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 …
CMS Issues Stricter DMEPOS Supplier Qualifications
September 2, 2010 Leave a Comment
On Friday, August 27, 2010, the Centers for Medicare & Medicaid Services (CMS) issued new regulations (75 Fed. Reg. 52629) that make qualifying for and retaining Medicare billing privileges more stringent for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers. The new …
Time Period to Submit Medicare Claims Is Shortened to Twelve Months
August 26, 2010 Leave a Comment
The proposed Medicare Physician Fee Schedule for 2011 (PFS) includes a proposal that Medicare fee-for- services claims for services furnished on or after January 1, 2010, must be filed within one calendar year after the date of services. This proposal by CMS is aimed at implementing Section 6404 of the Affordable …
Proposed CMS Rule Would Require Group Practices to Notify Medicare Beneficiaries of Alternative Advanced Imaging Suppliers
August 23, 2010 Leave a Comment
Section 6003 of the Patient Protection and Affordable Care Act (PPACA) amended the Stark Law in-office ancillary service exception as applied to physician practices furnishing MRI, CT, PET, and potentially other diagnostic imaging services. The Stark Law prohibits a physician from making a referral for certain …