In a recent RACMonitor.com article on The Curious Case of the CORF the CORF was described as an “orphan” program that had conflicting regulatory advice for providers in recent years. The Conditions of Participation, the State Operations Manual Interpretive Guidelines, and various instructions from the Medicare Contractors (fiscal intermediaries and MACs) put the provider at [...]
CMS has recently announced a new round of RAC informational sessions for providers. The video features the slide show used in the original fall RAC informational sessions along with commentary by Commander Marie Casey. This video production is one of many that have been posted by CMS/HHS on YouTube. This video is being released as [...]
Florida therapy providers are beginning to report the receipt of official “demand letters” from Connolly Healthcare, the Region C Recovery Audit Contractor. A Florida therapy provider, who asked not to be identified, has reported receiving several demand letters related to the billing of speech therapy untimed codes in units greater than one. This provider has multiple [...]
CGI, the Region B Recovery Audit Contractor has added several new CMS approved issues. The issue of untimed codes for therapy is now approved for Illinois, Indiana, Kentuckhy, Michigan, Minnesota, Ohio and Wisconsin. The issue was approved on 9/30/2009 and covers services from 10/1/2007 forward. According to CGI: Untimed Codes – CPT codes (excluding modifiers KX, [...]
CMS Issued New “Final” Recouping Regulation, at 42 CFR 405.370, 405.378, 405.379. The effect of this rule is to shorten providers decision making time in making appeals on overpayment demands. Recouping involves a Medicare Contractor holding back reimbursement to offset monies that a provider is deemed to owe to the Medicare Program. According to CMS [...]
With the Region A RAC adding three issues over this past weekend, including a new issue of Pharmacy Supply and Dispensing Fees, all four of the Recovery Audit Contractors are now on board with automated review underway. During the RAC roll-out process, often referred to as ‘town hall meetings” CMS as well as the four [...]