On March 3, 2009, CMS published the "Decision Memo for Sleep Testing for Obstructive Sleep Apnea." A summary of the decision follows:
"CMS finds that the evidence is sufficient to determine that the results of the sleep tests identified below can be used by a beneficiary’s treating physician to diagnose OSA, that the use of such…
CMS recently published a resource reference listing the internet resources available for fraud and abuse research and reference. Below is a link to the Medicare Learning Network publication and direct links to the fraud and abuse web resources cited therein.
Medicare Learning Network
http://www.cms.hhs.gov/MLNProducts/downloads/Fraud_and_Abuse.pdf
OIG Listserv
http://www.oig.hhs.gov/mailinglist.asp
CMS Website
CMS has aggregated the various web pages pertaining to Medicare fee-for-service providers. The link to that website is included below and is also included separately in the links section on the title page of the Blog.
http://www.cms.hhs.gov/MLNProducts/Downloads/FFS_Provider_Web_Pages.pdf
Medicare has announced the January 2009 ASC payment updates. It covers new surgical procedures, new and updated codes for drugs and biologicals, and additional services. The link is attached.
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6323.pdf
As required by Section 911 of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA), CMS is replacing its current claims payment contractors, previously known as Fiscal Intermediaries or Carriers, with new contract entities called Medicare Administrative Contractors (MACs).
The responsibility for paying Medicare Part A and Part B claims is divided into …
Thanks to Claire Miley of Bass, Berry & Sims in Nashville, Tennessee for posting an alert regarding the final DMEPOS Surety Bond requirements. Below is the text of the American Health Lawyers Association e-mail alert.
CMS Issues Final Rule Requiring Surety Bonds for DMEPOS
On December 29, 2008, the Centers for Medicare & …
The Congressional Budget Office has prepared two remarkably thorough analyses regarding the fundamental issues confronting healthcare policy and the projected costs of more than 100 different reform proposals. Great summer vacation reading — if you start now, you might finish by summer vacation. Check the links below:
CMS has established a Medicare learning network web page dedicated to Medicare fee for services advance practice nurses and physician assistants. It includes definitions, licensing requirements, enrollment procedures, reimbursement guidelines, and links to related materials. The website is accessible at the following link:
Independent Diagnostic Testing Facility Developments
The 2009 Medicare Physician Fee Schedule Regulations include two provisions regarding Independent Diagnostic Testing Facilities. 42 CFR §410.33 has been supplemented with two additional subsections.
First, Section (16) states all entities that provide diagnostic imaging services to Medicare beneficiaries will be required to enroll as IDTFs regardless…
The revised Anti-Markup Final Rules were published by CMS on November 19, 2008 in the Federal Register, as part of the Medicare 2009 Physician Fee Schedule. The entire text of the 2009 Medicare Physician Fee Schedule and the related rules, i.e. Anti-Markup, Independent Diagnostic Testing Facility, physician referral issues, etc. were posted by the Med …
