1.800.456.4350 info@prgweb.com

Archive for February, 2009

Competitive Bidding Program Rule Delayed

Tuesday, February 24th, 2009

The Centers for Medicare & Medicaid Services (CMS) has delayed implementation of its interim final rule for the Medicare competitive bidding program for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) until April 19th.  The rule implements certain provisions of the 2008 Medicare Improvements for Patients and Providers Act (MIPPA). Under the act, hospitals will be allowed to continue providing the following items to their patients without participating in the bidding program: crutches, canes, walkers, folding manual wheelchairs, blood glucose monitors and infusion pumps. CMS is accepting comments on the rule through March 17th.

The interim final rule is available at http://edocket.access.gpo.gov/2009/pdf/E9-863.pdf


President Signs Economic Recovery Package

Tuesday, February 24th, 2009

On February 17, President Obama signed into law the American Recovery and Reinvestment Act, also known as the economic stimulus bill. The legislation, approved by Congress on February 13, temporarily increases federal funding for Medicaid by nearly $87 billion and requires states to maintain current program eligibility. It also increases state disproportionate share hospital allotments by 2.5%. In addition, the Act provides subsidies to help the recently unemployed maintain COBRA coverage for up to nine months and provides $19 billion through Medicare and Medicaid to help physicians and hospitals adopt health information technology.

For further details, visit http://www.thomas.gov/

RAC Contract Protests Resolved

Tuesday, February 24th, 2009

According to the Centers of Medicare & Medicaid Services (CMS), PRG-Schultz USA Inc. and Viant Payment Systems,Inc, who lost their bids to become Medicare recovery audit contractors (RACs), will serve as subcontractors for the permanent RAC program as part of an agreement to settle contract bid protests.  The roll-out of the permanent program had been on hold as a result of the protests. Details on CMS’ plans to resume the program are pending and will be shared when available.

The announcement can be found by going to http://www.cms.hhs.gov/RAC/01_Overview.asp

CMS Responds to Request to Delete NCCI Edits for CPT Code 93296

Tuesday, February 24th, 2009

An error was discovered with two of the finalized National Correct Coding Initiative (NCCI) edits published for the new device monitoring services that became effective January 1, 2009 (Version 15.0). Version 15.0 edits prohibit billing the technical component (CPT code 93296) with the professional component for a 90-day remote interrogation evaluation of a single, dual or multiple lead pacemaker (CPT code 93294) or ICD system (CPT code 93295) on the same date of service. The Centers of Medicare & Medicaid Services (CMS), alerted to an error by the Heart Rhythm Society (HRS) and the American College of Cardiology (ACC), will delete these two code pair edits in the next quarterly update of the NCCI (Version 15.1). The deletion will be retroactive to the January 1st implementation date.

More information is available at http://www.hrsonline.org

President Signs SCHIP Bill

Tuesday, February 24th, 2009

President Obama signed into law the 2009 Children’s Health Insurance Program Reauthorization Act (H.R. 2), which passed the House by a vote of 290-135. Funded through a 62-cent increase in the federal tax on cigarettes, the act reauthorizes the State Children’s Health Insurance Program (SCHIP) through September 2013 to cover 7 million children currently enrolled and an additional 4 million eligible children. It also removes the five-year waiting period to optionally cover legal immigrant children and pregnant women.