Medicare Weekly Update

Each issue of this free weekly e-newsletter includes the latest CMS proposed and final rules, CMS manual revisions, and transmittals. Readers also find OIG audit reports, advisory opinions, and more.

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Issue 35, August 31, 2010

• Regulations: No issuances this week

• Transmittals and MLN Matters articles: CMS instructs on discarded drugs/biologicals, implements ESRD PPS

• Other Issuances: CMS reminds industry of 5010 testing deadline

• CMS Public Events: No events this week

Issue 34, August 24, 2010

• Regulations: No issuances this week

• CMS Public Events: Hospital Open Door Forum August 26

• Other Issuances: HDI begins medical necessity reviews, CMS posts EHR FAQs

• Transmittals and MLN Matters articles: CMS issues MLN Matters articles on IRFs, POA

Issue 33, August 17, 2010

• Regulations: CMS publishes final rules for FY 2011 IPPS, ESRD PPS

• Transmittals and MLN Matters articles: CMS revises POA process, updates IRF PPS, issues special article on medical record retention, and more

• Other Issuances: RACs begin medical necessity reviews, OIG reviews separately billed outpatient infusion therapy services

• CMS Public Events: No events this week

Issue 32, August 10, 2010

• CMS Public Events: CMS to hold EHR incentive program calls this week

• Other Issuances: No releases this week

• Regulations: CMS publishes 2011 OPPS proposed rule

• Transmittals and MLN Matters articles: CMS replaces ICD-9-CM transmittal, modifies pricers, and more

Issue 31, August 3, 2010

• CMS Public Events: No events this week

• CMS releases tip sheets for EHR incentive program

• Transmittals and MLN Matters articles: CMS instructs on timely filing, implements IPF interrupted stay policy, and more

• Regulations: CMS releases 2011 IPPS rulemaking, publishes EHR rule, and more

Issue 30, July 27, 2010

• CMS Public Events: Hospital Open Door Forum transcript available

• Other Issuances: CMS posts new RAC questions and answers

• Transmittals and MLN Matters articles: CMS updates SOM, issues quarterly lab NCD and interest rate update, and more

• Regulations: CMS publishes IRF PPS update in Federal Register

Issue 29, July 20, 2010

• Regulations: CMS, HHS post EHR incentive program final rules, CMS issues IRF PPS update, and more

• Transmittals and MLN Matters articles: CMS issues special edition RAC article

• Other Issuances: OIG analyzes 2009 CERT errors

• CMS Public Events: EHR incentive program conference call July 22

Issue 28, July 13, 2010

• Regulations: CMS proposes OPPS changes, HHS issues HIPAA-HITECH regulations

• Other Issuances: OIG posts audits of IRF transfers, oxaliplatin, and more

• CMS Public Events: Hospital Open Door Forum July 15

• Transmittals and MLN Matters articles: CMS posts MRA coverage changes, implements PPACA changes, and more

Issue 27, July 6, 2010

• CMS Public Events: No events this week

• Regulations: CMS proposes revised hospital/CAH CoPs

• Transmittals and MLN Matters articles: CMS implements MPFS updates, issues MLN Matters articles

• Other Issuances: CMS posts quarterly updates to data files, OIG audits neulasta, and more

Issue 26, June 29, 2010

• Regulations: HHS publishes HIT certification rule, CMS releases MPFS proposed rule

• Transmittals and MLN Matters articles: CMS releases ICD-10 special edition article, and more

• Other Issuances: Congress clarifies three-day rule

• CMS Public Events: No events this week

Issue 25, June 22, 2010

• Regulations: HHS releases HIT certification rule, CMS posts IPPS corrections

• Other Issuances: OIG reviews Part A/Part B bad debts, NGS payments to terminated providers, and more

• CMS Public Events: No events this week

• Transmittals and MLN Matters articles: CMS posts drug pricing files, issues special MLN Matters article for IPFs, and more

Issue 24, June 15, 2010

• Regulations: No issuances this week

• Transmittals and MLN Matters articles: CMS posts online appeal instructions, publishes inflation factor, and more

• Other Issuances: OIG audits bad debts, NCHS posts ICD-9 conversion table, and more

• CMS Public Events: Hospital ODF transcript available

Issue 23, June 8, 2010

• Regulations: CMS IPPS notice, proposals under PPACA

• Transmittals and MLN Matters articles: CMS issues supervision guidance, issues NCDs, and more

• Other Issuances: No releases this week

• CMS Public Events: RAC 101, Physician ODF transcripts available

Issue 22, June 1, 2010

• Regulations: CMS publishes CoP proposal in Federal Register

• Transmittals and MLN Matters articles: CMS instructs on cardiac rehab, issues quarterly updates, and more

• Other Issuances: FY 2011 ICD-9-CM addenda available, CMS posts corridor width memo

• CMS Public Events: No events this week

• MedicareFind spotlight: Physician supervision Q&A

Issue 21, May 25, 2010

• CMS Public Events: Hospital Open Door Forum Thursday, RAC 101 call transcript available

• Other Issuances: OIG reviews outpatient payments, CMS posts ICD-10 FAQs

• Transmittals and MLN Matters articles: CMS issues guidance on "clinical review judgment" to RACs and other auditors

• Regulations: CMS issues PPACA rulemaking, proposes CoP changes

Issue 20, May 18, 2010

• Regulations: No issuances this week

• Transmittals and MLN Matters articles: CMS issues MLN Matters articles on timely filing under PPACA, multiple procedure payment reduction, HIV screening, and more

• Other Issuances: OIG reviews excessive outpatient claims, and more

• CMS Public Events: Special Enrollment Open Door Forum Wednesday

Issue 19, May 11, 2010

• Regulations: CMS issues PPACA enrollment rulemaking, publishes IPPS proposed rule

• Transmittals and MLN Matters articles: CMS issues pulmonary rehab transmittals, implements new timely filing requirements, and more

• Other Issuances: OIG issues reviews of program safeguard contractor overpayments

• CMS Public Events: RAC 101 transcript available, next call scheduled for Wednesday

Issue 18, May 4, 2010

• Transmittals and MLN Matters articles: CMS instructs on discarded drugs/biologicals, addresses self-administered drugs, and more

• Other Issuances: OIG audits outpatient lithotripsy billing, high-dollar claims, and more

• CMS Public Events: RAC 101 calls

• Regulations: CMS publishes IPF PPS update for 2011, OCR asks for information on accounting of disclosures

Issue 17, April 27, 2010

• Regulations: CMS issues 2011 IPPS proposed rule

• Transmittals and MLN Matters articles: CMS seeks RAC appeals reports, modifies site verification, and more

• Other Issuances: No releases this week

• CMS Public Events: Physician Open Door Forum transcript/audio available

• MedicareFind Spotlight: Condition code 44

Issue 16, April 20, 2010

• Regulations: CMS publishes revisions to Medicare coverage Part C and Part D in Federal Register

• Transmittals and MLN Matters articles: CMS revises several previous transmittals and issues MLN Matters article on Medicare coverage of blood glucose monitors and testing supplies

• Other Issuances: President Obama's Continuing Extension Act, OIG reports on medical errors, and FAQs

• CMS Public Events: No events this week

Issue 15, April 13, 2010

• Regulations: CMS posts 2011 payment policies for Medicare Advantage, prescription drugs

• Transmittals and MLN Matters articles: CMS instructs on patients in custody, issues MLN Matters article on recoupment, and more

• Other Issuances: Region D RAC updates audit issue description

• CMS Public Events: Physician Open Door Forum, RAC educational calls, and more

Issue 14, April 6, 2010

• Regulations: No issuances this week

• CMS Public Events: No events this week

• Transmittals and MLN Matters articles: CMS instructs on reasonable cost payment, updates medical conditions list, and more

• Other Issuances: CMS updates lab NCDs, OIG audits overpayments, and more

Issue 13, March 30, 2010

• Regulations: No issuances this week

• Transmittals and MLN Matters articles: CMS instructs on cardiac defibrillator services, affirms PET coverage policy, and more

• Other Issuances: RACs update audit issues, OIG audits lab billing, and more

• CMS Public Events: Rural Health Open Door Forum transcript/audio available

Issue 12, March 23, 2010

• Regulations: No issuances this week

• Transmittals and MLN Matters articles: CMS revises signature requirements, issues lab coding guidance, and more

• Other Issuances: CMS delays CAH supervision enforcement, RAC updates audit issues, and more

• CMS Public Events: ICD-10 provider call March 23

Issue 11, March 16, 2010

• CMS Public Events: Hospital Open Door Forum transcript/recording available

• Regulations: HHS publishes EHR certification proposal in Federal Register

• Transmittals and MLN Matters articles: CMS to implement expanded ICD-9 processing, revise PTA and cardiac rehab coverage, and more

• Other Issuances: CMS issues lab memo

Issue 10, March 9, 2010

• Regulations: HHS issues EHR certification program proposal

• Transmittals and MLN Matters articles: CMS updates OPPS, implements HIV screening NCD, and more

• Other Issuances: CMS updates FAQs

• CMS Public Events: Rural Health Open Door Forum March 9

Issue 9, March 2, 2010

• Regulations: No issuances this week

• Transmittals and MLN Matters articles: CMS web site error, MLN Matters article

• Other Issuances: RACs update issues, OIG examines RAC fraud referrals, CMS posts OIVIT NCD

• CMS Public Events: Open Door Forum March 4

Issue 8, February 23, 2010

• CMS Public Events: No events this week

• Regulations: No issuances this week

• Other Issuances: OIG reviews oxaliplatin, issues FMAP report

• Transmittals and MLN Matters articles: CMS adds payment locality, issues MLN Matters articles

Issue 7, February 16, 2010

• Transmittals and MLN Matters articles: No issuances this week

• Other Issuances: Region D RAC updates issues

• CMS Public Events: No events this week

Issue 6, February 9, 2010

• Regulations: No issuances this week

• Transmittals and MLN Matters articles: CMS implements OIVIT NCD, deletes point of origin codes, and more

• Other Issuances: OIG reviews oxaliplatin billing

Issue 5, February 2, 2010

• Regulations: No issuances this week

• Transmittals and MLN Matters articles: CMS instructs on clinical trials, incorporates "compendia" definition into manual system, and more

• Other Issuances: RAC updates issues, CMS releases FAQs on observation, condition code 44, and more

• CMS Public Events: No events this week

Issue 4, January 26, 2010

• Regulations: No issuances this week

• Transmittals and MLN Matters articles: No issuances this week

• Other Issuances: Audit issues updated for RAC regions B and C, OIG reviews oxaliplatin

• CMS Public Events: Hospital Open Door Forum transcript/recording available

Issue 3, January 19, 2010

• Regulations: CMS, ONC publish EHR rulemaking

• Other Issuances: Region B RAC updates audit issues, CMS releases FAQs

• CMS Public Events: No events this week

• Transmittals and MLN Matters articles: CMS addresses OIG reports, revises previous transmittals, and more

Issue 2, January 12, 2010

• Regulations: No issuances this week

• Transmittals and MLN Matters articles: CMS corrects NCCI edit files, analyzes inclusion of additional ICD-9 codes on claims, and more

• Other Issuances: RACs update audit issues, CMS posts NCDs, and more

• CMS Public Events: Hospital Open Door Forum

• MedicareFind update: NCCI edits updated

Issue 1, January 5, 2010

• Regulations: CMS issues OPPS correction, publishes EHR proposed rule, and more

• Transmittals and MLN Matters articles: CMS issues MLN Matters articles

• Other Issuances: CMS issues lab NCD manual, Region C RAC updates audit issues

• CMS Public Events: No events this week