The latest Supreme Court term has been one of incredibly consequential decisions. Rulings regarding gun rights, immunity, and abortion access grabbed headlines for months. Yet, the most important ruling for the healthcare space writ large is the case of Loper Bright v. Raimondo, which involved regulations in the commercial fishing industry. What does a ruling about fishery regulation have to do with the Centers for Medicare and Medicaid Services (CMS)? In this situation, nearly everything.
July 22, 2024
Why Do Medicare Administrative Contractors Deny for “Skills of Therapist Not Supported”?
Maybe you have been involved in a Training, Probe and Educate (TPE) audit for your Medicare Part B claims this year. If so, you are not alone. The Medicare Administrative Contractors (MACs) have been focusing on Physical Therapy (PT), Occupational Therapy (OT) and Speech Language Pathology (SLP) documentation and the TPE is a common way to capture the attention of providers. The Centers for Medicare & Medicaid Services (CMS) TPE provides a full explanation of
The Review Choice Demonstration (RCD) project for Inpatient Rehabilitation Facilities (IRF) seemed like a pipe dream when the Centers for Medicare & Medicaid Services (CMS) started talking about it even before the Pandemic. But, now it is in full swing in Alabama and Pennsylvania. Texas and California are slated to be next in the roll out. If you are listed and bill as an Inpatient Rehabilitation Facility (IRF) or an Inpatient Rehabilitation Unit (IRU) in Pennsylvania,
