Medicare Compliance & Reimbursement

Plus: House of Representatives aims to streamline health information technology system. The days of fighting for SurgiMend payment for your ASC could be coming to a close. Starting July 1, you'll be able to report four drugs and biologicals codes that Medicare will deem "separately payable" in ASCs, according to MLN Matters article MM6095. The four new codes are as follows: • C9242 -- Injection, fosaprepitant • C9356 -- TendoGlide tendon prot, cm2 • C9357 -- Flowable wound matrix, 1 cc • C9358 -- SurgiMend, per 0.5 cm2. More good news: Also on the plus side, "no HCPCS codes are being deleted from the ASC DRUG file for July 2008," so you won't lose any payable drug codes this time around. CMS also offers several updated payment rates for ASC drugs in the new article. Read the MLN Matters document at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6095.pdf. In Other News ... • The government wants you to adopt health information technology in your practice. On June 25, the House Energy and Commerce Health Subcommittee approved the "Protecting Records, Optimizing Treatment, and Easing Communications Through Health Technology Act of 2008," which would, among other things, encourage medical practices to adopt records technology and offer grants for practices that institute information technology systems. The aim of the bill is to streamline medical records access and to protect patients' privacy. "Your grocery store automatically knows what brand of chips you bought last year, but your cardiologist doesn't automatically know what prescriptions your family doctor prescribed for you yesterday," said Rep. John D. Dingell (D-MI), chair of the Committee on Energy and Commerce, in a June 25 statement. Although the House voted favorably, the legislation is still in draft format, with a floor vote tentatively scheduled to occur this summer. • Home care and durable medical equipment suppliers are in the HHS Office of Inspector General's spotlight once again. A Washington, DC-based DME supplier agreed to pay $1.5 million to settle False Claims Act charges, says the OIG's report on state Medicaid Fraud Control Units for 2007. The supplier billed for items not ordered by a physician, not medically necessary and not delivered to residents in group homes as claimed.