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RACs

RAC Restart Facts…(Not Rumors)..So Far

RAC Restart Facts…(Not Rumors)..So Far

The therapy community is abuzz with all the rumors and misinformation on the RAC restart facts. So far there are a few things that we do know.  We know that CMS wrote letters to members of Congress on Friday August 1st announcing their intention to have a limited restart to the “paused” RAC program. We also know […]

August 12, 2014 2 Comments
CMS to Restart Some RAC Reviews

CMS to Restart Some RAC Reviews

CMS announced today that it is initiating contract modification with the current Recovery Auditors in Regions A, B, C and D to restart reviews of a limited number of issues.  While CMS had previously announced that new Recovery Auditor (RAC) contracts would be announced for Regions 1-5 no later than August 15th their announcement today […]

August 4, 2014 1 Comment
Medicare Audits

Medicare Audits

Have you had a Medicare audit?  Medicare has a number of program integrity contractors that can pry into your records, while you are sleeping, as well as during the day for an onsite “surprise ” visit.   Most likely if you have had a Medicare audit, it was most likely a medical review of a claim […]

July 10, 2014 0 Comments
RAC Updates

RAC Updates

RAC ‘n Rehab Series©~  Since the RAC “pause” in activities at the end of February have you been enjoying your summer, sitting at the beach and perhaps wondering about RAC updates?  CMS had previously announced that the RAC contracts would be awarded beginning in May.  The Region 5 contract for Home Health, Hospice and DME was […]

July 7, 2014 0 Comments

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Compliance

2015 Therapy Cap Values

2015 Therapy Cap Values

CMS has announced the 2015 Therapy Cap values for 2015 for physical therapy and speech-language pathology combined and occupational therapy.    The therapy caps were initiated under the Balanced Budget Act of 1997 (P.L. 105-33, Section 4541(c)) to implement a per beneficiary annual cap (financial limitation) on the amount of therapy services under Medicare Part B.  The original […]

November 26, 2014 0 Comments
Keep Using 59 Modifier

Keep Using 59 Modifier

 CMS issued MM 8863 on Modifiers for Distinct Procedural Services in August leaving the therapy community wondering how to best use the new subset of the 59 modifier.  The subset, referred to as  X{EPSU}, was established to further define those “distinct  procedural services” identified as: XE – Separate Encounter XS – Separate Structure XP – Separate Practitioner XU […]

November 25, 2014 1 Comment
Risky Business: Outsourcing SNF Therapy

Risky Business: Outsourcing SNF Therapy

Risky business in outsourcing SNF therapy you say?  A few weeks ago a news article was delivered to my inbox that might as well have been accompanied by alarm bells. Before you read the headline and consider yourself exempt, the startling aspect of the case is that it involves a SNF being held liable for […]

October 26, 2014 1 Comment
Top 3 Essential Compliance Components

Top 3 Essential Compliance Components

Do you have the top 3 essential compliance components in your therapy program or practice?   You may have a compliance plan that you wrote, or purchased a compliance program off the shelf, or maybe your compliance program consists of chart audits and quality reviews.  The Office of the Inspector General (OIG) has provided Compliance Guidances […]

July 31, 2014 1 Comment