Tag Archive

Medicare Strike Force: More DOJ Therapy Fraud Indictments in Detroit

Published on June 28, 2010 By Nancy

The US Department of Justice announced this month the indictment of yet another sham therapy operator in Detroit.  According to the DOJ Press Release Evidence at trial established that Bernice Brown was the owner and president of Wayne County Therapeutic Inc. (WCT) in Livonia, Mich. Daniel Smorynski was the vice president of WCT. WCT purported [...]

MedPAC June Report Issued: “Aligning Incentives in Medicare”

Published on June 28, 2010 By Nancy

The Medicare Payment Advisory Commission (MedPAC) relased their June report to Congress last week.  Of note to the rehab and therapy community is Chapter Eight:  “Addressing the Growth of Ancillary Services in Physician Offices.” The chapter on ancillary services addresses outpatient therapy including physical, occupational and speech therapies.  Of note is the discussion regarding the growth [...]

Final Rule Released – Includes Temporary Certification Programs for EHR

Published on June 18, 2010 By Nancy

The HHS Office of the National Coordinator for Health Technology released the final rule today that includes provisions for temporary certification of programs for EHR.  (This will eventually be replaced by a permanent certification program).  The entire press release can be found at the HHS website.  “By purchasing certified EHR technology, hospitals and eligible professionals [...]

OIG Testimony Before the House Sub-Committees on Health & Oversight

Published on June 15, 2010 By Nancy

Lewis Morris, the Chief Counsel to the Office of the Inspector General (OIG) of HHS provided testimony this morning before the subcommittes on Health & Oversight of the U.S. House Ways and Means Committee.  The text of Mr. Morris’s message provides insight into successful fraud and abuse intitatives by the OIG as well as the success [...]

Comprehensive Outpatient Rehabilitation Facilities (CORFs)

Published on May 20, 2010 By Nancy

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 [...]

Rehab Values Codes for OP Rehab Part A Providers Eliminated

Published on May 5, 2010 By Nancy

CMS has issued CR6899  indicating that effective 10-1-2010 outpatient rehab providers will no longer have to report value codes for the number of visits (Code 50 for PT, Code 51 for OT, Code 52 for SLP and Code 53 for Cardiac).  This change affects Part A outpatient therapy providers (billing on CMS 1450/UB04) including CORFs, [...]