[02/06/12]
Posted on February 6, 2012 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
The Centers for Medicare & Medicaid Services (CMS) has pushed back the start of two anti-fraud programs to June due to provider concerns. Two pilot programs, one that would require prior authorization for scooters and power wheelchairs and one allowing recovery audit contractors (RAC) to review claims prior to payment, were initially slated to begin January 1, 2012. READ MORE
Tags: abuse, authorization, bufford, California, claim, Claims, cms, demonstration project, Florida, fraud, Home Health, Illinois, january, jent, june, Litigation and Risk Management, long term care, Louisiana, Medicaid/Medicare Enrollment and Regulatory Compliance, Michigan, New York, North Carolina, Ohio, payment, Pennsylvania, power, prior, RAC, review, scooter, selby, Texas, wheelchair
[10/10/11]
Posted on October 10, 2011 in Long-Term Care, Home Health & Hospice
Written by: Bufford, David W.
Effective October 1, new PPS rules for fiscal year 2012 require nursing homes to diligently review claims prior to submission. As previously discussed, significant cuts in SNF reimbursement are aimed mostly at therapy services. SNFs submitting claims under the previous rules can expect high rates of denials and rejections. Even facilities billing under the new... READ MORE
Tags: 3.0, bufford, claim, cms, denial, fiscal year, fy, jent, long term care, mds, Medicaid/Medicare Enrollment and Regulatory Compliance, october 1, rate cut, rejection, review, selby, snf, submission, therapy
