Medicare Compliance & Reimbursement

But don't expect proposed changes to clear up your confusion. Figuring out which services Medicare will pay for is a toughie -- but don't think you'll be able to look to the Centers for Medicare & Medicaid Services for guidance. In the HH PPS Update 2010 proposed rule published in the Aug. 13 Federal Register, CMS included clarifications about coverage for evaluation and management services, something that agencies desperately need to determine whether Medicare will pay for skilled nursing and home health aide services as the primary payer, says Washington, D.C.-based attorney Elizabeth Hogue. CMS's clarifications don't come out of the blue. MedPAC, the Office of Inspector General, and Medicaid state agencies have all suggested that CMS remove any doubt about how or when Medicare will cover skilled services. After working with agencies to identify what was causing the confusion, CMS proposed these changes: • A new paragraph in Section 409.42(c)(1), [...]