Mandatory Payment Reductions in FFS

In a CMS Medicare FFS Provider e-News bulletin released 3-8-13, the Medicare Learning Network issued the following information about the effect of sequestration on Medicare Fee-For-Service Programs: Mandatory Payment Reductions in the Medicare Fee-for-Service (FFS) Program – “Sequestration” The Budget

Outpatient Therapy Claims Crossover Problem

In the Thursday March 7, 2013 CMS FFS Provider e-News reports problems impacting crossover of Medicare Part B Outpatient Therapy Claims.  CMS reports that providers who bill Medicare for outpatient therapy may have recently noticed an increase in the frequency of Health Insurance

Dementia Care Strategies

Caring for residents with dementia in a long term care setting requires an ongoing awareness of both their needs and identification of strategies that will facilitate the resident’s participation in their daily care. Caregivers must avoid offering too much assistance


By now everyone has heard of the value of communication and how a lack of it can only create problems for you. You have also heard that what is driving healthcare survival is outcomes. With accountability becoming increasingly more important

News: CMS responds regarding MMR & Therapy

CMS posted updated information about the agency’s Manual Medical Review process. The annual Medicare Part B therapy benefit for each Medicare beneficiary is $1,900 for Occupational Therapy and $1,900 for Physical Therapy/Speech Therapy combined.  There are exceptions to the these therapy caps for reasonable and necessary


Functional Pathways will be hosting Functional Limitation Reporting Webinars for all of our partners beginning this week.  The invitations have been sent out to all Administrators for all nine currently scheduled webinars.  Administrators can foward the invitation to the Business Office Managers

QAPI: Approach To Teamwork

Teamwork is a core component of Quality Assurance and Performance Improvement (QAPI).  Leadership must convey that it is everyone’ job to contribute to the organization’s Performance Improvement initiatives through clear guidelines identified in job descriptions.  Responsibility rests with the leadership

“Triple Check? Why? We Don’t Get Denials!”

Functional Pathways is committed to ensuring that the therapy treatment we provide is skilled in nature as well as reasonable and necessary.  We strongly recommend and encourage our partners to include us in their triple check process.  Why?  Because we


The Frazier Water Protocol (FWP) allows residents with dysphagia free access to water with little to no incidence of aspiration pneumonia. It was developed by Kathy Panther, MS, CCC-SLP, inpatient rehabilitation director at the Frazier Rehab Institute in Louisville, KY

QAPI: Leadership Responsibility

I do not think that anybody would disagree that creating a culture to support QAPI efforts begins with leadership. Support from the top is essential, and that support should foster the active participation of every caregiver.   The administrator and senior