December 8, 2003, through December 31, 2005. The notice implements a provision of the Medicare Drug, Improvement, and Modernization Act of 2003. The separate payment caps of $1,590 for combined outpatient physical therapy and speech-language pathology services, and for outpatient occupational therapy services remain in place for claims received from September 1, 2003, through December 7, 2003, for services provided during this time. For more information, visit: http://www.cms.hhs.gov/manuals/pm_trans/r89cp.pdf
Bush Nominates FDA Administrator to Head CMS
President Bush nominated FDA Commissioner Mark B. McClellan as administrator of the Centers for Medicare & Medicaid Services (CMS) on February 20, 2004. If approved by the Senate Finance Committee, McClellan will succeed Thomas A. Scully who left the position late last year. To view the announcement, go to: http://www.whitehouse.gov/news/releases/2004/02/20040220.html
CMS Summary of Therapy Cap Moratorium
Below are three helpful articles that CMS has provided to its healthcare providers:
1. The Department of Health & Human Services Centers for Medicare & Medicaid Services has released a summary of changes manual including new information on therapy caps. The changes are in red text. To view the PDF document, please go to: http://www.cms.hhs.gov/Manuals/pm_trans/R42CP.pdf
2. CMS has created this Medlearn Matters articles to educate and help answer questions for healthcare providers regarding the therapy caps. The articles outline billing guidelines and applicable HPCPS codes for outpatient rehabilitation services. To view the PDF document, please go to: http://www.cms.hhs.gov/medlearn/matters/mmarticles/2003/SE0310.pdf
3. CMS has created these two articles and combined them into one PDF link. The first article is to help education providers understand the renewed moratorium on outpatient rehabilitation therapy caps.
The second article on pages 4-5 is a helpful Medlearn Matters Glance Sheet that’s a quick summary on the therapy caps on:
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It's Impact to you
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What you need to know
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What you need to do
To view these articles, please go to: http://www.cms.hhs.gov/manuals/pm_trans/R40OTN.pdf
CMS Accepts Comments on Proposed Regulations via Internet
CMS is introducing a new tool for citizens to make their voices heard. Everybody can visit: www.regulations.gov to submit any comments or concerns in regards to pending legislation. For more information, link to: http://www.cms.hhs.gov/media/press/release.asp?Counter=957
CMS Announces the Standard Unique Health Identifier for Health Care Providers for Use in Standard Transactions under HIPAA
Filing and processing health care claims and other transactions will be used through one standard health identifier called the National Provider Identifier (NPI). This was announced as of late January and establishing standards is still underway. The date of this rule to be finalized is May 23, 2005. The need for NPI resulted from a mandate because of new HIPAA guidelines. For more information, link to: http://www.cms.hhs.gov/media/press/release.asp?Counter=946
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