Medicare Compliance & Reimbursement

BILL WATCH

Bills introduced in the House: H.R. 2664. A bill to provide for Medicare reimbursement for health care services provided to Medicare-eligible veterans in facilities of the Department of Veterans Affairs. Introduced July 8 by Rep. Sue Kelly (R-NY), referred to the Committee on Ways and Means and the Committee on Energy and Commerce. H.R. 2700. A bill to amend title XVIII of the Social Security Act to revise the methodology by which payments for orphan drugs and biologicals is made under program prospective payment system for hospital outpatient department services under the Medicare program. Introduced July 10 by Rep. Christopher Cox (R-CA), referred to the Committee on Energy and Commerce and the Committee on Ways and Means.   REGISTER WATCH Due to numerous errors in the chart published June 6, the Centers for Medicare & Medicaid Services July 15 reprinted the wage index charts for the prospective payment system for long-term acute care hospitals.   PROGRAM MEMO ROUNDUP Hospitals should get ready for new policies on outlier payments. In a July 3 program memorandum (A-03-058; http://cms.hhs.gov/manuals/pm_trans/A03058. pdf), the Centers for Medicare & Medicaid Services gave fiscal intermediaries marching orders on implementing the agency's June 9 rule updating outlier policies. The rule was issued in response to perceived abuses of the system. The memo addresses the use of more recent data to determine cost-to-charge ratios, appropriate use of statewide averages, reconciliation procedures and other topics. In other recent program memoranda, CMS: corrects recently implemented policies on a quartet of new patient status codes (A-03-059; http://cms.hhs.gov/manuals/pm_trans/A03059.pdf);
addresses issues relating to the 2004 hospice update (A-03-057; http://cms.hhs.gov/manuals/pm_trans/A03057.pdf);
revises earlier instructions relating to multiple primary payers on Part B claims (B-03-050; http://cms.hhs.gov/manuals/pm_trans/B03050.pdf);
corrects coverage and billing requirements for electrical stimulation for the treatment of wounds (AB-03-93; http://cms.hhs.gov/manuals/pm_trans/AB03093.pdf);
outlines disclosure-of-information requirements relating to hospice claims (A-03-055; http://cms.hhs.gov/manuals/pm_trans/A03055.pdf);
updates remittance advice remark and reason codes (AB-03-095; http://cms.hhs.gov/manuals/pm_trans/AB03095.pdf);
lays out 2004 changes to the long-term care hospital prospective payment system (A-03-056; http://cms.hhs.gov/manuals/pm_trans/A03056.pdf);
issues the October quarterly update for skilled nursing facility consolidated billing (AB-03-094; http://cms.hhs.gov/manuals/pm_trans/AB03094.pdf); and
updates HCPCS codes used for home health consolidated billing enforcement (AB-03-096; http://cms.hhs.gov/manuals/pm_trans/AB03096.pdf).