CCH NetNews™

(August 29, 2008)

Home Health Medicare and Medicaid Payment

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Featured This Week:


Medicare Conditions of Participation and Coverage


Denial of Injunction to stay DMEPOS competitive bidding program, American Association for Homecare v. Leavitt, No. 08-0992 (RMU), D.D.C., June 30, 2008, ¶100,436.

Medicare & Medicaid Provisions of Supplemental Appropriations Act of 2008, H.R. 2642, June 30, 2008, ¶400,466.

Prothrombin Time (PT/INR) Monitoring for Home Anticoagulation Management, Medicare National Coverage Determinations Manual, 100-03, Trans. No. 90, July 25, 2008, ¶502,053.

Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA), Medicare National Coverage Determinations Manual, 100-03, Trans. No. 91, July 25, 2008, ¶502,054.

Medicare Contractor Annual Update of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM), Medicare Claims Processing Manual, 100-04, Trans. No. 1566, July 29, 2008, ¶502,059.

Payments, Claims Filing and Cost Reports


Medicaid and Medicare: Clarification of policy on reimbursement for bad debts, CMS Memo, May 2, 2008, ¶400,467.

The Medicare Recovery Audit Contractor (RAC) demonstration; Final report, CMS Report, July 11, 2008, ¶400,470.

VMS Recognition of New Specialty Codes for Suppliers of Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) With Pedorthic Personnel, Medical Supply Companies With Pedorthic Personnel, and Rehabilitation Agencies. (DME MACs Only), Medicare Claims Processing Manual, 100-04, Trans. No. 1552, July 18, 2008, ¶502,049.

Hospice Discharge for Cause, Medicare Claims Processing Manual, 100-04, Trans. No. 1558, July 18, 2008, ¶502,050.

Notice of New Interest Rate for Medicare Overpayments and Underpayments - 4th Quarter of Federal Fiscal Year 2008, Medicare Financial Management Manual, 100-06, Trans. No. 140, July 17, 2008, ¶502,051.

Processing All Diagnosis Codes Reported on Claims Submitted to Durable Medical Equipment Medicare Administrative Contractors
(DME MACs), One-Time Notification Manual, 100-20, Trans. No. 360, July 18, 2008, ¶502,052.

Prothrombin Time (PT/INR) Monitoring for Home Anticoagulation Management, Medicare Claims Processing Manual, 100-04, Trans. No. 1562, July 25, 2008, ¶502,055.

Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code (CARC) Update, Medicare Claims Processing Manual, 100-04, Trans. No. 1563, July 25, 2008, ¶502,056.

New Hemophilia Clotting Factor and HCPCS Code, Medicare Claims Processing Manual, 100-04, Trans. No. 1564, July 25, 2008, ¶502,057.

Appeals


OIG Evaluation of implementation of Medicare appeals reconsideration by qualified independent contractors, OIG Report No. OEI-06-06-00500, July 1, 2008, ¶400,469.

Compliance


The National Provider and Plan Enumeration System (NPPES) and the Unique Physician Identification Number (UPIN) Data, Medicare Program Integrity Manual, 100-08, Trans. No. 263, July 25, 2008, ¶502,058.

Medicaid


Review of Social Security Act Section 1915(c) Waiver Payments for Home and Community-Based Services, OIG Report, June 24, 2008, ¶400,468.


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