On February 2, 2011, the Centers for Medicare and Medicaid Services (CMS) published a final rule implementing a number of program integrity provisions of the Patient Protection and Affordable Care Act (PPACA) (the Final Rule). The provisions are aimed at reducing fraud, waste and abuse in Medicare, Medicaid, and …
CMS Delays Some Section 111 Reporting Requirements
January 28, 2011 Leave a Comment
The Centers for Medicare and Medicaid Services (CMS) recently announced that it would extend some of the reporting obligations required by Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007. Section 111 amended the notice and reporting requirements under the Medicare Secondary Payer Statute …
President Obama Signs Temporary Legislative Fix for SGR Cuts
December 17, 2010 Leave a Comment
On December 15, 2010, President Obama signed the Medicare and Medicaid Extenders Act of 2010. This act delays for one year a 25% reduction in Medicare payments to physicians pursuant to the Sustainable Growth Rate (SGR). The impact of the act is to freeze reimbursement rates at the current levels until the end of …
Colorado Verbal Order Authentication Requirements
November 4, 2010 Leave a Comment
The Colorado Legislature gave the gift of more time to hospitals this year when it passed a law that extends the time period for hospitals to authenticate verbal orders. As a general rule, the Medicare conditions of participation for hospitals require authentication of verbal orders within 48 hours, unless State …
Colorado Opts Out of CRNA Physician Supervision Requirement, but Not Without a Challenge
October 8, 2010 Leave a Comment
Last week, Governor Bill Ritter announced that Colorado will become the 16th state to opt-out of a federal Medicare rule that requires physician supervision of certified registered nurse anesthetists (CRNAs) in hospitals. States have the authority to opt-out of the supervision requirement by notifying CMS in …
Signature Requirements for Orders May Result in Denied Payment
September 21, 2010 Leave a Comment
CMS’ Change Request 6698 for the Medicare Program Integrity Manual clarifies how Medicare claim contractors review authentication of certain orders and supporting medical documentation. This transmittal applies to claim reviews performed by Medicare Administrative Contractors (MACs), Comprehensive Error Rate …