Settlement Reached: Medicare’s “Improvement Standard”

Attorneys from the Center for Medicare Advocacy, Vermont Legal Aid and the Centers for Medicare & Medicaid Services (CMS) have agreed to settle the “Improvement Standard” case, Jimmo v. Sebelius. A proposed settlement agreement was filed in federal District Court

READY, SET, SUBMIT!

Phase 2 providers are approaching their debut for submitting their pre-approval requests for part B therapy residents who have met or will meet the $3700 threshold for OT and $3700 threshold for PT/ST.  You may have already submitted your pre-approval

Cardiac Recovery

Currently, more than two million Americans have heart failure and about 700 thousand new cases are diagnosed each year. The five year survival rate is approximately 50%, but varies depending on the cause of heart failure and the ability of

Part B Therapy: More Stormy Weather Ahead!

The final mandated report on “Improving Medicare’s Payment System for Outpatient Therapy Services” is due on June 15, 2013.  However, Congress has asked MedPAC to forward the recommendations in early- November so they are relevant to the discussion that will

What’s In Store for Quarter Four?

The manual medical review of therapy claims is well on its way for phase 1 providers.  I am going to take a break from the Manual Medical Review this week and talk about our focus for the fourth quarter—coding and

CHANGE, BUT DON’T FORGET !

There has been a tremendous amount of information lately discussing the changes that are taking place in the world of healthcare. The biggest leader of change has been the government by way of CMS. Cost is what is driving the

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