A proposed rule, titled Proposed Fiscal Year 2020 Payment and Policy Changes for Medicare Skilled Nursing Facilities (CMS-1718-P), was published in the Federal Register on April 25. Here are ten things you need to know.
Effective April 1, Medicare Advantage and Part D plans will reject or deny claims that are submitted for items prescribed or furnished by an individual or entity on the Preclusion List. The Preclusion List consists of individuals and entities that fall within either of the following categories.
Three changes happened recently for therapists that billers should know about: Medicare’s outpatient therapy cap was repealed and the therapy threshold was lowered; new modifiers for therapy assistants were added; and the requirement for functional limitations reporting was removed.
Download the first issue of AMBR Journal! In this issue we discuss how to focus on new incentives under PDPM without scrapping therapy; how to get your compliance and ethics program into shape before November 1; ICD-10 training for your staff; a breakdown of consolidated billing, category I; and what billers can do to properly handle long-term care insurance policies.
In a press release dated April 1, 2019, CMS announced finalized updates to items that Medicare Advantage (MA) plans will cover for 2020, a change that the agency says will “[give] chronically ill patients with Medicare Advantage the possibility of accessing a broader range of supplemental benefits that are not necessarily health-related but have a reasonable expectation of improving or maintaining the health or overall function of the enrollees.”
The Department of Labor has published three Notices of Proposed Rulemaking (NPRM) regarding the minimum salary requirement for an employee to qualify for overtime, which forms of payment can be included and excluded in the “time and one-half” calculation when determining workers’ overtime rates, and clarifications of and revisions to the responsibilities of employers and joint employers to employees in joint employer arrangements.
Review these Consolidated Billing Case Studies that illustrate common circumstances that can affect a SNF’s billing practices for beneficiaries who receive services from outside entities during a Part A stay.