CMS Updates
| Added | Download | |
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OMB Projects 11 Billion Reduction in Medicare Spending
If Congress does not enact deficit reductions, the law provides for automatic defecit reduction. This automatic defecit reduction includes an 11 Billion dollar decrease in Medicare Spending. The attached document from OMB has all of the details. Look at Table 3 on Page 9. |
09/14/12 |
 defecit-reduction.pdf |
| New standards for electronic funds transfers in health care | 01/08/12 |
eft_standards_release.pdf |
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Final Rule : Medicaid Program Recovery Audit Contractors
Final Rule : Medicaid Program; Recovery Audit Contractors |
09/17/11 |
2011-23695_pi.pdf |
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OIG Report on POS overpayments in 2009
OIG Report on POS overpayments in 2009 |
09/17/11 |
11000516.pdf |
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OIG Report on POS overpayments in 2008
OIG Report on POS overpayments in 2008 |
09/17/11 |
11000513.pdf |
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Affordable Care Act - Section 3113 - Laboratory Demonstration for Certain Complex Diagnostic Tests (This CR fully Rescinds and Replaces CR 7413)
This Change Request (CR) fully rescinds and replaces CR7413, Transmittal 2226, issued May 20, 2011, and revises the language in the background and policy section to clarify that Critical Access Hospitals are also included in this demonstration. |
09/12/11 |
r2261cp.pdf |
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Addition of Medical Severity Diagnosis Related Group (MS-DRG) 265 to the list subject to Inpatient Prospective Payment System (IPPS) Replaced Devices Offered Without Cost or With a Credit Policy
This CR adds MS-DRG 265 to the list of DRGs subject to the final policy for the IPPS reimbursement of replaced devices offered without cost or with a credit |
09/12/11 |
r922otn.pdf |
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Anesthesiologist Services in a Method II Critical Access Hospital (CAH)
This instruction clarifies the payment calculation for anesthesia services performed by an Anesthesiologist. |
09/12/11 |
r2268cp.pdf |
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Clarification of Payment for ESRD-Related Services Under the Monthly Capitation Payment
In CY 2011 Physician Fee Schedule (PFS) final rule with comment period (75 FR 73295-73296), CMS required monthly capitation payment (MCP) physicians or practitioners furnish at least one face-to-face patient visit per month for the home dialysis MCP service as described by CPT codes 90963, 90964, 90965, and 90966. Documentation by the MCP physician or practitioner should support at least one face-to-face encounter per month with the home dialysis patient. For required MCP visits for center based patients and home dialysis patients, the MCP physician or practitioner may use other Medicare certified physicians or practitioners to provide some of the visits during the month. Visits must be furnished face-to-face by a physician, clinical nurse specialist, nurse practitioner, or physician’s assistant. The MCP physician or practitioner does not have to be present when these other physicians or practitioners provide visits. The non-MCP physician or practitioner must be a partner, an employee of the same group practice, or an employee of the MCP physician or practitioner. |
09/12/11 |
r2269cp.pdf |
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Common Working File (CWF) Editing Update for Pulmonary Rehabilitation Services (PR) and Cardiac and Intensive Cardiac Rehabilitation Services
This change request (CR) updates CWF editing to allow institutional and professional providers to bill 36 sessions of cardiac rehabilitation services, without the KX modifier, over a period of 36 weeks. In addition, this CR allows institutional and professional providers to bill 72 sessions of intensive cardiac rehabilitation, without the KX modifier over a period of 18 weeks. This CR updates CWF editing to allow institutional and professional providers to bill 36 sessions of pulmonary rehabilitation services, without the KX modifier, over a period of 36 weeks. |
09/12/11 |
r941otn.pdf |