Medicare Update

Top Ten Medicare Update Blog Posts in October 2009

Below are the top ten Medicare Update posts during October 2009 (based on the number of views):

1)   CMS Announces 2010 Medicare Premiums and Deductibles

2)   OIG Work Plan Reveals Possible Risk Areas for Medicare Providers and Suppliers

3)   Senator Stabenow Introduces Medicare Physician Fairness Act of 2009

4)   OIG Work Plan Identifies Possible Areas of Concern for Home Health Agencies and DMEPOS Suppliers

5)   CMS Directs Medicare Contractors to Take Action on OIG Reports

6)   CMS Posts FAQ on Code 432 and Medicare Recovery Audit Contractors

7)   The Changing Dynamics of Medicare Fraud Schemes?

8)   Medicare Fraud and Recovery Audit Contractor Program

9)   CMS to Shelve Medicare Medical Home Demonstration

10) Region D Recovery Audit Contractor Updates CMS Approved Audit Issues

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MedPAC Releases Updated Medicare Payment Basics Documents

On October 14, 2009, the Medicare Payment Advisory Commission (MedPAC) released updated documents for its Medicare Payment Basics series, which provide an overview of 18 Medicare payment systems. 

To view the updated documents, visit the Medicare Payment Basics page of the MedPAC website or click on any of the following links:

• Oxygen and oxygen equipment payment system
• Skilled nursing facility services payment system
• Physician services payment system
• Psychiatric hospital services payment system
• Rehabilitation facilities (inpatient) payment system
• Part D payment system
• Outpatient therapy services payment system
• Medicare Advantage program payment system
• Outpatient dialysis services payment system
• Outpatient hospital services payment system
• Home health care services payment system
• Hospice services payment system
• Hospital acute inpatient services payment system
• Long-term care hospitals payment system
• Clinical laboratory services payment system
• Critical access hospitals payment system
• Durable medical equipment payment system
• Ambulatory surgical centers payment system

MedPAC is an independent Federal body established by the Balanced Budget Act of 1997 to advise Congress on issues affecting the Medicare program.

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OIG Work Plan Reveals Possible Risk Areas for Medicare Providers and Suppliers

On October 1, 2009, the Department of Health and Human Services' Office of Inspector General (OIG) released its Work Plan for fiscal year 2010 (Work Plan).

The Work Plan addresses the areas and issues the OIG intends to audit, evaluate and inspect during fiscal year 2010.  The Work Plan also provides some insight into the areas and issues that may evolve into future OIG enforcement activities. Therefore, health care providers and suppliers should consider the Work Plan in relation to their operations.

This post briefly highlights some of the Work Plan priorities for hospitals, physicians and other health care providers with respect to Medicare Parts A and B. Work Plan priorities for Medicare provider and supplier types not addressed in this post (e.g., home health agencies) will be covered in subsequent posts.

MedPAC Releases Updated Medicare Payment Basics Documents

On October 7, 2008, the Medicare Payment Advisory Commission (MedPAC) released updated 2008 documents for its Medicare Payment Basics series, which provide an overview of 18 Medicare payment systems.  To view the updated 2008 documents, visit the Medicare Payment Basics page of the MedPAC website or click on any of the following links:

• Oxygen and Oxygen Equipment Payment System

• Skilled Nursing Facility Services Payment System
• Physician Services Payment System
• Psychiatric Hospital Services Payment System
• Rehabilitation Facilities (Inpatient) Payment System
• Part D Payment System
• Outpatient Therapy Services Payment System
• Medicare Advantage Program Payment System
• Outpatient Dialysis Services Payment System
• Outpatient Hospital Services Payment System
• Home Health Care Services Payment System
• Hospice Services Payment System
• Hospital Acute Inpatient Services Payment System 
• Long-Term Care Hospitals Payment System
• Clinical Laboratory Services Payment System
• Critical Access Hospitals Payment System
• Durable Medical Equipment Payment System
• Ambulatory Surgical Centers Payment System

MedPAC is an independent Federal body established by the Balanced Budget Act of 1997 to advise Congress on issues affecting the Medicare program.

OIG Work Plan Reveals Possible Risk Areas for Medicare Providers and Suppliers

On October 1, 2008, the Department of Health and Human Services’ Office of Inspector General (OIG) released its Work Plan for federal fiscal year 2009 (Work Plan).  The Work Plan addresses the areas and issues the OIG intends to audit, evaluate and inspect during federal fiscal year 2009. The Work Plan also provides some insight into the areas and issues that may evolve into future OIG enforcement activities. Therefore, health care providers and suppliers should consider the Work Plan in relation to their operations.  This post briefly highlights some of the Work Plan priorities for the Medicare program and hospitals, physicians and other health professionals.

CMS Announces Provider Feedback Town Hall Meeting

The Centers for Medicare & Medicaid Services (CMS) recently announced in a notice that it will host a town hall meeting from 2:00 p.m.- 4:00 p.m. (ET) on September 22, 2008.  The meeting will be held via conference call and in the CMS auditorium at 7500 Security Boulevard, Baltimore, Maryland.

The purpose of the town hall meeting is to entertain provider feedback on Medicare fee-for-service (FFS) policy and operational issues.  The meeting is open to all Medicare FFS providers and suppliers that participate in the Medicare program.  CMS reports that agenda topics will include, but not be limited to:

• 5010- Possible next version of HIPAA standards for claims and other transactions; and
• Recovery auditing and Medicare Administrative Contractor transitions.

During the town hall meeting, CMS will offer meeting participants an opportunity to provide feedback on agenda topics. However, CMS reports that not all participants will have an opportunity to speak due to time constraints.  Nevertheless, CMS reports that it will accept written submissions at MFG@cms.hhs.gov through September 30, 2008. By September 19, 2008, CMS is also expected to post meeting agenda and discussion materials for download here.

To participate in the town hall meeting, registration is required.  Registration will open on August 29, 2008 and close on September 17, 2008. CMS reports that registered participants may be contacted for follow up meetings to solicit additional opinions and clarify any issues that arise during the town hall meeting.

CMS reports that persons attending the town hall meeting in person will be required to show photographic identification (a valid driver's license or passport).  For further details, CMS refers possible meeting participants to the August 22, 2008 Federal Register notice.  For questions or additional information, CMS reports that email may be sent to MFG@cms.hhs.gov.

CMS to Update Inpatient Psychiatric Facility Prospective Payments

On May 1, 2008, the Centers for Medicare & Medicaid Services (CMS) released a display copy of a Notice that updates the prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPF).  The updated IPF prospective payment rates are effective for discharges occurring on or after July 1, 2008 through June 30, 2009. CMS is expected to publish the Notice in the Federal Register on May 7, 2008.