LEGISLATIVE UPDATE The Year Ahead 1. Legislative & Budget Landscape in a New Congress In the 114th Congress staring in January 2015, Republicans will control both the House of Representatives and the Senate. What will this … [Read more...] about December 2014 – The Year Ahead & Other Issues
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October 2014 – The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) & Other Isues
1. LEGISLATIVE UPDATE: THE IMPACT ACT OF 2014 On October 6, 2014, President Obama signed into law the “Improving Medicare Post-Acute Care Transformation Act of 2014” or IMPACT Act. The bill resulted from a bipartisan, … [Read more...] about October 2014 – The Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act) & Other Isues
August 2014 – Restructuring of Medicare’s Quality Improvement Organizations (QIO) & Other Issues
1. CHANGES TO MEDICARE’S QUALITY IMPROVEMENT ORGANIZATIONS (QIOs) CMS has restructured its Quality Improvement Organization (QIO) Program to separate the beneficiary complaint review functions from the quality improvement … [Read more...] about August 2014 – Restructuring of Medicare’s Quality Improvement Organizations (QIO) & Other Issues
Delivery and Set-Up Guidelines for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
The Centers for Medicare & Medicaid Services (CMS) is charged with the implementation and oversight of the DMEPOS program.[1] Since the rollout of the DMEPOS competitive bidding program (CBP) in July, 2008, there has been confusion over … [Read more...] about Delivery and Set-Up Guidelines for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
Durable Medical Equipment (DME)
When Should Coverage be Available for Durable Medical Equipment? A Quick Guide to Identify Coverable Items Durable Medical Equipment (DME) may be covered by Medicare if the DME meets the following criteria: 1. Prescribed as medically … [Read more...] about Durable Medical Equipment (DME)
June 2014 – Losing Your Voice: Medicare Coverage of Speech Generating Devices During Part A Stays & Other Issues
1. MEDICARE’S COVERAGE OF CAPPED RENTAL ITEMS DURING PART A INSTITUTIONAL STAYS: LOSING ACCESS TO SPEECH GENERATING DEVICES (SGDs) CMS Changes Its Coverage of Speech Generating Devices Through a new interpretation of longstanding … [Read more...] about June 2014 – Losing Your Voice: Medicare Coverage of Speech Generating Devices During Part A Stays & Other Issues
CMA Community News – May 2014
A Word from the Executive Director As you will see in this issue, Center staffers have been busy this month testifying before Congress and meeting with lawmakers and policy leaders to educate them about issues affecting access to health care for … [Read more...] about CMA Community News – May 2014
April, 2014 – Ongoing Medicare Appeal Concerns & Other Issues
1. LITIGATION UPDATES Jimmo v. Sebelius (Improvement Standard) No. 11-cv-17 (D.Vt. filed 1/18/11). As reported during previous Alliance calls, the Settlement in Jimmo was approved on January 24, 2013 during a scheduled fairness … [Read more...] about April, 2014 – Ongoing Medicare Appeal Concerns & Other Issues
Self-Help Packet for Outpatient Therapy Denials Including “Improvement Standard” Denials
Introduction Checklist for Outpatient Therapy Discharges Checklist for Outpatient Therapy Appeals Quick Screen: Medicare Coverage for Outpatient Therapy Outpatient Therapy Appeal Details Additional Information 1. Introduction Dear … [Read more...] about Self-Help Packet for Outpatient Therapy Denials Including “Improvement Standard” Denials
CMA Community News – January 2014
Editor's Note: We received some feedback that our text was a bit small, so we are bumping it up for this edition. Please let us know what you think. A Message from the Executive Director News You Can Use Legislative Watch CMA In the … [Read more...] about CMA Community News – January 2014